CNA Skills Set: Making an Occupied Bed

In the next section of our CNA Skill Set Test Study Guide, we will be covering the procedures for making an occupied bed.

Out of all the procedures in the Skill Set exam, the Occupied Bed making procedure is the most complex and for many, the most difficult. It is key to concentrate on the patients safety at all times because if the proctor feels as though the patient was at risk, you will automatically fail.

Remember, like all of our procedures, you should always start by entering the room, announcing that you are there and that you will be doing the procedure. Then wash your hands and verify that the room is prepped. In this specific case, you will want to make sure your sheets, and other equipment are ready and standing by. If you don’t see them, ask the proctor, or just get them yourself (if you know where they are).

Supplies Needed:
1. Top Sheet
2. Bottom Sheet
3. Privacy Sheet
4. Bed Sheet

Making an Occupied Bed

1. Check the patients records and verify their current status. Do they have a catheter? Is it secured? IV, straps, etc.
2. So as to mitigate any stress on your back, adjust the bed’s height.
3. Place the privacy sheet over the patient
4. Remove the bedspread first and then the blanket by rolling them down so as to mitigate the spread of soiled waste.
5. Dispose of the sheets appropriately.

1. Ensure that the patient is safe, and lower the rail on the side in which you intend to begin working.
2. Have the patient scout over to the side in which you are. Ensure they are covered. If they cannot move, then safely slide them over to your side of the bed.
3. Then have the patient roll to the other side (where the bed rail is up).
4. At this point, take the mattress linen and fold it over top of itself so as to keep all soiled material inside the linen. Fold the linen in until you reach the patient’s back. Once there, tuck the sheet under their shoulders, mid section and feet.
5. Clean and disinfect the mattress if the sheets were soiled. Ensure it is dry before moving on to the next step.
6. Place the new clean sheets over the exposed portion of the mattress starting with the corners of the bed. Once connected, roll the sheets towards the patient and tuck them under the patient. Make sure that the sheets are smooth and no creases exist.
7. Have the patient roll towards you and inform them that they will feel a bump in the middle of the mattress.
8. Once comfortably into position, raise the bed arm rail and move over the other side of the bed.
9. Now that the other side is exposed, removed the soiled linen keeping the open side up so as to minimize the spread of soiled material.
10. Place the dirty linen into the correct receptacle.
11. Again, clean and sanitize the exposed mattress ensuring that it is dry before you move on to the next step.
12. Begin pulling the clean linen fully across the bed and secure the corners, verifying that the sheets are smooth and there are no creases.
13. Assist the patient in moving into a comfortable position.
14. Place the top sheet overtop of the privacy sheet and tuck under the foot of the bed. Then do the same for the comforter.
15. Once both sheets are secure, take the privacy blanket and place in the hamper.
16. Then take the top edge of the top sheets, and create a cusp.
17. Raise the bed rail
18. Have the patient raise their head and remove the pillow, slowly letting them rest their head on the mattress.
19. Replace the pillow case, placing the old pillow case in the appropriate receptacle.
20. Place the pillow back under the patients head.
21. As per you work place’s policy, dispose of the dirty linen.
22. Before concluding this procedure, check with your patient and verify they are okay and ask if they need anything.
23. Throughout the procedure, you should be looking for any red spots or sores. Take appropriate action if you do spot any conditions.

Key Factors that Could Make You Fail

1. Make sure the sheets don’t touch your uniform or the floor. This will render them as soiled. If you do make the mistake of letting them touch either. Inform the proctor that you just did that, place the patient in a safe position and get new sheets.

2. Do not shake the sheets.

3. Improperly rolling the sheets will cause contamination.

3. Forgetting to raise the bed rail and leaving that section will be a major safety violation.

Video Exercise to Help you Visualize and Practice this Section

Here is a video on oral care that should help to illustrate the above steps in performing dental care.