Log Rolling (Nursing)

by Samantha Rhea, MSN, RN

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    00:04 Welcome to log rolling a client, now you may think log rolling that's quite a odd thing to do to a client but this is actually a really useful tactic that we're going to do to help change a bed for example or to help move a patient up in bed so let's take a look at this. Now why do we even log roll? This method is really important if someone has a spinal injury for example or we need to keep that spine in alignment when we move our patient in bed. Now this is also really useful for a bed bound client, you can imagine being in beds really uncomfortable, sometimes the patient gets pretty stiff so this is a nice fluid way to move the patient as well in bed. Now we can also use this for repositioning like I had mentioned earlier to change bed linens when a patient's in there or providing a bed bath. Now when you log roll it's ideal that you want at least two of you sometimes you may use three so use your discretion on this. So first of all what are we going to need to log roll our patient, now if your facility has a slide sheet that's really great, all these are really slick and it kind of helps move the patient around but most commonly you're going to see a draw sheet, it's going to look a lot like just a plain old sheet and we can use this as well and again don't forget it's much safer to use another staff member when you log roll a patient so try to get help. So before we start don't forget your hand hygiene and make sure you provide privacy for your patient and as always we want to make sure we tell the patient what's going to happen next and explain the procedure. Now anytime you log roll, it's important that you position the bed to a comfortable working height now remember you may have a partner helping you here so it needs to be comfortable for not only you but also your partner so make sure you get agreeable position. Now that we've positioned the bed, now we want to lower those side rails however, only if staff are present on both sides of the bed this is really important, anytime you lower a side rail make sure staff is standing on each side of the bed we don't want the patient rolling out here. Now this is a good time to stand directly next to the bed now before we start, position your patient where you can reach the client's shoulder and their hips. This is really their trunk area and the heaviest part and this is where we want to center ourselves. Now we want to have our client fold their arms across their chest, think of like a mummy so this is going to be helpful so when they roll it's much more comfortable and their arms don't get tangled up during the log roll. Now we want to grasp the far side of the client's body so you're going to be rolling the patient towards you, so you want a hand on the shoulder and even the thigh or the hip and you're going to place those both at the same time across the patient. Now we want to turn the client towards us, again with your hand on the shoulder, on their hips or thigh with one motion. Now here's the key note, here is that you want to communicate as healthcare providers so it should be one swift motion with you pulling towards you, your nurse on the other side is assisting the client towards you as well. Now it's always useful to use a draw sheet here so instead of grabbing onto the client their shoulder and thigh or shoulder and hip and moving, sometimes it's much easier to either use a draw sheet or a slide sheet for example, you can grasp on the sheet and use that to assist you. Now once we've log rolled the client it's a great idea to place pillows behind their trunk, this is definitely going to ensure alignment and support and it's just much more comfortable for the patient. Now before we leave the room, again make sure that clients in a comfortable position and again don't forget those side rails make sure those are up, put the bed in the lowest position before you exit the room, perform that hand hygiene and maybe make sure you document.

    04:10 Hi guys, I'm going to show you how to log roll a patient so I've got some assistance here Dean and you may think okay what is log rolling? This is actually used quite a bit in nursing especially with someone who has a spinal injury for example and what I'm talking about is when we log roll a patient, the main objective is to move the patient in one swift smooth movement and it also helps keep their spine in alignment also if someone's bed bound for example and we need to make their bed or turn them over, this is a great technique that's really comfortable and much easier to manipulate and move your client. Okay, so now let's go ahead and get started, of course when we enter a room make sure we perform our hand hygiene so we're log rolling a patient and you have assistance which I definitely recommend, log rolling is usually a two-person piece to that so make sure you get help so once we've performed our hand hygiene again you can see some height differential between me and Dean you want to make sure there's a good working height for both parties then you want to make sure you communicate on which side the patient's going to roll so that's something you want to work out with your team member before you get started. Okay so now that we've got the bed to a comfortable working height now since me and Dean are on both sides of the patient, we can remove the side rails and don't forget as a nursing student or a nurse, never put down a side rail if someone's not there but we're both here so let's do that now.

    05:40 Okay so we've moved our side rails so now what we're going to do is take the patient and we're going to log roll them towards me so anytime you log roll a patient again, you want to communicate, explain to the patient what's going on, if they can help you that's great, sometimes though the patient cannot especially if it's a patient with a spinal injury for example so before you log roll one thing to keep in mind anytime you log roll the patient, you want to use the heaviest portion which is their trunk to help move them so for example what I mean by that when I log roll I'm going to place my hand over the shoulder and the hip of the patient when I help turn them so this is really the main portion of the patient's body and we're going to do it all at once. So I can use that with the help of dean also if you have a draw sheet or a sheet underneath the patient, Dean and myself can use that to also lift the patient if the patient, if you need that with your patient. Next, after you log roll, you can help stuff a pillow for support. So now we're going to demonstrate so make sure your linen is loose because you're going to be moving your patient right? So now what I'm going to do is with the help of Dean, I'm going to take the shoulder then notice I'm going to take my other hand behind the trunk and again notice me as someone who's not very tall, now as a person we don't want to stoop over but make sure that maybe you squat a little bit and making sure you're keeping good body mechanics. So now I'm going to reach over, I've got my shoulder, my excuse me, my hand behind the shoulder and behind the hip and with one movement we're going to log roll the patient so notice here that the patient's spine stayed in alignment and now dean can put a pillow underneath the patient for support of that back.

    07:29 Great! Thank you dean, so a lot of the times you may also turn a patient this way as well if you're trying to offload them from their back or change linens or just reposition the patient all together. So make sure that the patient's comfortable and their body's aligned and then of course before you leave make sure the side rails are up, that the bed is in the lowest position and you perform hand hygiene before exiting the room.

    About the Lecture

    The lecture Log Rolling (Nursing) by Samantha Rhea, MSN, RN is from the course Using Safe and Effective Transfer Techniques (Nursing).

    Included Quiz Questions

    1. Log rolling is a method to turn the client while keeping the spine aligned.
    2. Log rolling is useful for repositioning when changing bed linens.
    3. Clients that require c-spine precautions must be log rolled with two or more staff members.
    4. Log rolling should be used for ambulatory and bed-bound clients.
    5. One nurse can logroll a client who does not have c-spine precautions.
    1. Provide privacy for the client
    2. Position the bed to a comfortable working height
    3. Stand directly next to the bed to access the client's shoulders and hips
    4. Lower the side rails with both people standing on the same side of the bed
    5. Have the client hold their arms straight above their head
    1. Turn the client towards you in one motion
    2. After the log roll, pillows should be placed behind the client's trunk
    3. Communicate to the other staff member which side the client will roll
    4. Grasp the far side of the client's body with a hand on their rib and thigh
    5. A drawsheet should only be used for obese clients
    1. Do not leave the bed until both side rails are up.
    2. To have a minimum of three staff members assisting
    3. Ensure the positioned bed height works for one of the nurses
    4. Don't allow the client to help with the log roll procedure.

    Author of lecture Log Rolling (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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