Definition
Logrolling is a technique used to turn a patient whose body must all times be kept straight alignment (like a long)
Indication
Client with spinal injury for whom care must be taken to prevent further injury.
Technique
- Logrolling requires two nurses or if the client is large, three nurses.
- For the client who has a cervical injury, one nurse must maintain the client’s head and neck alignment.
Procedure
| Nursing Action | Rationale | |
| 1 | Before procedure Preparation Determine presence of any encumbrance to movement Determine assistance required from other health care personal Determine assistance required from other health care personnel. Explain to client what you are going to do why it is necessary for her to cooperate. | Intravenous equipment, cast on leg, need special attention. Certain medication may hamper movement or alertness of client. Prepares patient for what will be done. |
| 2 | During procedure Wash hands and observe other appropriate infection control measures. | Reduce chance of cross infection |
| 3 | Close curtains or door | Provides for client privacy |
| 4 | Position yourselves and the client appropriately before the move Stand on the same side of the bed and assume a broad stance with one foot ahead of the other. Place the client’s arms across the chest. Lean your trunk, and flex your hips, knees and ankles. Place your arms under the client as shown inTighten your gluteal, abdominal, leg and arm muscles. | Ensure that the arms will not be injured or become trapped under the body when the body is turned. Each staff member then has a major weight area of the client centered between the arms. |
| 5 | Pull the client to the side of the bed. One nurse counts: one, two, three go. Then at the same time, all staff members pull the client to side of the bed by shifting their weight to the back foot. Elevate the side rail on the side of the bed. | Moving the client in unison maintains the client body alignment. This prevents the client from falling while lying so close to the edge of the bed |
| 6 | Move to the other side of the bed, and place supportive device for the client when turned. Place a pillow where it will support the client’s head after the turn. Place one or two pillows between the client leg to support the upper leg when the client is turned | The pillow prevents lateral flexion of the neck and ensure alignment of the cervical spine. This pillow prevents adduction of the upper leg and keeps the legs parallel and aligned. |
| 7 | Roll and position of the client in proper alignment. All nurses flex their hips, knees and ankles and assume a broad stance with one foot forward.All nurses reach over the client and place hands on the same side of the Patient’s shoulder, hip and legs.One nurse counts one, two, three, go. Then at the same time, all nurses roll the patient to lateral position.Support the patient’s head, back and upper and lower extremities with pillows.Raise the side rails and place the call bell within the client’s reach. | Doing so centers a major weight area of the client between each nurse’s arms. |
Variation Using a Lift or Lifter Sheet
| Nursing action | Rationale | |
| 1 | Use of a turn sheet to facilitate logrolling. | |
| 2 | First stand with another nurse on the same side of the bed. Assume a broad stance with one foot forward, and grasp half of the fan folded or rolled edge of the turn sheet. On a signal, pull the patient toward both of the nurses. | |
| 3 | Before turning the client, place pillow supports for the head and legs. | This helps to maintain the client’s alignment when turning. |
| 4 | One nurse goes to the other side of the bed (farthest from the client) and assumes a stable stance. Reaching over the client, grasp the far edges of the turn sheet, and roll the client toward you. | |
| 5 | The second nurse (behind the client) helps turn the client and provides pillow support back to ensure good alignment in the lateral position. | |
| 6 | After procedure Document all relevant information Time and change of position mentioning the position in which patient is placed Any signs of pressure ulcers. Support devices used. Ability of client to assist in moving and turning. Response of client to moving and turning |
Special Considerations
- Spinal alignment must be maintained throughout.
- Use pillows or supports to stabilize the patient after the roll.
- Ideal for spinal trauma, post-op spinal surgery, or unconscious patients.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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