Headmaster Skill Procedures

Which procedures is hand washing required?

Bedpan, catheter care, urinary bag, and perineal care

What are the first five steps to applying anti embolic stockings?

1. Perform hand hygiene with hand sanitizer

2. Explain the procedure to the resident

3. Raise the bed

4. Provide for privacy using a curtain

5. Provide for the privacy of the resident by only exposing one leg

What are steps 6-10 for applying anti embolic stockings?

6. Roll, gather, or turn the stocking down inside out to the heel

7. Place the stocking over the resident’s toes, foot, and heel

8. Roll or pull the stockings up the leg

9. Check toes for possible pressure from the stocking

10. Adjust the stocking as needed

What are steps 11-15 for applying anti embolic stockings?

11. Run hands over stocking to ensure it is wrinkle free

12. Lower the bed

13. Maintain respectful, courteous interpersonal interactions at all times

14. Place the call light within reach

15. Apply hand sanitizer

What are steps 1-5 for assisting a resident to ambulate using a gait belt?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Obtain a gait belt for the resident

4. Lock the bed brakes to ensure the resident’s safety

5. Lock the wheelchair brakes to ensure the resident’s safety

What are steps 6-15 for assisting a resident to ambulate using a gait belt?

6. Position the bed so the resident’s feet will rest comfortably flat on the floor when sitting on the bed

7. Bring the resident to a sitting position with the resident’s feet flat on the floor

8. Properly place the gait belt around the resident’s waist to stabilize the trunk

9. Tighten the gait belt

10. Check the gait belt for tightness by slipping fingers between the gait belt and the resident

11. Assist the resident in putting on non-skid footwear BEFORE standing

12. Bring the resident to a standing position

13. Use proper body mechanics at all times

14. Grasp the gait belt

15. Stabilize the resident

What are steps 16-22 for assisting a resident to ambulate using a gait belt?

16. Ambulate the resident for at least ten steps

17. Assist the resident to pivot/turn

18. Sit the resident in the wheelchair in a controlled manner that ensures safety at all times

19. Remove the gait belt

20. Maintain respectful, courteous interpersonal interactions at all times

21. Place the call light within reach

22. Apply hand sanitizer

What are steps 1-5 for assisting a resident who is dependent with a meal?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Ask the resident to state their name and verify the name matches the name on their diet card

4. Position the resident in an upright position, at least 45 degrees

5. Protect the resident’s clothing from soiling using a napkin, clothing protector, or towel

What are steps 6-15 for assisting a resident who is dependent with a meal?

6. Provide hand hygiene for the resident with hand sanitizer BEFORE feeding

7. Position yourself at eye level, facing the resident while assisting the resident with their meal

8. Describe the food being offered to the resident

9. Offer each fluid frequently

10. Offer small amounts of food at a reasonable rate

11. Allow the resident time to chew and swallow

12. Wipe the resident’s face during the meal at least once (The actor will say “I’m full,” before all the solid food and fluids are gone)

13. Leave the resident clean

14. Leave the resident in bed with the head of the bed set up to at least 30 degrees

15. Record your intake as a percentage of the total solid food eaten on the previously signed recording form

What are steps 16-21 for assisting a resident who is dependent with a meal?

16. The candidates calculation must be within 25 percentage points of the RN test observer’s

17. Record the sum total of the estimated fluid intake on the previously signed recording form

18. The candidate’s calculation must be within 60mls of the RN test observer’s

19. Maintain respectful, courteous interpersonal interactions at all times

20. Place the call light within reach

21. Apply hand sanitizer

What are steps 1-10 for assisting a resident with a bedpan?

1. Knock

2. Introduce yourself to the resident

3. Apply hand sanitizer

4. Explain the procedure to the resident

5. Provide for privacy using a curtain

6. Put on gloves

7. Turn the resident or raise the resident’s hips and place a barrier under the resident’s buttocks

8. Position the resident on the bedpan/fracture pan correctly

9. Position the resident on the bedpan/fracture pan using correct body mechanics

10. Raise the head of the bed to a comfortable level

What are steps 11-20 for assisting a resident with a bed pan?

11. Leave the call light within reach

12. Move to an area of the room away from the actor

13. When the RN test observer indicates, the candidate returns

14. Gently remove the bed pan/fracture pan (hold the bedpan/fracture pan while the RN test observer pours liquid into the bedpan/fracture pan)

15. Empty the equipment used in the designated toilet

16. Rinse the equipment and empty the rinse water into the designated toilet

17. Safely remove the barrier from under the resident’s buttocks

18. Remove gloves, turning them inside out

19. Dispose of gloves in an appropriate container

20. Maintain respectful, courteous interpersonal interactions at all times

What are steps 21-33 for assisting a resident with a bedpan?

21. Place the call light within reach

22. Wash hands: Begin by wetting your hands

23. Apply soap to hands

24. Rub hands together using friction with soap

25. Rub hands together for at least 20 seconds

26. Interlace fingers pointing downwards

27. Wash all surfaces of your hands with soap

28. Wash wrists with soap

29. Rinse hands thoroughly under running water with fingers pointing downwards

30. Dry hands with a clean paper towel(s)

31. Turn off the faucet with a clean, dry paper towel

32. Discard paper towels sin a trash container as used

33. Do not recontaminate hands by touching the faucet or sink at any time during/after the hand-washing procedure

What are steps 1-10 for catheter care for a female resident?

1. Knock

2. Introduce yourself to the resident/manikin

3. Apply hand sanitizer

4. Explain the procedure to the resident/mainkin

5. Provide for privacy using a curtain

6. Put on gloves

7. Avoid overexposure throughout the procedure

8. Check that urine can flow unrestricted into the drainage bag

9. Use a clean washcloth, soap, and water, to carefully wash the catheter where it exits the urethra

10. Use a clean washcloth to carefully rise the catheter where it exits the urethra

What are steps 11-290 for catheter care for a female resident?

11. Hold the catheter where it exits the urethra with one hand

12. While holding the catheter, use a clean washcloth, soap, and water, or a clean portion of the washcloth, and clean 3-4 inches down the catheter tube for each stroke

13. Clean with strokes only away from the urethra (at least two strokes)

14. Rinse using a clean washcloth with strokes only away from the urethra

15. Rinse using a clean portion of the washcloth for each stroke

16. Pat dry

17. Do not allow the tube to be pulled during the procedure

18. Replace the top cover over the resident

19. Leave the resident in a position of safety and comfort

20. Place the call light within reach

What are steps 21-33 for catheter care for a female resident?

21. Maintain respectful, courteous interpersonal interactions at all times

22. Wash hands:Begin by wetting your hands

23. Apply soap to hands

24. Rub hands together using friction with soap

25. Rub hands together for at least 20 seconds

26. Interlace fingers pointing downward

27. Wash all surfaces of your hands with soap

28. Wash wrists with soap

29. Rings hands thoroughly under running water with fingers pointed downward

30. Dry hands with a clean paper towel(s)

31. Turn of the faucet with a clean, dry paper towel

32. Discard paper towels in a trash container as used

33. Do not recontaminate hands by touching the faucet or sink at any time during/after the hand washing procedure

What are steps 1-12 for upper or lower denture care?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Line the bottom of the sink with a protective lining that would help prevent damage to the denture (Towels, wash clothes, or paper towels are allowed for lining)

4. Put on gloves

5. Apply denture cleanser to a denture brush/toothbrush

6. Remove the denture from the cup

7. Handle the denture carefully to avoid damage

8. Handle the denture carefully to avoid contamination

9. Thoroughly brush the denture inner surfaces

10. Thoroughly brush the denture outer surfaces

11. Thoroughly brush the denture chewing surfaces

12. Rinse the denture using clean, cool water

What are steps 13-22 for upper or lower denture care?

13. Place the denture in the rinsed cup

14. Add cool, clean water to the denture cup

15. Rinse equipment (denture brush or toothbrush)

16. Return equipment to storage

17. Discard the protective lining in an appropriate container

18. Remove gloves, turning them inside out

19. Dispose of gloves in an appropriate container

20. Maintain respectful, courteous interpersonal interactions at all times

21. Place the call light within reach

22. Apply hand sanitizer

What are steps 1-15 for donning an isolation gown and gloves to empty a urinary bag, measuring and recording output, and doffing gown and gloves?

1. Apply hand sanitizer

2. Face the back opening of the gown

3. Unfold the gown

4. Place arms through each sleeve

5. Secure the neck opening

6. Secure the waist, ensuring the back flaps cover clothing as completely as possible

7. Put on gloves

8. Ensure the gloves overlap the gown sleeves at the wrist

9. Knock

10. Introduce yourself to the resident

11. Explain the procedure to the resident

12. Place a barrier on the floor under the drainage bag

13. Place the graduate on the previously placed barrier

14. Open the drain to allow the urine to flow into the graduate

15. Avoid touching the graduate with the tip of the tubing

What are steps 16-30 for donning an isolation gown and gloves to empty a urinary bag, measuring and recording output, and doffing gown and gloves

16. Close the drain

17. Wipe the drain with an alcohol wipe AFTER emptying the drainage bag

18. Replace the drain in the holder

19. Place the graduate on a level, flat surface

20. With the graduate at eye level, read the output

21. Empty the graduate into the designated toilet

22. Rinse equipment, emptying the rinse water into the designated toilet

23. Return equipment to storage

24. Leave the resident in a position of comfort and safety

25. Place the call light within reach

26. Maintain respectful, courteous interpersonal interactions at all times

27. Remove gloves, turning them inside out

28. Remove gloves before removing the gown

29. Dispose of the gloves in an appropriate container

30. Unfasten the gown at the waist

What are steps 31-47 for donning an isolation gown and gloves to empty a urinary bag, measuring and recording output, and doffing the gown and gloves?

31. Unfasten the gown at neck

32. Remove the gown by folding the soiled area to the soiled area

33. Dispose of the gown in an appropriate container

34. Record the output in ml on the previously signed recording form

35. The candidate’s recorded measurement is within 25mls of the RN test observer’s pre-measured amount

36. Wash hands: Begin by wetting your hands

37. Apply soap to hands

38. Rub hands together using friction with soap

39. Rub hands together for at least 20 seconds

40. Interlace fingers pointing downward

41. Wash all surfaces of hands with soap

42. Was wrists with soap

43. Rinse hands thoroughly under running water with fingers pointed downward

44. Dry hands with a clean paper towel(s)

45. Turn off the faucet with a clean, dry paper towel

46. Discard paper towels in a trash container as used

47. Do not recontaminate hands by touching the faucet or sink at any time during/after the hand-washing procedure

What are steps 1-18 for dressing a bedridden resident with an affected side?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Provide for privacy using a curtain

4. Raise the bed height

5. Keep the resident covered while removing the gown

6. Remove the gown from the resident’s unaffected side first

7. Place the soiled gown in a designated laundry hamper

8. Dress the resident in a button-up shirt. Insert your hand through the shirt sleeve and grasp the resident’s hand

9. When dressing the resident in a button-up shirt, always start dressing form the resident’s weak side

10. Assist the resident to raise their buttocks or turn the resident from side to side and draw the pants over the buttocks and up to the resident’s waist

11. When dressing the resident in pants, always dress the resident’s weak side leg first

12. Put on the resident’s non-skid socks. Draw the socks up the resident’s foot until they are smooth

13. Leave the resident comfortably/properly dressed

14. Leave the resident in a position of safety

15. Lower the bed

16. Maintain respectful, courteous interpersonal interactions at all times

17. Place the call light within reach

18. Apply hand sanitizer

What are steps 1-15 for providing foot care for one foot?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Fill a basin with warm water

4. Put on gloves

5. Remove the sock from the resident’s left/right foot (the scenario read to you will specify left or right)

6. Immerse the resident’s foot in warm water (you must verbalized the 5-20 minutes of soaking time after you begin soaking the foot)

7. Use water and a soapy washcloth

8. Wash the resident’s entire foot

9. Wash between the resident’s toes

10. Rinse the resident’s entire foot (A soapy washcloth dipped in the basin and wrung out is okay for rinsing)

11. Rinse between the resident’s toes

12. Dry the resident’s foot thoroughly

13. Dry thoroughly between the resident’s toes

14. Warm lotion by rubbing it between your hands

15. Massage lotion over the resident’s entire foot

What are steps 16-29 for providing foot care for one foot

16. Avoid getting lotion between the resident’s toes

17. If there is any excess lotion, wipe it with a towel

18. Replace the sock on the resident’s foot

19. Empty basin

20. Rinse basin

21. Dry basin

22. Return the basin to the storage area

23. Place the soiled linen in a designated laundry hamper

24. Remove gloves, turning them inside out

25. Dispose of gloves in an appropriate container

26. Leave the resident in a position of safety and in proper alignment in the chair

27. Maintain respectful, courteous interpersonal interactions at all times

28. Place the call light within reach

29. Apply hand sanitizer

What are steps 1-15 for providing a modified bed bath for a resident?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Provide for privacy using a curtain

4. Fill a basin with warm water

5. Raise the bed height

6. Cover the resident’s left with a bath blanket

7. Fanfold the bed linens at least down to the resident’s waist or move the linens to the opposite side

8. Remove the resident’s gown without exposing the resident

9. Place the soiled gown in a designated laundry hamper

10. Wash the residents face without soap

11. Pat dry the resident’s face

12. Place a towel under the resident’s arm, exposing one arm

13. Wash the resident’s arm with soap

14. Wash the resident’s hand with soap

15. Wash the resident’s underarm with soap

What are steps 16-31 for providing a modified bed bath for a resident?

16. Rinse the resident’s arm

17. Rinse the resident’s hand

18. Rinse the resident’s underarm

19. Pat dry the resident’s arm

20. Pat the resident’s hand dry

21. Pat dry the resident’s underarm

22. Assist the resident in putting on a clean gown

23. Empty the equipment

24. Rinse equipment

25. Dry equipment

26. Return equipment to storage

27. Place the soiled linen in a designated laundry hamper

28. Lower the bed

29. Maintain respectful, courteous interpersonal interactions at all times

30. Place the call light within reach

31. Apply hand sanitizer

What are steps 1-15 for providing oral care?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Provide for privacy using a curtain

4. Put on gloves only AFTER supplies have been gathered

5. Drape the resident’s chest with a towel to prevent soiling

6. Wet a toothbrush

7. Apply toothpaste to the toothbrush

8. Brush the resident’s teeth, including the inner surface of all upper and lower teeth, while verbalizing the surfaces you clean

9. Brush the resident’s teeth, including the outer surface of all upper and lower teeth, while verbalizing the surfaces you clean

10. Brush the resident’s teeth, including the chewing surfaces of all upper and lower teeth, while verbalizing the surfaces you clean

11. Clean the resident’s younger

12. Assist the resident in rinsing their mouth

13. Wipe the resident’s mouth

14. Remove the soiled chest barrier

15. Place the soiled chest barrier in the appropriate container

What are steps 16-26 for providing oral care?

16. Empty the emesis basin

17. Rinse the emesis basin

18. Dry emesis basin

19. Rinse the toothbrush

20. Return equipment to storage

21. Remove gloves, turning them inside out

22. Dispose of gloves in an appropriate container

23. Leave the resident in a position of comfort

24. Place the call light within reach

25. Maintain respectful, courteous interpersonal interactions at all times

26. Apply hand sanitizer

What are steps 1-15 for providing perineal care for a female resident?

1. Knock

2. Introduce yourself to the resident/manikin

3. Apply hand sanitizer

4. Explain the procedure to the resident/manikin

5. Provide for privacy using a curtain

6. Raise the bed height

7. Fill a basin with warm water

8. Put on gloves

9. Direct the RN test observer to stand on the opposite side of the bed or raise the side rail on the opposite side of the bed

10. Turn the resident or raise the resident’s hips and place a barrier (The candidate will choose a barrier such as a towel, waterproof pad, chug, etc.) under the resident’s buttocks

11. Expose the perineum only

12. Separate the labia

13. Use water and a clean, soap washcloth

14. Clean one side of the labia from top to bottom

15. Use a clean portion of a washcloth and clean the other side of the labia from top to bottom

What are steps 16-35 for providing perineal care for a female resident?

16. Use a clean portion of the washcloth, and clean the vaginal area from top to bottom

17. Use a clean washcloth and rinse one side of the labia from top to bottom

18. Use a clean portion of a washcloth, and rinse the other side of the labia from top to bottom

19. Use a clean portion of the washcloth, rinse the vaginal area from top to bottom

20. Pat dry

21. Avoid overexposure throughout the procedure

22. Assist the resident/manikin to turn onto their side away from the candidate

23. Use water and a clean, soapy washcloth

24. Clean from the vagina to the rectal area

25. Use a clean portion of the washcloth with any stroke

26. Pat dry

27. Safely remove the barrier from under the resident’s buttocks

28. Position the resident (manikin) on their back

29. Place the soiled linen in a designated laundry hamper

30. Empty the equipment

31. Rinse equipment

32. Dry equipment

33. Return equipment to storage

What are steps 36-52 for providing perineal care for a female resident?

36. Remove gloves, turning them inside out

37. Dispose of gloves in an appropriate container

38. Lower the bed

39. Maintain respectful, courteous interpersonal interactions at all times

40. Place the call light within reach

41. Wash hands: Begin by wetting your hands

42. Apply soap to hands

43. Rub hands together using friction with soap

44. Rub hands together for at least 20 seconds

45. Interlace fingers pointing downward

46. Wash all surfaces of your hands with soap

47. Wash wrists with soap

48. Rinse hands thoroughly under running water with fingers pointed downward

49. Dry hands with a clean paper towel(s)

50. Turn off the faucet with a clean, dry paper towel

51. Discard paper towels in a trash container as used

52. Do not recontaminate hands by touching the faucet or sink at any time during/after the hand-washing procedure

What are steps 1-15 for positioning a resident on their side?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Provide for privacy using a curtain

4. Position the bed flat

5. Raise the bed height

6. Raise the side rail or direct the RN test observer to stand on the side of the bed opposite the working side of the bed to provide safety

7. Move the resident’s body toward yourself from the working side of the bed

8. Assist/turn the resident’s body toward onto their left/right side (the RN test observer will read the side to the candidate in the scenario)

9. Ensure the resident’s face is never obstructed by the pillow

10. Check to ensure the resident’s face is not lying on their down side arm

11. Ensure the resident is in the center of the bed

12. Ensure the resident is in correct body alignment

13. Place support devices under the resident’s head

14. Place support devices under the resident’s upside arm

15. Place support devices behind the resident’s back

What are steps 16-21 for positioning a resident on their side?

16. Place support devices between the resident’s knees

17. Leave the resident in a position of safety and comfort

18. Lower the bed

19. Maintain respectful, courteous interpersonal interactions at all times

20. Place the call light within reach

21. Apply hand sanitizer

What are steps 1-15 for range of motion for a resident’s hip and knee?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Do not cause the resident discomfort or pain anytime during ROM

4. Raise the bed height

5. Provide for privacy using a curtain

6. Position the resident supine

7. Position the resident in good body alignment

8. Place one hand under the resident’s knee

9. Place the other hand under the resident’s ankle

10. ROM for hip: Move the resident’s entire leg away from their body (Abduction)

11. Move the resident’s entire leg toward their body (Adduction)

12. Complete abduction and adduction of the resident’s hip at least three times

13. Continue correctly supporting the resident’s joints by placing one hand under the resident’s knee and the other hand under the resident’s ankle

14. Bend the resident’s knee and hip toward the resident’s trunk (Flexion of the hip and knee at the same time)

15. Straighten the resident’s knee and hip (extension of the knee and hip at the same time)

What are steps 1-15 for range of motion for a resident’s shoulder?

1. Apply hand sanitizer

2. Explain the procedure to the resident

3. Do not cause the resident discomfort or pain at any time during ROM

4. Provide privacy using a curtain

5. Raise the bed height

6. Position the resident supine

7. Position the resident in good body alignment

8. Place one hand under the resident’s elbow

9. Place the other hand under the resident’s wrist

10. Raise the resident’s arm over the resident’s head(flexion)

11. Bring the resident’s arm back down to the resident’s side(extension)

12. Complete flexion and extension of the resident’s shoulder at least three times