UNIVERSITY OF CEBU @ PARDO and TALISAY, INC.

Bulacao, Cebu City

College of Nursing and School of Midwifery

Name of Student: ______________________________________ Grade: ___________

Year and Section: ______________________________________ Date: ____________
OCCUPIED BED
LEGEND: 1 – Excellent
2 - Above Average
3- Average
4 - Below Average
5 - Poor
STEPS RATIONALE GRADE
1 2 3 4 5
1. Prepare all linens and arrange
according to use before bringing at
bedside.

2. Explain the procedure.

3. Remove pillowcase from the pillow

and place it at the back of the chair
to serve as a hamper.

4.Place the bedside rail in the raised

position on the opposite side from
which you will begin to prevent the
patient from rolling off bed.

5. Help the patient to the far side of

the bed near the raised side rail.

.
6. Loosen the soiled bottom linens
and roll them well toward the center
of the bed under the patient.

7. Place a bottom sheet folded

lengthwise starting from the edge of
the foot part of the mattress. Make
it, as you would do on unoccupied
bed.

8. Do the same with the rest of the

sheets (rubber sheet, draw sheet
and top sheet) as in doing an open
bed.
9. Roll the patient over the soiled
linens at his back to the freshly
made half of the bed.

10. Place the bedside rail in raised

position on the side of the bed
where you have been working (if
bed is with side rails).

11. Go to the opposite side of the bed,

drop the side rail on the bedside,
loosen the sides of the soiled linens
and place on a mini-hamper provided.

12. Pull the clean linens through

tightly. A smoother bed will be
possible if the clean linen is pulled
directly behind the patient’s back.

13. Complete arranging the bottom

linen on the bed.

14. Do the same with the draw sheet

and rubber sheet.

15. Help the patient to the center of

the bed.

16. Arrange the clean fan-folded top

linen on the top of patient’s chest
with its smooth side approximately
18 inches from edge of the head part of
the mattress.

17. Tuck in the remainder portion of

the sheet at the patient’s foot part
18. Put on the pillow case to pillow
and place under patient’s head
with the open side facing away from
the door.

19. Make necessary adjustments.

20. Ability to answer questions:

TREATMENT OF DATA
Step 1: Compute the Total Score
Step 2 : Compute the Weighted Mean
Formula:
Weighted Mean - ____Total Score____
Total Number of items
Step 3: Determine the Weighted Mean Description. (Refer to the Point Scale)
Point scale Categories
1.00--1.80 Excellent
1.81-- 2.60 above Average
2.61--3.40 Average
3.41--4.20 Below Average
4.21--5.00 Poor

RATING: ________________________
Comments
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Student’s Signature over printed name Clinical instructor’s signature

Printed Name over Printed Name
 UNIVERSITY OF CEBU @ PARDO and TALISAY, INC.
Bulacao, Cebu City
College of Nursing and School of Midwifery
Name of Student: ______________________________________ Grade: ___________
Year and Section: ______________________________________ Date: ____________
CLOSED BED
LEGEND: 1 – Excellent
2 - Above Average
3- Average
4 - Below Average
5 - Poor
STEPS RATIONALE GRADE
1 2 3 4 5
1. Bring necessary linens to bedside.
Fold linens crosswise four folds.

2. Straighten mattress, turn if

necessary.

3. Place bottom sheet on mattress,

wrong side up with centerfold of
sheet over center of mattress.

4. Draw top fold towards the head of

the bed, while facing the foot part
of the bed.

5. Tuck head end of the sheet well

under the mattress, miter corner.
And tuck side smoothly towards
foot part.

6. Place rubber sheet across center

of the bed, upper edge, about 2
feet from head of mattress.

7. Cover with cotton draw sheet and

truck together with the rubber
sheet.

8. Place top sheet right side up,

starting from the edge of the head
part of the bed.

9. Draw top fold towards foot of

the
bed while facing the head part of
the bed.
10.Tuck sheet under mattress at the
foot part and miter corner.

11.Fold back top sheet about 18

inches from the edge of mattress
(head part)

12. Fold side of top sheet toward

center of the bed.

13.Place bedspread six inches

beyond edge of mattress at head
part.

14.Draw top fold toward the foot

part
of the bed while facing the head
part of the bed. Miter corner at
foot
part. Fold back head end of
bedspread, 20 inches.
15.Put pillowcase to pillow and place
on the bed. The opening of the
pillowcase should not face the
door. Place pillow over folded
bedspread.

16.Go to the other side of the bed;

fold bedspread, top sheet, rubber
sheet, and cotton sheet back
neatly
over half of the bed.

17.Tuck head end of the bottom

sheet tightly, milter corner, and
tuck side smoothly and tightly
toward the foot part.

18.Pull the rubber sheet and cotton

draw sheet tightly. Tuck in center
first then the side.

19. Milter top sheet at foot part and

fold side of top sheet toward the
center of the bed.
20.Tuck bedspread at foot part of
the
bed and miter corner.

21. Bring folded end of bedspread to

cover pillow.

22. Inspect the bed and make

necessary adjustment

23. Ability to answer questions:

TREATMENT OF DATA
Step 1: Compute the Total Score
Step 2 : Compute the Weighted Mean
Formula:
Weighted Mean - ____Total Score____
Total Number of items
Step 3: Determine the Weighted Mean Description. (Refer to the Point Scale)
Point scale Categories
1.00--1.80 Excellent
1.81-- 2.60 above Average
2.61 --3.40 Average
3.41 --4.20 Below Average
4.21 --5.00 Poor

RATING: ________________________
Comments
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________

Student’s Signature over printed name Clinical instructor’s signature

Printed Name over Printed Name
 UNIVERSITY OF CEBU @ PARDO and TALISAY, INC.
Bulacao, Cebu City
College of Nursing and School of Midwifery

Name of Student: ______________________________________ Grade: ___________

Year and Section: ______________________________________ Date: ____________

OPEN BED
LEGEND: 1 – Excellent
2 - Above Average
3- Average
4 - Below Average
5 - Poor
Steps RATIONALE GRADE
1 2 3 4 5
1.Bring necessary linen to bedside
and arrange them in order of use .
bottom and top sheets should be
folded crosswise – four folds.

2. Place bottom sheet on mattress,

wrong side up with centerfold of
sheet over center of mattress.

3. Place bottom sheet on mattress,

wrong side up with centerfold of
sheet over center of mattress.

4. Draw top fold towards head of bed,

while facing the foot part of the bed.

5. Tuck head end of sheet well under

the mattress, miter corner, and truck
side smoothly towards foot part.

6. Place rubber sheet across center of

bed, upper edge, about 2 feet from
head of mattress.

7. Cover with cotton draw sheet and

tuck together with the rubber sheet.
8.Place top sheet right side up,
starting from the edge of the head
part of the bed.

9. Draw top hold towards foot of the

bed while facing the head part of the
head.

10.Tuck sheet under mattress at foot

and miter corner.

11. Fold back top sheet about 18

inches from edge of mattress.

12. Go to the other side of the bed,

old top draw sheet back neatly
over half of the bed.

13. Tuck head end of bottom sheet

tightly, miter corner, and tuck
side smoothly and tightly
towards the foot part.

14. Pull the rubber and cotton draw

sheets tightly. Tuck in center first
then the side.

15.Tuck in top sheet under mattress

at foot part and miter corner. Fold
back top sheet about 18 inches
from edge of mattress.

16. Put pillow in pillowcase and

place in bed. The opening of the
pillowcase should not face the
door.
17. Inspect bed and make
necessary adjustments.

18. Ability to answer questions:

TREATMENT OF DATA
Step 1: Compute the Total Score
Step 2 : Compute the Weighted Mean
Formula:
Weighted Mean - ____Total Score____
Total Number of items
Step 3: Determine the Weighted Mean Description. (Refer to the Point Scale)
Point scale Categories
1.00 -- 1.80 Excellent
1.81 -- 2.60 Above Average
2.61 -- 3.40 Average
3.41 -- 4.20 Below Average
4.21 -- 5.00 Poor

RATING: ________________________
Comments
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Student’s Signature over printed name Clinical instructor’s signature

Printed Name over Printed Name