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

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.

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.

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.

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.