20 Skills for NNAAP Exam

These are the outlines steps for each of the 20 skills that could possibly be given on 07/31.

Skill 1 - Hand Hygiene (Hand Washing)

1. Addresses client by name and introduces self to client by name.

2. Turns on water at sink

3. Wets hands and wrists thoroughly

4. Applies soap to hands

5. Lathers all surfaces of wrists, hands, and fingers producing friction, for at least 20 seconds, keeping hands lower than elbows and fingertips down.

6. Cleans fingernails by rubbing fingertips against palms of the opposite hand

7. Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down.

8. Uses clean, dry paper towel/towels to dry all surfaces of fingers, hands, and wrists starting at fingertips then disposes of paper towel/towels into waste container.

9. Uses clean, dry paper towel/towels to turn off faucet then disposes of paper towel/towels into waste container or uses knee/foot control to turn off faucet

10. Does not touch inside of sink at any time.

Skill 2 - Applies One Knee-High Elastic Stocking

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Provides privacy with a curtain, screen, or door.

3. Client is in supine position (lying down in bed) while stocking is applied.

4. Turns stocking inside-out, at least to the heel.

5. Places foot of stocking over toes, foot, and heel.

6. Pulls top of stocking over foot, heel, and leg.

7. Moves foot and leg gently and naturally, avoiding force and over-extension of limb and joints.

8. Finishes procedure with no twists or wrinkles and heel of stocking. If present, is over heel and opening in toe area (if present) is either over or under toe area; if using a mannequin, candidate may state stocking needs to be wrinkle-free.

9. Signaling device is within reach and bed is in low position.

10. After completing skill, washes hands.

Skill 3 - Assists to Ambulate Using Transfer Belt

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Provides privacy with a curtain, screen, or door.

3. Before assisting to stand, client is wearing non-skid shoes/footwear.

4. Before assisting to stand, bed is at a safe level.

5. Before assisting to stand, checks and/or locks bed wheels.

6. Before assisting to stand, client is assisted to sitting position with feet flat on the floor.

7. Before assisting to stand, applies transfer belt securely at the waist over clothing/gown.

8. Before assisting to stand, provides instructions to enable to client to assist in standing including prearranged signal to alert client to begin standing.

9. Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing.

10. On signal, gradually assists client to stand by grasping transfer belt on both sides with upward grasp (candidate’s hands are in upward position) and maintaining stability of client’s legs by standing knee to knee, or toe to toe with client.

11. Walks slightly behind and to one side of client for a distance of 10 feet, while holding onto the belt.

12. Assists client to bed and removes transfer belt.

13. Signaling device is within reach and bed is in low position.

14. After completing skill, washes hands.

Skill 4 - Assists With Use of Bedpan

1. Explains procedure speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Provides privacy with a curtain, screen, or door.

3. Before placing bedpan, lowers head of bed.

4. Puts on clean gloves before placing bedpan under client.

5. Places bedpan correctly under client’s buttocks.

6. Removes and disposes of gloves (without contaminating self) into waste container and washes hands.

7. After positioning client on bedpan and removing gloves, raises head of bed.

8. Toilet tissue is within reach.

9. Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished.

10. Signaling device within reach and client is asked to signal when finished.

11. Puts on clean gloves before removing bedpan.

12. Lowers head of bed before bedpan is removed.

13. Ensures client is covered except when placing and removing bedpan.

14. Empties and rinses bedpan and pours rinse into toilet.

15. Places bedpan in designated dirty supply area.

16. Removes and disposes of gloves (without contaminating self) into waste container and washes hands.

17. Signaling device is within reach and bed is in low position.

Skill 5 - Cleans Upper or Lower Denture

1. Puts on clean gloves before handing denture.

2. Lines bottom of sink and/or partially fills sink with water before denture is held over sink.

3. Rinses denture in moderate temperature running water before brushing them.

4. Applies denture toothpaste to toothbrush.

5. Brushes all surfaces of denture.

6. Rinses all surfaces of denture under moderate temperature running water.

7. Rinses denture cup and lid.

8. Places denture in denture cup with moderate temperature water/solution and places lid on cup.

9. Rinses toothbrush and places in designated toothbrush basin/container.

10. Maintains clean technique with placement of toothbrush and denture.

11. Appropriately removes and disposes of sink liner and/or drains sink/

12. Removes and disposes of gloves (without contaminating self) into waste container and washes hands.

Skill 6 - Counts and Records Radial Pulse

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Places fingertips on thumb side of client’s wrist to locate radial pulse.

3. Count beats for one full minute.

4. Signaling device is within reach.

5. Before recording, washes hands.

6. Records pulse rate within plus or minus 4 beats of evaluator’s reading.

Skill 7 - Counts and Records Respirations

1. Explains procedure (for testing purposes), speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Counts respirations for one full minute.

3. Signaling device is within reach.

4. Before recording, washes hands.

5. Records respiration rate within plus or minus 2 breaths of evaluator’s reading.

Skill 8 - Donning and Removing PPE (Gown and Gloves)

1. Picks up gown and unfolds.

2. Facing the back opening of the gown, places arms through each sleeve.

3. Fastens the neck opening.

4. Secures gown at waist making sure that back of clothing is covered by gown ( as much as possible).

5. Puts on gloves.

6. Cuffs of gloves overlap cuffs of gown.

7. Before removing gown, with one gloved hand, grasps the other glove at the palm, remove glove.

8. Slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed.

9. Disposes of gloves into designated waste container without contaminating self.

10. After removing gloves, unfastens gown at waist and neck.

11. After removing gloves, removes gown without touching outside of gown.

12. While removing gown, holds gown away from body without touching the floor, tuns gown inward and keeps it inside out.

13. Disposes of gown in designated container without contaminating self.

14. After completing skill, washes hands.

Skill 9 - Dresses Client with Affected (Weak) Right Arm

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Provides privacy with a curtain, screen, or door.

3. Asks which shirt he/she would like to wear and dresses him/her in shirt of choice.

4. Avoids overexposure of client by ensuring client’s chest is covered.

5. Removes gown from the left (unaffected) side first then removes gown from the right (affected/weak) side.

6. Before dressing client, disposes of gown into soiled linen container.

7. Assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on left (affected) arm.

8. While putting on shirt, moves body gently and naturally, avoiding force and over-extension of limbs and joints.

9. Finishes with clothing in place.

10. Signaling device is within reach and bed is in low position.

11. After completing skill, washes hands.

Skill 10 - Feeds Client Who Cannot Feed Self

1. Explains procedure to client, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

2. Before feeding, looks at name card on tray and asks client to state their name.

3. Before feeding client, client is in an upright sitting position (75-90 degrees).

4. Places tray where the food can be easily seen by client.

5. Cleans client’s hands before beginning feeding.

6. Sits in a chair facing client during feeding.

7. Tells client what foods and beverages are on tray.

8. Asks client what he/she would like to eat first.

9. Using spoon, offers client one bite of each type of food on tray, telling client the content of each spoonful.

10. Offers beverage at least once during meal.

11. Candidate asks client if they are ready for next bite of food or sip of beverage,

12. At end of meal, candidate cleans client’s mouth and hands.

13. Removes food tray.

14. Leaves client in upright sitting position (75-90 degrees) with signaling device within client’s reach.

15. After completing skills, washes hands.