CNA Skills

What do all skills start with?

• All start with hand hygiene; hand sanitizer

What are the 4 skills that require hand washing when completing?

1. Assist resident with use of Bedpan, Measure and Record Urine Output

2. Catheter Care for Female

3. Donn PPE, Empty a Urinary Drainage Bag, Measure and Record Urine Output, Remove PPE

4. Perineal care for female

What are the basic steps to Applying a Knee High Anti-Embolic Stocking to Resident’s Leg?

1. Perform Hand Hygiene

2. Introduce yourself and explain procedure to resident

3. Provide Privacy

4. Raise bed height to your arm level

5. Only expose one leg

6. Grab stocking and scrunch it up to place it on the person’s foot

7. Roll the stocking all the way up the leg, above the knee

8. Ensure the stocking is wrinkle free

9. Lower bed

10. Give them the call light

11. Ask if they need anything else

12. Perform hand hygiene (handwashing

What materials do you need for Applying Knee High Embolic Stockings?

• Stocking

• Hand sanitizer

What materials do you need for Assisting a Dependent Resident with a Meal in Bed?

• Food; solid and fluid

• Napkin

• Utensils

What are the basic steps to Assisting a Dependent Resident with a Meal in Bed?

1. Perform Hand Hygiene

2. Introduce yourself and explain procedure to resident

3. Ask resident to verify their name to match the meal card

4. Position the resident in an upright position, at least 75-90 degrees

5. Protect clothing from soiling with napkin

6. Allow resident to perform hand hygiene before eating; using hand sanitizer or washcloth

7. Describe each food or fluid being given to resident

8. With each bite of food, give resident a sip to drink

9. Record intake as a percentage of total solid food eaten on recording form

10. Calculation must be within 25 percent

11. Record estimated intake as the sum total fluid in mLs

12. Calculation must be within 30 mLs

13. Give resident call light

14. Ask if they need anything else

15. Perform hand hygiene

What materials do you need for Assisting a Resident to Ambulate using a Gait Belt?

• Gait Belt

• Nonslip shoes

• Wheelchair

What are the basic steps to Assisting a Resident Ambulate using a Gait Belt

1. Perform hand hygiene

2. Introduce yourself and explain the procedure (ask consent)

3. Obtain a gait belt

4. Put on non-skid shoes

5. Lower bed to where residents feet lay flat on the floor

6. Place wheelchair on the end of the bed

7. Lock bed brakes

8. Lock wheelchair

9. Bring resident in sitting position

10. Tie gait belt around resident’s waist and tighten it

11. Grasp the gait belt and bring resident to a standing position

12. Assist resident to walk for at least 10 steps to the wheelchair (in a circle)

13. Assist resident to sitting in wheelchair

14. Remove gait belt

15. Give resident the call light

16. Ask if they need anything else

17. Perform hand hygiene

What materials do you need for Assisting a Resident with the use of a Bedpan, Measure and Record Urine Output?

• Bedpan

• Urine container

• Warm basin or hand sanitizer

• Tissue

• Waterproof pad

What are the basic steps to Assisting a Resident with use of a Bedpan, Measuring and Recording Urine Output, Handwashing?

1. Perform hand hygiene

2. Introduce yourself and explain procedure to resident

3. Provide privacy

4. Put on gloves

5. Obtain waterproof pad and place it under resident

6. Obtain bed pand and place it in the correct position under the resident’s behind

7. Raise head of bed to comfortable area

8. Leave call light within reach

9. Stand behind privacy curtain

10. When indicated to return, lower head of bed

11. Gently remove bedpan and pour it into urine measure container

12. Record in mLs

13. Rinse bedpan and pour in the toilet

14. Return equipment

15. Assist resident in washing their hands with basin and washcloth

16. Recording of urine must be within 25mLs

17. Give resident call light and ask if they need anything

18. Perform hashwashing for at least 20 second

19. Do not recontaminate hands by touching handles of sink

What materials do you need for Catheter Care of a Female Resident?

• 3 washcloths for labia and between

• 3 washcloths for rectal area

• Basin with warm water and soap

• Towel to cover to hips

What are the basic steps to Catheter Care for a Female Resident?

1. Perform hand hygiene

2. Introduce yourself and explain the procedure

3. Provide privacy

4. Fill basin with warm water

5. Put on gloves

6. Prepare and fold washcloth with soap and wet with water

7. Expose area surrounding catheter

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

9. While holding catheter, clean 3-4 inches down

10. Clean with strokes only away from urethra, using soapy washcloth

11. Use clean portion of washcloth each time, 3 times

12. Use another washcloth with only water to rinse catheter

13. Use another washcloth to dry catheter

14. Do not allow tube to be tugged/pulled at any time

15. Return equipment

16. Remove gloves, turning them inside out

17. Give resident the call light

18. Perform hand washing for at least 20 seconds

19. Do not recontaminate hands by touching handle bars

What materials do you need for Denture Care?

• Toothpaste and brush

• Dentures

• Liners for sink

• Cold water

What are the basic steps to Denture Care?

1. Perform hand hygiene

2. Introduce yourself and explain the procedure

3. Line the bottom from sink with protective lining

4. Put on globes

5. Handle denture care carefully

6. Place toothpaste on toothbrush

7. Begin brushing dentures on lower, upper side and teeth

8. Rinse dentures

9. Replace water in denture cup container

10. Return Equipment and remove lining

11. Remove gloves

12. Perform hand hygiene, hand sanitizer

13. Give resident the call light

14. Ask resident if they need anything else

What materials are needs to Don PPE, Empty a Urinary Drainage Bag, Measure Urine Output, Doff PPE?

• Gloves and gown

• Waterproof pad

• Urinary basin/container

• Alcohol pad

What are the basic steps to Donn PPE, Empty a Urinary Drainage

1. Perform hand hygiene

2. Unfold gown and put on gown

3. Put on gloves to cover cuffs of gown

4. Explain procedure to resident

5. Place barrier or waterproof pad

6. Place urinary graduate on floor below catheter bag

7. Open catheter and do not touch tip

8. Let it drain and avoid touching tip

9. Close the drain

10. Wipe drain with alcohol pad and then close it

11. Measure and record graduate volume

12. Empty graduate into the toilet and rinse

13. Rinse and return equipment

14. Recording must be within 25 mLs

15. Give call light to resident

16. Remove gloves before removing gown

17. Remove gown without touching outside of it

18. Perform hand washing for at least 20 seconds

19. Do not recontaminate at anyy point

What materials are needed for Dressing a Resident with an Affected side?

• Shirt

• Pants

• Socks

What are the basic steps to Dressing a Resident with an Affected (Weak Side)?

1. Perform hand hygiene (hand sanitizer)

2. Introduce yourself and explain the procedure

3. Provide privacy

4. Raise bed height to your arms

5. Remove gown from UNAFFECTED side first

6. Place soiled gown in dirty laundry

7. Grab shirt, always dress affected (weak) side first

8. Grab pants, always dress affected leg first

9. Lift buttocks from side to side to pull pants up wait

10. Put on socks

11. Lower bed

12. Give resident the call light

13. Ask if they need anything else

14. Perform hand hygiene

What materials are needed for Foot Care?

• Basin with warm water

• 3 wash clothes (soapy, rinsing, drying)

• Lotion

• Soap

What are the basic steps for Foot Care?

1. Perform Hand hygiene

2. Introduce yourself and explain the procedure

3. Obtain basin of warm water and place below feet of resident on the ground

4. Immerse resident’s foot in warm water

5. VERBALIZE 5-20 minutes of soaking time in water

6. Wash entire foot with soapy washcloth

7. Rinse the foot with water

8. Another washcloth to dry the foot

9. Ensure foot is thoroughly dried

10. Apply lotion only on bottom and top, not between toes

11. Replace sock

12. Empty, rinse, and dry equipment

13. Place soiled linens in hamper

14. Perform hand hygiene

15. Give resident the call light

16. Ask if they need anything else

What materials are needed for the Modified Bed Bath-Face and one Arm, Hand and Underarm?

• Basin with warm water

• Soap

• 3 washcloths (soapy, rinse, dry)

• Washcloth for face

• Gown

What are the basic steps to Modified Bed Bath-Face and One Arm, Hand, and Underarm?

1. Perform hand hygiene

2. Introduce yourself and explain procedure

3. Provide privacy

4. Raise bed

5. Obtain a basin full of warm water

6. Cover resident with bath blanket

7. Remove top covers and fold to the bottom of the bed

8. Remove the gown without exposing resident

9. Start with the eyes and then wash the face WITHOUT SOAP

10. Pat dry face

11. Wash resident’s arm, hand, underarm with soapy washcloth

12. Rinse resident’s arm, hand, underarm with wet washcloth

13. Dry resident’s arm, hand, underarm

14. Assist resident in putting on clean gown

15. Return equipment to storage

16. Lower bed

17. Perform hand hygiene

18. Give them call light

19. Ask if the resident needs anything else

What materials are needed for Mouth Care?

• Gloves

• Spit bowl/cup

• Toothbrush and toothpaste

• Towel

What are the basic steps for Mouth Care?

1. Perform hand hygiene

2. Introduce yourself and explain procedure

3. Provide privacy

4. Place a towel over chest to prevent soiling

5. Obtain toothbrush, toothpaste, and spit cup

6. Put on gloves before brushing

7. Wet toothbrush with water

8. Brush the upper, lower teeth, and the tongue

9. Assist resident with rinsing mouth

10. Dry residents mouth

11. Remove soiled linen

12. Rinse and return materials

13. Remove gloves

14. Perform hand hygiene

15. Give resident the call light

16. Ask if the resident needs anything else

What are the basic steps to Passive Range of Motion of Resident’s Hip and Knee, and Shoulder?

1. Perform hand hygiene

2. Introduce yourself and explain procedure

3. Provide for privacy

4. Raise the bed

5. Position resident in supine (flat) position

6. Abduction: move resident’s entire leg/arm AWAY from body

7. Adduction: move resident’s entire leg/arm TOWARD body

8. Flexion: move resident’s entire leg/arm upward toward trunk or to ear level

9. Extension: move resident’s entire leg/arm downward

10. Ask at least once during each exercise if there is any discomfort or pain

11. Lower bed

12. Give resident the call light

13. Ask if there is anything else they need

14. Perform hand hygiene

What are the materials needed for Female Perineal Care?

• 6 washcloths

• Soap

• Basin full of warm water

• Towel

• Gloves

• Waterproof pad

What are the basic steps for Female Perineal Care?

1. Perform hand sanitizer

2. Introduce yourself and explain procedure

3. Provide for patient’s privacy

4. Obtain basin full of warm water and washcloths with soap

5. Raise bed

6. Put on gloves

7. Obtain waterproof pad and turn patient to place it under their buttocks

8. Uncover resident’s perineal area, covering both the stomach and lower legs, leaving only that area exposed

9. Fold washcloth and put soap on it to clean side labia and middle

10. Fold washcloth to rinse side labia and middle

11. Fold washcloth to dry labia and middle

12. Use clear portion of washcloth each time to clean front to back

13. Assist resident in turning away from yourself (toward RN)

14. Fold clean washcloth and put soap to clean from vaginal to rectal area

15. Fold wet washcloth to rinse from vaginal to rectal area

16. Fold dry washcloth to dry from vaginal to rectal area

17. PAT DRY

18. Place soiled linen in dirty laundry

19. Rinse and return equipment to storage

20. Remove gloves

21. Lower bed

22. Give call light to resident

23. Ask if there is anything they need

24. Perform hand washing for at least 20 seconds and do not contaminate

What are the basic steps to Positioning a Resident in Bed on their Side?

1. Perform Hand hygiene

2. Introduce yourself and explain procedure

3. Provide for residents privacy

4. Position bed flat

5. Raise bed

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

7. Stand on resident’s working side, move residents upper body toward yourself

8. Move resident’s hips, then legs toward yourself

9. Asst resident in slowly rolling on to side

10. Adjust pillow and arms

11. Place support device under upside arm

12. Place support device behind back

13. Place support device between knees

14. Lower bed

15. Give resident the call light

16. Ask if there is anything else they need

17. Perform hand hygiene

What materials are needed for Transferring a Resident from Their Bed to Wheelchair Using Gait Belt?

• Gait belt

• Wheelchair

• Non-skid footwear

What are the basic steps to Transferring a Resident from Their Bed to Wheelchair Using Gait Belt?

1. Perform Hand hygiene

2. Introduce yourself and explain procedure

3. Provide for resident’s privacy

4. Obtain gait belt

5. Position wheelchair at foot or head of the bed

6. Assist resident in putting on non-skid footwear

7. Lower bed height to residents feet laying flat on ground

8. Lock bed and wheelchair

9. Assist resident to a sitting position

10. Place gait belt around the residents waist

11. Face resident and grab gait belt by the sides

12. Bring resident to standing position and move them toward wheelchair

13. Remove gait belt

14. Give resident the call light

15. Ask if there is anything else they need

16. Perform hand hygiene

What are the basic steps to Vital Signs—Count and Record the Resident’s Radial Pulse and Respirations?

1. Perform hand hygiene

2. Introduce yourself and explain procedure

3. Locate resident’s radial pulse

4. Count pulse for one full minute

5. Tell observer when you START and STOP counting

6. Record pulse on recording form

7. Must be within 4 beats of RN observer

8. Count resident’s respiration for one minute

9. Must be within 2 respirations of RN observer

10. Give resident the call light

11. Ask if resident needs anything else

12. Perform hand hygiene

What are the basic steps to Vital Signs—Take and Record the Resident’s Manual Blood Pressure?

1. Perform hand hygiene

2. Explain procedure

3. Provide privacy for resident

4. Position forearm palm up and at heart level

5. Roll resident’s sleeve up or remove shirt

6. Apply appropriate cuff size

7. Line cuff arrows up with brachial artery

8. Clean earpieces and diaphragm of stethoscope

9. Locate stethoscope and put it over brachial artery

10. Inflate cuff to 160-180 mmHg

11. Slowly release air from cuff

12. There are 3 attempts

13. Record BP on recording form

14. Diastolic and systolic must be within 6 mmHg of RN Observer’s blood pressure

15. Give resident the call light

16. Ask if they need anything else

17. Perform hand hygiene