Changing the sheets of an occupied bed is a critical skill in healthcare that directly impacts a resident’s comfort, hygiene, and overall well-being. In many care settings, residents may be immobile or too weak to get out of bed, making it essential for caregivers to know how to change linens without removing the individual from the bed. Proper technique not only maintains the resident’s dignity and safety but also plays a key role in infection control by reducing the risk of skin irritation, pressure injuries, and the spread of harmful microorganisms. Performing this task with care and efficiency shows respect for the resident’s condition while upholding professional standards of cleanliness and comfort.

You will need the following to Make an Occupied Bed: 

• Barrier
• Pillowcase
• Bottom Sheet
• Privacy Blanket
• Top Sheet
• Dirty Linen Hamper

1. Preparation & Hand Hygiene

• Read and follow the Care Plan, the whole Care Plan, and nothing but the Care Plan.
• Knock and announce yourself before entering.
• Greet the Resident by name and introduce yourself.
• Explain the task to the Resident and ensure their comfort and consent.
• Close the Privacy Curtain
• Wash your hands thoroughly before beginning.
• Place Barrier on Bedside Table. 
• Gather your Supplies.
• Place Supplies on Bedside Table.
  
  • Do Not let Supplies touch your Uniform. 
• Assess Glove Rules (Are Gloves required for this Resident?)

2. Positioning Resident

• Ensure Resident is lying flat in the center of the Bed. 
• Describe movement to Resident
• Ask Resident to notify you of any pain or discomfort throughout. 
• Stay vigilant for un-vocalized signs of pain throughout:
  • Wincing
  • Sharp Breaths
  • Grunts
• Retrieve Privacy Blanket and spread it out to cover Resident.
  • Do Not Snap or Shake the Privacy Blanket.
• Ask Resident to hold the top of the Privacy Blanket and carefully remove the sheet from underneath. 
• Roll Top Sheet into a ball as you remove it, and place in the Soiled Linens.
  • Do not allow sheet corners to “fly around” or touch anything. 

3. Scoot & Roll

• Ask Resident to carefully Scoot towards you, near the edge of the bed. 
• During the Scoot, remain on the edge of the bed to ensure Resident safety. 
• Ask Resident to Roll away from you, onto their side. 
• Ensure they are in the center of the bed after the Roll. 
• Ensure Resident Privacy throughout this process. 

4. Beginning the Linen Change

• Staying on your side of the Resident’s bed, remove the sheet from the corners on the bed. 
• Begin TIGHTLY rolling the soiled sheet in, towards the Resident. 
• Gently tuck the rolled soiled sheet underneath the Resident all along their body. 
• Retrieve the clean sheet, and unfold
  • Do Not Snap or Shake. 
•  Connect clean sheet to the corners of the Resident’s bed. 
•  TIGHTLY roll clean sheet towards you. 
• Ensure sheet is smooth and free of wrinkles. 
• Tuck clean, tightly rolled sheet UNDERNEATH the dirty sheet. 
• Once both edges of the sheets are tucked under the Resident, you are ready to move to the other side.

5. Scoot & Roll

• Ask Resident to Roll back onto their Back. 
• Move to the other side of the bed. 
• Ask Resident to carefully Scoot towards you, near the edge of the bed. 
• During the Scoot, remain on the edge of the bed to ensure Resident safety. 
• Ask Resident to Roll away from you, onto their side. 
• Ensure they are in the center of the bed after the Roll. 
• Ensure Resident Privacy throughout this process. 

6. Completing the Linen Change

• Remove the dirty sheet from the bed at the corners. 
• Roll Sheet into a ball as you remove it, and place in the Soiled Linens.
  • Do not allow sheet corners to “fly around” or touch anything.
• Unroll the Clean sheet and secure the corners on the bed. 
  • Ensure sheet is smooth and free of wrinkles. 
• Retrieve the clean Top Sheet, and unfold.
  • Do Not snap or shake.
• Cover Resident with clean Top Sheet, and gently remove Privacy blanket.
• Roll Sheet into a ball as you remove it, and place in the Soiled Linens.
  • Do not allow sheet corners to “fly around” or touch anything. 

7. Making Hospital Corners

• Move to the foot of the bed, lift the Mattress and smooth the sheet underneath the mattress on both sides.
• Pull the foot of the sheet towards the head of the bed. 
• On the side of the bed, lift the top edge of the Sheet, about 1 foot from the end of the mattress, straight up onto the bed. 
• This forms a Triangle, from the edge of the bed, to the corner of the sheet. 
• Tuck the portion of the sheet hanging from the bed under the mattress. 
• Pull the sheet corner down. 
• Repeat on the other side of the Resident’s Bed.
• Loosen the area over Resident’s Toes for comfort.
• Remove Resident’s pillow from the pillowcase.
• Do Not allow pillowcase to touch your uniform. 
• Retrieve clean pillowcase, and scrunch it up.
  
  • Place pillow in pillowcase tag side in, open end AWAY from the door.  
• Ensure all soiled linens are in soiled linens bin. 
• Dispose of Barrier
• Remove and dispose of your gloves. 

8. Address Resident Comfort 

• Ensure Resident is comfortable.
• Ask about Resident needs and preferences.
• Provide Resident with Call light.
• Open the Privacy curtain
• Ensure bed is in lowest position.
• Thoroughly wash your hands.
• Think about the Steps of your Skill. Make any corrections. Tell the evaluator your Skills is complete.

• Not reading and following the Care Plan, the whole Care Plan, and nothing but the Care Plan.
• Allowing Resident to lie on bare mattress.
• Removing Pillow at the start of skill, and not returning it until the end of the skill. 
• Leaving creases, folds or wrinkles in the bottom sheet. 
• Not greeting Resident or describing Task. 
• Not following Proper privacy practices while changing Resident’s sheet.
• Allowing linens to touch the floor.
• Holding linens against your uniform.
• Touching Resident with dirty hands.
• Not closing Privacy Curtain. 
• Not ensuring Resident safety/positioning while performing Scoot & Roll.
• Not ensuring Resident is positioned in the center of the bed. 
• Shaking or Snapping sheets.
• Not ending Skill with clean hands. 
• Not providing Resident with the Call Light. 
• Not ensuring bed is left in the lowest position.