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Occupied Bed Change

Changing bed linens with the resident in the bed (occupied bed) maintains cleanliness and skin health while minimizing resident discomfort and fall risk.

21 steps·5 evaluator checkpoints·5 common mistakes

1Step-by-Step Procedure

1
Gather equipment: fitted sheet, flat sheet, pillowcase, drawsheet or incontinence pad, gloves.
2
Wash hands.
3
Identify the resident and explain the procedure.
4
Provide privacy.
5
Raise the bed to a comfortable working height; raise the side rail on the far side.
6
Lower the side rail on your side.
7
Loosen all linens from the mattress, starting on your side.
8
Assist the resident to turn away from you onto their side (toward the raised rail).
9
Roll soiled linens toward the resident and tuck them under their body.
10
Place the clean fitted sheet on your half of the mattress; tuck it in at the head and foot.
11
Roll the remaining clean sheet toward the resident against the soiled linens.
12
Raise the side rail on your side; move to the other side and lower the far rail.
13
Assist the resident to roll over the rolled linens to the clean side.
14
Remove soiled linens by rolling them away from you; place in the soiled laundry — do not shake.
15
Pull the clean sheets through and tuck in on this side.
16
Reposition the resident in the center of the bed in a comfortable position.
17
Change the pillowcase.
18
Raise appropriate side rails; lower the bed to the lowest position.
19
Place the call light within reach.
20
Remove gloves; wash hands.
21
Document linen change and any skin observations.

What the Examiner Is Watching For

✓
Soiled linens are rolled inward — never shaken or held against the uniform.
✓
Clean linens are rolled against the soiled linen, not brought into contact with the floor.
✓
Side rails are raised on the far side before the resident rolls.
✓
Resident is repositioned comfortably in the center of the bed.
✓
Bed is lowered and call light is accessible before leaving.

Common Mistakes That Cause Failure

⚠
Shaking soiled linens — this spreads microorganisms into the air.
⚠
Allowing clean linens to touch the floor.
⚠
Not raising the side rail before rolling the resident over it.
⚠
Leaving lumps or wrinkles under the resident — skin breakdown risk.
⚠
Forgetting to change the pillowcase.

Tips for Exam Day

→
Roll soiled linens tightly inward — contaminated side always faces in.
→
Never shake any linen; roll everything.
→
Side rail on the far side up before turning the resident — always.
→
Finish by smoothing all sheets flat; wrinkles cause pressure injuries.

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