Changing the sheets for a person who must remain in bed is necessary for maintaining hygiene and comfort. This procedure requires careful attention to safety and efficiency to minimize disturbance to the patient. The goal is to replace soiled linens with clean ones smoothly while protecting the person’s skin integrity and ensuring privacy. This method is often called the “half-bed” technique. It allows the caregiver to work on one side of the bed at a time while the patient remains safely positioned.
Essential Preparation and Safety Checks
Before beginning the linen change, the caregiver must gather all necessary supplies to prevent leaving the patient unattended. Supplies include a clean bottom sheet, top sheet, pillowcase, and often a draw sheet or incontinence pad, along with a receptacle for soiled laundry. Performing hand hygiene and donning gloves are standard precautions. The caregiver should explain the steps of the process to the patient to build trust and cooperation.
Raise the bed to a comfortable working height, typically around the caregiver’s waist level, to promote good body mechanics and prevent back strain. The bed’s wheels must be securely locked before any movement begins. The side rail on the side the patient will turn toward should be raised to prevent accidental falls. Maintain the patient’s privacy by drawing curtains or closing the door and covering the patient with a bath blanket before removing the top covers.
Executing the Roll and Removing Soiled Linens
Turning the patient safely away from the working side is the most delicate part of the procedure. The caregiver stands on the unoccupied side and gently assists the patient to roll onto their side, facing the raised side rail. If able, the patient can assist by bending the knee closest to the caregiver and holding the rail securely. This technique keeps the patient’s shoulders and hips aligned, which is important for those with back or spinal concerns.
Once the patient is positioned, loosen the soiled bottom sheet from the mattress on the working side. Roll the sheet tightly inward, from the edge toward the patient’s back, containing any soil inside the fold. Tuck this rolled portion firmly against the patient’s back to clear half of the bed surface. This creates room for the clean linens without disturbing the patient. Use proper body mechanics, including a wide stance and bent knees, to avoid twisting the back while reaching across the bed.
Placing the Clean Linens and Finishing the Bed
Place the clean bottom sheet onto the cleared side of the mattress. The unused portion should be rolled or fan-folded toward the center, next to the soiled roll. Securely tuck the edges of the clean sheet under the mattress at the head and foot of the bed on the working side. If using a draw sheet, center it over the bottom sheet from the patient’s shoulders to their buttocks, fan-folding the excess length toward the center.
Raise the side rail on the working side and lower the opposite side rail. Gently assist the patient to roll over the central mound of rolled linens and onto the clean side of the bed. Verbally prepare the patient for the sensation of rolling over this temporary “bump” of linens. Once the patient is secure, the caregiver moves to the opposite side of the bed.
Completely remove the soiled linens by pulling the rolled bundle away from the patient. Roll them into a contained ball and place them into the laundry receptacle. Grasp the clean linens tucked against the patient’s back and pull them taut across the entire mattress. Smooth out all wrinkles and creases to prevent skin breakdown and pressure ulcers. Tuck the finished sheet under the mattress, replace the top sheet and blanket, and return the bed to its lowest, safest position with the side rails positioned appropriately.