CNA Skills 2025

22 CNA Skills with Critical Steps Bolden

Hand Washing

Turn on faucet and adjust temp to warm water

Wet hands keeping fingertips point down and hands below elbow

Apply Soap

Lather Palms, Palms with fingers interlaced, back of hand w/ fingers interlaced, thumbs, fingertips and wrists

Repeat Sequence Twice, Keep fingertips pointed down

Rinse hands with water w/ fingertips down. Don’t shake your hands

Dry hands w/ paper towel and dispose of each paper towel before switching to another

DON’T touch the sink w/ body or hands

With new paper towel turn of faucet

Knee High Compression Stocking

Items are Compressions Stocking

Open Procedure, PLACE SUPPLIES in CLEAN SURFACE. Wash hands put gloves on, privacy, lock wheels, bed up, rails down. Ensure res. is in supine position

Expose leg that will have sock on.

Go to foot of bed. Fold sock inside out from the line. Put over foot of Res while being gentle. Once placed to heel extend sock to knee. Ensure and say there are no wrinkles in the sock

Cover Res, ask if comfortable and give call light. Lock wheels, bed down, rails up. Undo privacy. Take gloves off, wash hands, report to chart. PT. tolerated the procedure well.

Assist to Ambulate with Gait Belt

Supplies: Gait Belt, Nonskid socks and Nonskid Shoes. Remember if given a res with weak side, stand on weak side of res.

Open Procedure, Place supplies in clean surface. Wash hands, privacy, wheels locked, bed up, rail down.

Place nonskid socks and nonskid shoes on Res. Ask Res to move closer to your working side. Ask PT if able to, to sit up, assist Res. to pivot toward the edge of the bed on the count of three. Ask if dizzy. Let Res. know to hold onto the rail. Lower the bed till feet are planted on the floor, Place gait belt on res. check w/ 2 fingers to check the for over tightness. Face patient with one foot in between legs and other out in wide stance. Ask res. to place arms on shoulder. Tell the res on the count of 3 to push up from the bed and that in between counts you’ll rock them forward and back to prepare them for standing. On the count of three once Res. is up, ASK IF DIZZY. Move to weak side of res.(if applicable) slightly behind them. one arm in front and other in back toward further side. ENSURE GOOD GRIP ON BELT. Ask Res to walk five feet forward. turn res and ask to walk five feet back to bed. Turn res away from bed and ask if res feels bed behind their legs. If not ask res to move back until they feel the bed. Once they do ask res to hold onto rail with one arm and other arm on your shoulder and to sit down on count of three. Take off Gait belt and set of clean surface. Assist res back to bed. Cover res. ask if comfortable and give call light. Lock wheels, bed down, rail up undo privacy, gloves off wash hands, report to chart Res tolerated procedure well, no dizziness.

Assist w/ use of bed pan

Supplies: Fractured Bed Pan, Disposable chuck, toilet paper, wipes, baby powder, privacy towel, paper towel

Open Procedure, place supplies in clean surface, wash hands, gloves, lock bed wheel, bed up, rail down. ENSURE HEAD OF BED IS DOWN

Ask res. to move closer to you. Turn res over following side lying position steps. place chuck under res. and put baby powder on bed pan and place on top of chuck and under res. Position the res. correctly on bedpan. Ensure deeper portion of bedpan is directed towards toes of res, and res shoud be centered on bedpan.

Put privacy towel on res.

RAISE HEAD OF BED. Ensure Res. is covered with privacy towel. Give res. toilet paper, wipes and call light. Let resident know if finished to call you and if you don’t hear anything from them you’ll be back in 5 minutes.

Remove gloves, wash hands. and wait nearby allowing for privacy. Come back after 5 minutes wash hands, gloves.

LOWER HEAD OF BED

Ask RES if they wiped well. Say I’ll help you with perineal care. Wipe res hands. With wipes. Wipe perineal area and place toilet paper on bed pan.

Turn pt to side position using same steps. Gently remove bed pan and place on foot of bed, place PAPER TOWEL on top of bedpan

Remove gloves and wash hands and place new gloves again

Fold chuck away from you till under res. Turn res back and then turn towards you if you can’t continue folding chuck away. Put chuck aside. Cover res, ask if comfortable, and give call light. lock wheels, lower bed, rails up, undo privacy.

Place soiled linen in disposable linen basket. Dispose of chuck. Dump bedpan into toilet and rinse and dump three times. dry and place in dirty supply area. Remove gloves wash hands. Report to chart, pt tolerated procedure well, stool is brown, soft and medium size.

Clean Upper or lower Denture (2025 skills)

Supplies: Dentures, Emesis Basin, Wash cloth, tooth brush, tooth paste Denture cup

Open Procedure, place supplies in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rail down. Place a towel on res. Line sink with towel, ask res to remove dentures and place them in denture cup, Turn on water and wet denture brush and apply toothpaste. place emesis basin on top of towel. and dentures on emesis basin. Wash denture cup and fill with cold water and place on paper towel. Wash dentures thoroughly on all chewing surfaces including inner and outer surfaces.

Rinse dentures and place them in cup. Rinse toothbrush and emesis basin

Return cup to side stand of res. Return supplies to designated storage. Remove towel from res. Cover res, ask if comfortable and give call light. lock bed wheels, lower bed, rails up. Undo privacy. Dispose of towel in dirty laundry. and remove gloves, wash hands. Report to chart. Pt tolerated procedure well

Counts and Records Radial Pulse

Open procedure. Wash hands place gloves, privacy, bed wheels locked, bed up, rails downl.

Located pulse on res. Count pulse for 60 seconds.

Cover res, ask if comfortable, give call light.

wheels locked, bed down, rail up. privacy undone.

Remove gloves wash hands and report pulse within plus or minus 4 from instructor.

Counts and records respirations

Open procedure, wash hand place gloves, privacy, wheels locked, bed up, rails down. Explain procedure. Count respirations for 60 seconds. Cover res, ask if comfortable, give call light. Wheels locked, bed down, rails up. Undo privacy. remove gloves, wash hands. Report respirations within plus or minus 4 from evaluator’s result.

Putting on and removing PPE

Say you’ll wash your hand and place ppe before entering pt’s room.

Unfold gown and put arms through sleeves. Secure neck and waist ensuring the back overlaps the other flap before tying.

Put on gloves

When done with res. and it’s time to remove ppe

Remove gloves and dispose of in appropriate container, wash hands, untie gown. slight move hand under sleeve and pinch. pull free arm from other sleeve while pinching elbow area. Loop around other arm and clasp other side and loop that around your arm and fold gown which is inside out away from you. Dispose of gown in appropriate container before leaving room. Wash hands. Procedure done

Dressing PT with affected (weak) Right Arm

Supplies: Two shirts

Open procedure, place shirts in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rails down. Ask res which shirt they prefer

USA. UNDRESS STRONG ARM first. give res covered with gown. Undress other side. Keep res covered with gown. Get shirt and DRESS WEAK ARM FIRST. Hold their hand and insert through sleeve guiding hand. Ask res. to sit up and loop shirt. Dress other side. Hold hand and guide through that sleeve. Button shirt. Cover res, ask if comfortable, give call light. Lock wheels, bed down, rails up. Undo privacy. Remove gloves, wash hands, report to chart pt tolerated procedure well.

Feed pt who cannot feed self

Supplies: Food, Towel, utensils

Remember NO GLOVES, NO PRIVACY for this skilll

Open procedure, Wash Hands and VERIFY the pt name matches diet card and that diet restrictions, food texture and liquid consistency matches diet card. Position pt in fowler’s position.

Place towel over resident chest. Ask res. if they would like mouth care before eating. Assist res. to cleaning their hands with sanitizer or soapy and wet wash clothes. Position yourself in chair facing res at eye level. Describe foods and fluids to pt. Offer small amounts. Cut into small pieces. Give pt adequate time to chew. offer liquid frequently. Alternate between solids and liquids. Wipes res when necessary. Continue giving food until res indicates they are full. Clean the pt face and hands. Ask if they would like mouth care. LEAVE PT head elevated at least 30 degrees. Cover res, ask if comfortable, place call lights. Lock wheels, bed down. rails up., wash hands, report to chart, pt tolerated procedure well, document intake.

Modified Bed bath

Supplies: Basin, 2 wash clothes, 2 towels, soap, lotion

Only skill where u replace gown

Remember towel soft side face resident

Open procedure, place supplies in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rail down.

Ask res to move closer to you. Fill basin with water, check temp, and ask res to check if ok with temp. Place basin on flat surface on top of disposable chuck. Put wash clothes in to soak.

Raise head of bed. Place towel back of res head and another on chest of res. removed gown. WASH EYES. SAY NO SOAP FOR THE EYES. Wash eye furthest from you from inner to outer using different sides of washcloth. Wash FACE with no soap also using different sides of washcloth, cheeks, nose, forehead, neck, behind ears.

Pat dry face.

Remove towel from head and move to underneath arm.

Soap up wash cloth and lather. Wash from fingers to armpit. Clean in between fingers and armpit. Place wash cloth on side of basin with soapy side away from water. Get another wash cloth and rinse arm. Pat dry arm. Apply lotion and pat dry excess lotion. Remove towels and put on new gown. Cover res, ask if comfortable and give call light. Lock wheels, bed up, rails down undo privacy. Dispose of linen in dirty laundry basket. Return equipment to designated storage. Dump basin water unto toilet and rinse and dump three times, dry, and place in designated dirty supply area. Remove gloves, wash hands. report to chart. pt tolerated procedure well. skin intact.

Measures and records urinary output

Supplies: Cylindrical Gradual Container

Open procedure, place container in flat surface on top of paper towel. wash hands, gloves, privacy, Get bedpan and pour liquid onto gradual cylinder. At eye level bending the knee get the output of liquid. Rinse and dump bedpan and place is designated dirty supply area. Rinse and dump cylinder and place in dirty supply area.

Remove gloves, wash hands undo privacy and report to chart the volume of liquid within plus or minus 25mL

Urine is light yellow, and no strong smell

Measures and records weight of ambulatory pt

No gait belt for this one.

Supplies: nonskid socks and nonskid shoes

Open procedure, wash hands, gloves, privacy, wheels locked, bed up, rails down.

Ensure res has nonskid socks and nonskid shoes. Ask res to sit up and pivot to edge of bed facing you. assist to stand up. Walk pt to scale. BALANCE Scale (move weights to zero)

Ask pt if they emptied their bladder

assist pt to scale and check if centered on scale and that pt isn’t holding on to anything. And has arms on their side.

Adjust the weights until scale is balanced and read scale result. Keep in mind.

Assist res off scale and walk back to bed. Assist onto bed and remove nonskid socks and shoes. Cover res, ask if comfortable, give call light. wheels locked, bed down, rails up, undo privacy. remove gloves, wash hands and report to chart weight plus or minus 2lbs

Passive Range of motion for one hip and one knee

Open procedure, wash hands, gloves, privacy, wheels locked, bed up, rails down. Let res know you’ll be performing Abduction/adduction and flexion/extension of knee and hip and if they feel any pain during the procedure to let you know and that you’ll stop right away. Perform Abduction/adduction for hip of res. Keep res leg straight having on hand under ankle and other under knee. Move leg gently away from body and ask if in pain. then move leg back. Do this three times. Stop if res reports pain. No perform Flexion/extension of knee and hip. Bend the pt knee and hip toward up toward pt. with hand underneath ankle and knee. when up ask if they feel any pain. Then gently bring down leg. Do this three times. Cover res. ask if comfortable and give call light. wheels locked, bed down, rail up. undo privacy. remove gloves and wash hands, report to chart that pt tolerated the procedure well and experienced no pain.

Passive ROM for one shoulder

Open procedure, Wash hands, gloves, privacy, wheels locked, bed up, rails down.

Explain to res. you’ll be performing abduction/adduction and flexion/extension of their should and report any pain to you and you’ll immediately stop. Perform Abduction/Add. to res. Hold arm with one hand under wrist and other under elbow. Move arm away from body to the side. Ask if res is in pain. then bring back to body. Do this three times. Now perform flexion/extension on res. Hold the same way move res arm up over their head and ask if in pain. Then bring arm back down. do this three times. Cover res, ask if comfortable, give call light. Wheels locked, bed down, rails up, undo privacy, remove gloves, wash hands. report to chart pt tolerated procedure well, no pain

Position on the side

Supplies: 3 pillows

Remember pillow behind back is long ways and open end faces towards head of bed, pillow under arm long ways is perpendicular to the body and open end faces in front of res., pillow under legs long ways is parallel to body and open end faces feet

Open procedures, wash hands, gloves, privacy, wheels locked, bed up, rails down.

Position bed flat. Ask res to move closer to you so they don’t hit rail when they turn over. If res can’t move then assist them closer to you on the count of three. Bend res knee up. Ask res how they prefer to have their arm up or straight toward rail. move their other arm across chest. Push res. knee gently to expose hip. tell res that on the count of three you’ll push them and have them grab the rail. On the count of three push form their hip and shoulder. Check res. isn’t lying on their bottom arm and adjust pillow of head. Place a pillow behind pt back so they don’t fall back. PULL PATIENT SLIGHTLY BACK ONTO PILLOW FOR SUPPORT. move to end of bed and check for pt alignment. and in middle of bed. Place a pillow in between the pt top arm and their rib cage. ensuring the elbow isn’t directly on their ribs. place another pillow under the top knee ensuring the knee isn’t directly resting on the other knee or the ankle isn’t on top of the other ankle. Adjust pillow under pt head for comfort. Cover res. ask if comfortable, give call light. wheels locked, bed down, rail up. undo privacy, remove gloves, wash hands, report to chart that pt tolerated the procedure well.

Catheter Care

Supplies: Basin, 2 wash clothes, 2 towels, soap, chuck

Open procedure, places supplies in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rails down. Fill basin with water and check temp, ask res to check if temp is ok w/ them. Place basin on flat surface with barrier underneath(chuck). Put in wash clothes to soak. Place towel over upper legs and another over lower abdomen only exposing the urethra and catheter. Follow the tubing from pt toward drainage bad, ensuring that the tubing is lower level as it goes toward the bag. be sure no kinks or elevation can cause backflow to the bladder. Ask res to lift hips up and place chuck underneath. Get first wash cloth , soap and lather. Hold the catheter by the meatus to prevent tugging. Wash around the catheter where you are holding and wash 4” down the catheter moving away from the urethra. use a clean portion of the cloth for each stroke. Put put washcloth in linen bag. Now rinse the catheter using same steps but without soap. Put that cloth in soiled linen bag. Pat dry with towel. REMOVE TOWELS AND CHUCK , place on foot of bed. Cover res. ask if comfortable, give call light. wheels locked. bed down, rails up, undo privacy and dispose of soiled linen in soiled linen basket, dump and rinse basin 3 times and place in designated dirty supply area. Remove gloves, wash hands and report to chart pt tolerated procedure well. no signs of infection.

Foot care on one foot

Supplies: Basin, soap, lotion, 2 towels, 2 wash clothes and chuck

Open procedure, places supplies in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rails down. Fill basin with water and check temp, ask res to check temp if ok. place basin on flat surface with chuck underneath. Place towel under foot and another over calves. Remove res. socks and place foot in water w/ basin vertical to body for 5-20 minutes. Put wash clothes to soak. Soap and lather wash cloth and wash foot and between the toes. Rinse the foot next and then place foot on towel and pat dry thoroughly including between the toes. Ask pt if they would like lotion. if yes apply but avoid lotion between the toes. Pat dry excess with towel. Replace socks. Remove towels. cover Res , ask if comfortable, give call light. Wheels locked, bed down, rails up. Undo privacy. Dispose of soiled linen in the soiled linen basket. Dump and rinse basin three times and place in designated dirty supply area. Remove gloves, wash hands and report to chart, pt tolerated procedure well, skin intact

Provides mouth care

Supplies: Emesis basin, tooth brush, tooth paste, cup, towel

Open Procedure, place supplies in clean surface w/ barrier, wash hands, gloves, privacy, wheels locked, bed up, rails down.

Raise head of bed if permissible, cover patient with towel, fill cup with water and place in surface with barrier, wet toothbrush and apply toothpaste. ask res to hold emesis basin underneath to the side of mouth. Brush the res teeth, inner, outer, and chewing surfaces of all upper and lower teeth. after each quadrant (ex: lower right, upper right. etc) allow the res to rinse with water and spit into emesis basin. Clean the res tongue, rinse and spit. Set aside, remove towel. cover res, ask if comfortable, give call light, wheels locked, bed down, rails up, undo privacy. dispose of towel into soiled linen cart, dump and rinse emesis basin and place into dirty supple area. Rinse toothbrush and place is designated storage area alongside toothpaste. Remove gloves, wash hands, report to chart that pt tolerated the procedure well.

Perineal Care

Supplies: 4 wash clothes, 2 towels, disposable chuck, basin, soap

Open Procedure, place supplies on clean surface, wash hands, gloves, privacy, wheels locked, bed up, rails down. Fill basin w/ water and check temp, ask res to check if temp ok. Place basin on flat surface on top of protective barrier. Place wash clothes in basin to soak. Ask res to lift hips and place chuck underneath. Place towel over upper legs and another towel over lower abdomen only exposing perineal area. Get wash cloth soap and lather. Expose labia and wash left side front to back, now with a different side of the cloth wash the right, different side then wash middle. Front to back for all sides. Put wash cloth in linen bag. Now rinse using same steps as above but without soap. Dispose of that cloth. Now pat dry. Assist res into side lying position using same steps. Get new wash cloth soap and lather. Clean left side of buttock front to back wiping away from perineal area and with different side of cloth clean other side, then middle with another side of the cloth. Dispose of wash cloth in linen bag. Rinse using same steps but without soap. dispose of wash cloth. Pat dry. Remove chuck and place aside. Remove gloves and wash hands and put on new gloves. assist patient back onto bed. remove towels, Cover res, ask if comfortable, give call light. wheels locked, bed down, rail up, undo privacy. dispose of soiled linen into soiled linen basket, dump and rinse basin 3 times and place in designated dirty supply area. remove gloves, wash hands and report to chart pt tolerated procedure well, no signs of infection.

Transfer from bed to W/C

Supplies: Nonskid socks, nonskid shoes, Gait belt.

Open procedure, place supplies in clean surface, wash hands, privacy, wheels locked, bed up rail down

Lock the wheels on wheelchair, and remove footrests.

Ask res if able to, to move close to your working side. Place nonskid socks and nonskid shoes on res. Assist res into seated position on side of bed. Ask if dizzy. lower bed until feet reach the floor. Put on gait belt. check for tightness with two fingers. Stand in front of res w/ wide stance and one foot in between res legs. ask res to place arms on shoulder and on the count of 3 to help lift up from the bed. in between counts rock them forward and back to prepare them for the standing up. after the count of 3 and lifting res up ASK IF DIZZY. Pivot patient until wheelchair is behind their legs. ask if they feel the wheelchair behind their legs. Ask res to hold onto wheelchair with one arm and the other on your shoulder and to sit on the count of 3. Once sat ask res to scoot back. remove gait belt. release wheel chair brakes. cover res, ask if comfortable and give call light. Ensure bed wheels are locked, lower bed and rails up, undo privacy. remove gloves, wash hands and report to chart that patient tolerated procedure well.

Measure and records manual BP

Supplies: Cuff, stethoscope

Open Procedure, place supplies in clean surface, wash hands, gloves, privacy, wheels locked, bed up, rails down.

Clean the stethoscope and BP Cuff. Place res in relaxed reclining position or sitting. Ask res which arm they prefer to use. Arm should be supported at heart level. Center bladder of BP cuff over the brachial artery with the lower margin 1” above the antecubital space (front elbow area) Fit the cuff evenly and snugly. Palpate the brachial artery in the antecubital space.

INFLATE CUFF to 160-180mmHG

Deflate cuff gradually until first sound is heard (systolic) and until the last sound is heard (diastolic). Deflate cuff completely and remove cuff from pt arm. Inform pt of BP reading.
Cleanse the stethoscope and BP cuff.

Cover res, ask if comfortable, give call light, wheels locked, bed down, rails up, undo privacy. remove gloves, wash hands and report to chart systolic and diastolic pressures with plus or minus 8 mm hg of evaluator’s reading.

Clean upper or lower dentures helen way

Supplies: emesis basin, tooth brush, tooth paste, 2 towels, denture cup

*wet gloves before removing dentures

Place dentures aside on emesis basin bc you will place then on res again

Lock wheels bed down rails up before leaving to wash dentures

Raise head of bed

Open procedure

Get supplies place on clean surface

Wash hands, gloves, privacy, wheels locked, bed up, rails down

Raise head of bed, place towel on chest of pt, ask res to take off dentures and place them on cup or you assist in removing dentures. WET GLOVES BEFORE removing dentures for preventing friction. Set dentures in cup aside. Lock wheels, bed down, rails up, give call light. Go wash dentures. Turn on sink, place towel under. Set emesis basin aside, wet tooth brush and apply toothpaste, rinse dentures and brush thoroughly all chewing surfaces and roof of dentures. Rinse dentures and place on emesis basin. Rinse and dump denture cup 3 times and fill with new cold water and set asid. Rinse toothbrush and set aside. Dispose of towel in laundry basket. Go back to res. Place supplies on side. Wheels locked, bed up, rails down. Wet gloves and get dentures and place on res. Remove towel from res. And cover, ask if comfortable, and give call light. Place denture cup in first drawer of bed stand. Place toothbrush and tooth paste in storage drawer. Rinse and dump emesis basin 3 times and place in designated dirty supply area. Dispose of towel into soiled linen basket. Remove gloves, wash hands, undo privacy and report to chart. Pt tolerated procedure well. No signs of infection.

Mouth care hellen way

Supplies: emesis basin, tooth brush, tooth paste, towel, cup w/ water

Open procedure, place supplies in clean surface, wash hands, gloves, wheels locked, bed up, rails down. Raise head of bed, place towel on res., wet tooth brush and begin brushing teeth, all surfaces and then tongue. Put tooth brush aside and ask res to hold emesis basin if able to and give cup of water to rinse and spit 3 times. Once done set aside and pat dry with towel. Lower head of bed, three c’s, wheels locked, bed down, rails up. Dispose of soiled linen into basket, wash tooth brush and place in designated storage area along with toothpaste, rinse and dump cup 3 times and put in designated dirty supply area, same for emesis basin. Remove gloves, wash hands, report to chart pt tolerated procedure well, no bleeding in gums