Logrolling a Patient

Goal: The patient’s spine remains in proper alignment, thereby reducing the risk for injury.

1. Review the medical record and nursing plan of care for activity orders and conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient.

4. Close curtains around bed and close the door to the room, if possible. Explain the purpose of the logrolling technique and what you are going to do, even if the patient is not conscious. Answer any questions.

5. Place the bed at an appropriate and comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009).

6. Position at least one caregiver on one side of the bed and the two other caregivers on the opposite side of the bed. If a cervical collar is not in place, position one caregiver at the top of the bed, at the patient’s head. Place the bed in flat position. Lower the side rails. Place a small pillow between the patient’s knees.

7. If a friction-reducing sheet is not in place under the patient, take the time to place one at this time, to facilitate future movement of the patient.

8. If the patient can move the arms, ask the patient to cross the arms on the chest. Roll or fanfold the friction-reducing sheet close to the patient’s sides and grasp it. In unison, gently slide the patient to the side of the bed opposite to that which the patient will be turned.

9. Make sure the friction-reducing sheet under the patient is straight and wrinkle free.

10. If necessary, reposition personnel to ensure two stand on the side of the bed to which the patient is turning. The third helper stands on the other side. Grasp the frictionreducing sheet at hip and shoulder level.

11. Have everyone face the patient. On a predetermined signal, turn the patient by holding the friction-reducing sheet taut to support the body. The caregiver at the patient’s head should firmly hold the patient’s head on either side, directly above the ears. Turn the patient as a unit in one smooth motion toward the side of the bed with the two nurses. The patient’s head, shoulders, spine, hips, and knees should turn simultaneously.

12. Once the patient has been turned, use pillows to support the patient’s neck, back, buttocks, and legs in straight alignment in a side-lying position. Raise the side rails, as appropriate.

13. Stand at the foot of the bed and assess the spinal column. It should be straight, without any twisting or bending. Place the bed in the lowest position. Ensure that the call bell and telephone are within reach. Replace covers. Lower bed height.

14. Reassess the patient’s neurologic status and comfort level.

15. Remove PPE, if used. Perform hand hygiene.