POSITIONING THE BODY VIA LOGROLLING

PURPOSES:
1. Prevents injury to unstable spine by maintaining correct alignment without tension
on spinal column, thus maintaining present level of neurologic functioning
2. Maintains body alignment
3. Maintains skin integrity (facilitates pressure distribution, prevents friction and shear
on tissue)
4. Prevents injury to and deformities of the musculoskeletal system
5. Promotes comfort
6. Promotes optimal lung expansion

EQUIPMENT:
Support devices required by client (e.g., draw sheet, trochanter roll, footboard, heel
protectors, sandbags, hand rolls, foam wedges)
Several pillows needed for proper alignment and support
Gloves if contact with body fluids is likely be needed

ASSESSMENT:
Assessment should focus on the following:

 Physician's orders for activity (logrolling)

 Neurologic status
 Urinary bladder and bowel function (continence)
 Reports of pain or discomfort

STEPS RATIONALE EXCELLENT VERY GOOD FAIR POOR

GOOD
5 4 3 2 1
1. Obtain assistance. Prevents back and muscle
strain in nurse and injury to
client
2. Perform hand Reduces microorganism
hygiene. transfer
3. Explain procedure Decreases anxiety;
to client, emphasizing increases compliance;
importance of facilitates turning without
maintaining a rigid twisting spine
position with the spine
straight and arms
folded across the
chest while being
turned.
4. Provide privacy. Decreases embarrassment
5. Adjust bed to Prevents back and muscle
comfortable working strain in nurse
height.
6. Use the following
guidelines in
repositioning client:
 Secure all Prevents accidental
equipment, lines, dislodgment and injury
and drains attached
to client.
 Close off drains; Prevents reflux of drainage
if necessary
(remember to
reopen them after
 positioning client).
 The nurse and Prevents back and muscle
one assistant stand strain in nurse and injury to
on the side of the client
bed opposite the
side the client will
face following the
turn. Another
assistant stands on
the side of the bed
that the client will
turn toward.
 Place pillows Maintains body alignment
between client's
legs from thighs to
feet. Place pillow in
position to support
head, preventing
lateral flexion.
(Have additional
pillows available for
support following
the turn.)
 Using Prevents injury; prevents
appropriate body body from being too close
mechanics, move to the rail after
client to side of the repositioning
bed toward the
nurse and assistant.
 Instruct client Maintains correct
to fold arms across alignment; prevents injury
chest to maintain
body in a straight,
rigid position.
 The nurse and Balances weight to avoid
assistant grasp the shearing of skin tissue;
draw sheet, turning promotes comfort
the client toward
the assistant on the
opposite side of the
bed. The assistant
on the other side of
the bed grasps the
draw sheet,
stabilizing the
client, while the
nurse and other
assistant place
pillows or other
support devices
behind the client to
maintain the spine
in straight
alignment. Client is
then eased back
against support
structures.
 Use pillows, Maintains correct
 trochanter rolls, alignment; prevents injury
and special and promotes comfort;
positioning balances weight to manage
supports as needed tissue load
to maintain body
alignment in a
manner that keeps
the spine in a
neutral (straight)
position, keeps
extremities in a
normal position,
and avoids placing
undue pressure on
vulnerable skin
surfaces.
 Be certain that Maintains adequate
client's face is not respirations
pressed into bed or
pillow while turning
and that body
position does not
prevent full
expansion of
diaphragm.
7. Assess client's Determines if position
alignment, adjustment is needed
neurovascular status,
comfort, and character
of respirations.
Reassess client
periodically.
8. Once client is Prevents falls
positioned, lift side
rails, lock wheels, and
place bed in low
position.
9. Place call light within Facilitates communication
reach. while preventing twisting
of spine
10. Move over bed Places items used
table close to bed and frequently within easy
place frequently used reach
items on table.
11. Perform hand Decreases microorganism
hygiene. transfer

STUDENT COMMENTS CI SIGNATURE ABOVE PRINTED

SCORE NAME/DATE
DOCUMENTATION:
The following should be noted on the client's chart:

 Client's position
 Any equipment, lines, or drains attached to client
 Client reports of pain, dyspnea, discomfort
 Exertion or dyspnea observed during repositioning
 Abnormal findings regarding integumentary or neurovascular assessment
 Status of equipment needed for stabilization of body parts (e.g., pillows, foam
wedges, orthotics)
 Special positioning supports used
 Teaching regarding importance of maintaining position