Nursing & Healthcare Programs

Logrolling the Resident

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Logrolling is a technique used to roll a resident onto their side without the resident helping, and while keeping the resident’s spine in a straight line. This is especially important for residents who have had spinal surgery or injury.

Logrolling Technique

  1. Safe logrolling requires three people. This prevents injury to the resident and to the healthcare workers.
  2. Two workers should stand on the side of the bed the resident is being rolled toward. One should stand on the opposite side.
  3. Raise the bed to a comfortable working height.
  4. Make sure that the draw sheet is under the resident and extends at least from the resident’s shoulders to their knees.
  5. Have the resident cross their arms over their chest and place a small pillow between their knees.
  6. The worker on the side the resident is being turned away from should fanfold the draw sheet until it is close to the resident.
  7. One worker on the side the resident is turning to face should grasp the fan-folded draw sheet at the resident’s lower back and shoulder. The other worker should grasp the draw sheet at the level of the resident’s lower hips and thighs.
  8. On the count of three, the two workers holding the draw sheet should pull toward themselves in a continuous, smooth motion.
  9. The worker now äóìbehindäó the resident should support the resident’s head in line with their body and immediately place a pillow under the resident’s head. If the resident is to stay on their side, this worker should place pillows along the resident’s back to help support them in that position.
  10. The workers holding the draw sheet should gently release the tension so that the resident rolls back onto the pillows.
  11. Ask the resident if they are comfortable. Make adjustments as necessary.
  12. Lower the bed back to the lowest position.
  13. Document the position per institutional or unit policy. Report any difficulty getting the resident into position, or maintaining position to the nurse per policy.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 217). St. Louis, MO: Mosby Elsevier.

More Resources

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.