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

Safe logrolling requires three people. This prevents injury to the resident and to the healthcare workers.
Two workers should stand on the side of the bed the resident is being rolled toward. One should stand on the opposite side.
Raise the bed to a comfortable working height.
Make sure that the draw sheet is under the resident and extends at least from the resident’s shoulders to their knees.
Have the resident cross their arms over their chest and place a small pillow between their knees.
The worker on the side the resident is being turned away from should fanfold the draw sheet until it is close to the resident.
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.
On the count of three, the two workers holding the draw sheet should pull toward themselves in a continuous, smooth motion.
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.
The workers holding the draw sheet should gently release the tension so that the resident rolls back onto the pillows.
Ask the resident if they are comfortable. Make adjustments as necessary.
Lower the bed back to the lowest position.
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

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

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.).

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.