CNA Skills Stars

Washing Hands (3)

• rub hands together to create a lather for at least 20 seconds

• rinse all surfaces of hands and wrists. run water down from wrists to fingertips

• use clean, dry paper towel to dry all surfaces of hands, wrists, and fingers. dispose without touching trash

Removing Gloves (2)

• touch only the outside of one glove, pull off

• slip two fingers underneath and remove glove

Adbominal Thrust (3)

• ask “are you choking?”

• make a fist with one hand and place flat thumb side to abdomen above navel but below breastbone

• grasp fist and pull both hands toward you quickly and forcefully

Moving a Resident Up In Bed (3)

• place your feet 12" apart with thr foot at the top of the bed pointed in the direction you are moving the resident. keep back straight and bend at hips and knees

• place one arm under resident’s shoulders adn other under the hips

• tell the resident on the count of three to push against the mattress with feet and lift their hips. at the same time, move the resident up by shifting your weight from the foot at the bottom of the bed to the foot pointed toward the top

Moving a Resident Up In Bed - 2 Person (2)

• place your feet 12" apart with thr foot at the top of the bed pointed in the direction you are moving the resident. keep back straight and bend at hips and knees

• tell the resident and your coworker to lift on the count of three. With your back straight and on the count of three, lift the resident in the correct direction. avoid dragging the resident.

Turning a Resident (2)

• Away: place one hand under the shoulder and the other under the hip. keep your back straight, bending at the knees; smoothly roll the resident away from you

• Towards: place one hand on the far shoulder and the other hand on the far hip. keep your back straight, bending at the hips and knees; smoothly roll the resident toward you

Lateral Position - Towards (2)

• Towards: place one hand on the far shoulder and the other hand on the far hip. keep your back straight, bending at the hips and knees; smoothly roll the resident toward you

• Position the resident in good body alignment. visually evaluate teh resident to determine if they look comfortable

Passive Range of Motion Exercises (1)

• move all joints gently, smoothly, and snd slowly through the range of motion to the point of resistance. stop if any pain occurs. have the resident repeat each exercise three times.

Assisting a Resident to Ambulate (2)

• Hold the resident close to your center of gravity. provide instructions to allow resident to help with standing. Tell the resident to lean forward, push down on the bed with his hands, and stand on the count of three. When you start to count, begin to rock, On three, with hands still grasping the gait belt on both sides and moving upward, rock your weight onto your back foot. Slowly help resident to stand.

• Walk slightly behind patient on weak side while holding on to gait belt. use hand not holding gait belt to offer support on weak side. ask resident to look forward and not down.

Assisting to Ambulate - Cane/Walker (3)

• Place the cane in the unimpaired hand so the resident can grasp it.

• stand on the weak side slightly behind resident and grasp the back of the gait belt.

• instruct resident to place cane 6” in front of the stronger leg. have resident bring the weaker leg even with the cane. resident then brings stronger leg forward slightly ahead of the cane. repeat

Transferring from Bed to Wheelchair (4)

• lock bed wheels, assist to lowest position

• place the wheelchair at the foot of the bed, facing the head of the bed on their strong side or at the middle of the bed on their strong side. the arm shold almsot be touching the bed,.

• lock the wheels of the wheelchair

• place gait belt around the resident’s waist. tighten until snug. check no hair or skin folds are caught under the belt

Transferring from Wheelchair to Toilet (3)

• position wheelchair next to the toilet so teh resident will pivot on their strong side. lock the wheelchair and move footrests out of the way

• stand facing the resident with feet 12” apart. position your legs to block the resident’s legs from buckling while standing. Grasp the gait belt on both sides of the resident’s waist, keeping your back straight and bending at the hips and knees.

• pivot the resident on the strong side toward the toilet, keeping your back and the resident’s back straight. the resident’s legs should be centered in front of the toilet and they should be touching the front of the toilet.

Partial Bath (3) Armpits, Face, Hands, Perineal

• place the basin 2/3 full of water on overbed table. check the temperature (no more than 105 degrees) and have resident test water

• uncover only one part of the body at a time. place a towel underneath the body part being washed

• wash eyes with wet washcloth (no soap) using a different area of the washcloth for each eyes, washing inner to outer area. rinse and pat dry.

Complete Bed Bath (3)

• place the basin 2/3 full of water on bedside table. test water with thermometer or inside of your wrist and test with patient’s wrist. water should be no warmer than 105 degrees. change the water when it becomes to cool, soapy, or dirty.

• place a bath blanket over teh resident. ask resident to hold onto blanket while you remove top sheet. remove gown

• cover the resident with the blanket

Male Peri Care (5)

• place the basin 2/3 full of water on bedside table. test water with thermometer or inside of your wrist and test with patient’s wrist. water should be no warmer than 105 degrees. change the water when it becomes to cool, soapy, or dirty.

• cover the resident with a bath blanket without exposing them

• wet the washcloth in warm water, wring out, and apply soap. use a different section of teh washcloth for each stroke. fo not put the washcloth back into the basin of water. change washcloths as needed placing used cloths in separate plastic bag. never place dirty cloths on overbed table

• if resident is uncircumcised, gently return foreskin to normal position

• wash teh perineum and then the anal area with a soapy washcloth. work from front to back

Female Peri Care (5)

• place the basin 2/3 full of water on bedside table. test water with thermometer or inside of your wrist and test with patient’s wrist. water should be no warmer than 105 degrees. change the water when it becomes to cool, soapy, or dirty.

• cover the resident with a bath blanket without exposing them

• wet the washcloth in warm water, wring out, and form a mitt around hand with washcloth. use a different section of washcloth for each stroke.

• wipe only from front to back. use a different section of the washcloth each time.

• wash the perineum and then the anal area with a soapy washcloth. work from front to back

Providing Catheter Care (5)

• place the basin 2/3 full of water on bedside table. test water with thermometer or inside of your wrist and test with patient’s wrist. water should be no warmer than 105 degrees. change the water when it becomes to cool, soapy, or dirty.

• wet washcloth in basin, apply soap. clean area around meatus. use a clean area for each stroke

• clean at least four inches of the catheter tubing closest to meatus. move only in one direction

• dip a clean washcloth in the water. rinse area around meatus and pat dry

• dip a clean washcloth in the water. rinse at least four inches of catheter nearest the meatus. pat dry.

Emptying the Urinary Drainage Bag (3)

• OPen the clamp on the bag so that the urine flows out of the bag and into the graduate. do not let the spout or clamp touch teh graduate.

• when the urine has drained from the bag, close clamp. using alcohol wipes, clean the drain spout. place spout back in its spot.

• go to the bathroom and place the graduate on a flat surface and measure at eye level. note the amount an dcharacteristics of urine. empty into toilet and flush

Measuring and Recording Blood Pressure (3)

• locate brachial pulse

• open the valve, deflate cuff completely

• record both the systolic and diastolic pressures like a fraction and which arm was used

Dressing a Resident (3)

• place a bath blanket over the resident. Ask her to hold onto it as your remove or fold back the top bedding to the foot of the bed. Remove resident’s gown. Keep resident covered with bath blanket. Remove clothes from stronger side when undressing. Then remove weaker side. Place gown in proper container.

• Help resident top on top. If it goes over the head, slide teh top over the headfirst then weak, strong side. Help resident lean forward and smooth their back. If the top fastens from the front, slide your hand into the sleeve and grasp resident’s hand and pull through weak, then strong. Smooth and fasten top.

• Roll one sock over the weaker foot. Mkae sure the heel is over the heel of the foot. Make sure there are no twists or wrinkles in the sock after it is on. Repeat for other foot.

Undressing a Resident (2)

• Start with top/shirt. If it fastens in the front, slide garment off with strong side first. Bring garment over to the impaired side and slide off the weak arm. Raise the. head of teh bed. If the shirt is pull over, remove shirt from strong side and bring garment up to the neck.

• Ask resident to lift their hips and gently slide pants and undergarments down the legs. If the resident cannot lift their hips, roll the person from side to side to remove pants.

Applying of Elastic Support Stockings (1)

• Make sure there are no wrinkles or twists in the stokcing after it is on. It must mit smoothly. Make sure heel of the stocking is over the heel of the foot. If the stocking has an opening in the toe area, make sure the opening is either over or under the toe area. This depends on manufacturer’s instruction. Adjust if needed.

Changing Incontinent Briefs (2)

• Perform peri care, cover resident with towel.

• Remove brief, rolling it inside itself. dispose of teh brief according to company policy.

Assisting Independent Resident with a Bedpan (2)

• Place bed protector under resident’s buttocks and hips. Slide the bedpan in the correct position under the hips. Fracture pan is handle facing the end of the bed.

• Remove bedpan carefully and cover it.

Assisting Dependent Resident with Use of a Bedpan (2)

• Turn the resident so their back is towards you. Place bed protector and bedpan down against buttocks, push bedpan down as you turn resident back towards you.

• While holding the bedpan flat, roll resident off the bedpan and cover.

Assissting Male Resident with Urinal (2) *no bath blanket

• Hand the urinal to the resident. If the resident cannot hold it himself, place urinal between the legs and insert penis. Replace the covers

• Raise the bed of the bed, return bed to lowest position. Place disposable wipes within the resident’s reach. Ask resident to clean his hands with the hand wipe when finished if able.

Assisting Dependent Resident with Dining (2)

• Look at the diet card and ask resident to state their name and check with ID band. Verify resident has received the correct tray.

• Check the temperature of food with hand, cut into bit sized pieces, tell resident what you are feeding them, feed them a variety of food, do not feed all of one type at once, make sure mouth is clear, and report any changes or difficulty in swallowing to nurse.

Making an Unoccupied Bed (2)

• remove and discard gloves. wash your hands

• plave top sheet and blanket over bed. Center these and tuck under bed and make hospital corners. Fold down top sheet about 6 inches. Fan fold both top sheet and blanket down so resident can easily get into bed. If the resident will not be returning immeadiately, leave bedding up.

Making an Occupied Bed (4)

• Raise side rail nearest you. Go to other side and lower side rails. Help resident roll over to the other side away from you. Protect resident from soiled linens.

• Loosen any soiled linens from top to bottom. CHECK FOR PERSONAL ITEMS. Avoid contact with your skin or clothes. Place in hamper. Do not shake because they are filled with microorganisms.

• Place a bedspread over the top sheet. Match top edges. Tuck the bottom edges of the top sheet, blanket, and bedspread under the foot of the bed. Make hospital corners. Loosen linens above the feet. Fold top sheet down 6 inches.

• Remove and discard gloves

Measuring and Recording Oral Temperature (2)

• Put on disposable sheath. Wait until ready sign appears.

• Remove the thermometer, read temperature, and remember reading

Counting and Recordign Radial Pulse (2)

• Place the tips of your index and middle finger on the thumb side of the resident’s wrist. Locate radial pulse.

• Count beats for one full minute.

Counting and Recording Respirations (2)

• Count the number of respriations for one full minute. If you see signs of troubled, shallow, or noisy breather, such as wheezing, report to nurse.

• Place call light within reach

Giving a Back Rub (2)

• Place hands on either side of the spine, above the patient’s buttocks. Use full palm of each hand to make long, smooth, upward strokes around the patients back adn shoulders. Repeat this heart motion for 3-5 minutes without lifting hands

• Gently massage bony areas using circular motions of your fingertips. Use little or no pressure. If any of these areas are white, red, or purple, do not massage and report.

Providing Oral Care (responsive) (2)

• If resident is in bed, lock bed and raise rails. Raise the head of the bed to sitting position.

• Clean entire mouth starting on top teeth, moving from inner to outer, reaching the gumline and the chewing surfaces. Repeat for the bottom. Brush the tongue.

Providing Oral Care (Unresponsive) (2)

• Dip swab in cleaning solution. Squeeze excess solution to prevent aspiration. Wipe teeth, gums, tongue, and inside surfaces of the mouth. Change swab often and repeat.

• Rinse with clen swab dipped in water. Squeeze to remove excess water.

Cleaning and Storing Dentures (2)

• Brush dentures on all surfaces including inner, outer, and chewing surfaces of dentures as well as the groove touching the gums.

• Place dentures in clean case filled with cool water and a denture cleaning tablet. Place lid on cup and return to storage based on resident name. If resident wants to wear dentures now, do not place in solution and give to resident.

Providing Fingernail Care (2)

• Fill the basin halfway with warm water. Test with your wrist and patients wrist no warmer than 105 degrees. Place at a comfortable level for resident.

• Wipe orangewood stick on towel after each pass for each finger. Wash and dry hands, especially between fingers

Shaving a Resident (2)

• Clean razor head with a brush. Do not shave a resident if there is water or oxygen present, or if the resident has a pacemaker.

• Turn on the razor and pull skin taut. Shave in the direction of hair growth and go back and forth if it’s a foil razor and in circular motions if it’s a three head shaver. Shave the chin and under the chin.