Florida CNA Prometric Skills (22 skills)

Important things to note before the skills

• The skills exam will consist of 3 random skills to be performed in front of 2 nurses.

• While there are 3 skills, there are 2 skills that need to performed at all times throughout the skills test. This is indirect care and handwashing.

• With handwashing, you need to perform this for real 2 times ONLY DURING THE FIRST SKILL. Afterwards, you have to simulate it.

• Indirect care is another skill that needs to performed every single time during the skill as well.

• If you make a mistake during the skill, you are allowed to correct yourself. An example of this would if the basin you are cleaning touches the sink, you can say “Correction, basin touched the sink.” The idea is to explain what you did wrong and the nurse will not take points off.

Indirect Care

This skill will be present in all of the skill you are tested on (IC will state this is tested within every skill so do not forget!):

• Step 1: Greet the resident, address by name, and introduce yourself (IC)

• Step 2: Provide the explanation of care to resident, this should happen before care and during the care (IC)

• Step 3: Asking the resident about preferences during care: are they comfortable, what can I do as the CNA to make you more comfortable, do you need extra pillows, blankets, are you warm enough? (IC)

• Step 4: Prodvide infection control during care, this means don’t touch the resident until hands are clean and end the skill with clean hands, remove gloves without touching yourself, avoid the linen touching floor, avoid shaking, fluffing, or throwing them. Do not place bed pan on the bed table, bed protector placed on bed table. (IC)

• Step 5: Leave the resident covered with top sheet as much as possible throughout the skill, address the resident by their name, close curtain before providing care, minimize exposure of resident, and knock and announce self before walking into the room. (IC)

• Step 6: When leaving the room, place the call light near the residents hand or within reach of them. ALWAYS leave bed in the lowest position before ending the skill (this will be an automatic fail), and make sure to keep resident away from the edge and positioned a safe distance away at all times (auto fail as well). (IC)

Handwashing

Key points:

• Wet hands before applying soap

• Do not shake the water from your hands

• Work up a lather cleaning front and back of hands, wrists, between fingers, around cuticles and under nails. Don’t forget finger scratch as well.

• Friction on the hands should be done for 20 seconds.

• Rinse soap while holding fingers lower than the wrists.

• Dry hands with a paper towel, pat dry only.

• Turn water off with a paper towel and throw it away

• Complete the task without having hands touch the sink and make sure uniform does not touch sink as well.

This needs to be done for real for the first skill, then simulated for the rest of the skills.

• Step 1: Turn water on. Make sure to use warm water

• Step 2: Wet hands, fingers need to be pointing down

• Step 3: Apply a generous amount of soap; lather all surfaces of your hands.

• Step 4: For 20 seconds, there needs to be friction of both palms, wash the back of hands as well

• Step 5: Interlace fingers and thumbs to get in between the fingers

• Step 6: Wash the wrists

• Step 7: Clean each cuticle along with the finger scratch (all 5 fingers together and scratch against the palms)

• Step 8: Rinse each hand one at a time with fingers pointing down.

• Step 9: Turn the faucet off with a clean paper towel and throw it away

• Step 10: Dry each hand with a clean paper towel using a patting motion

Ambulate resident using a transfer/ gait belt

Key points:

• Placing the gait belt around the residents waist before beginning ambulation

• Gait belt should not be too loose or tight

• Assist the resident to stand while holding gait belt at the back or both sides of the resident

• Ask: Are you dizzy when you pick them up

• Walk slightly behind the resident and to one side while holding gait belt in the back

• Ask about comfort, dizziness or fatigue during ambulation

• Assist resident to turn adn position to sit back in chair

• Remove gait belt gently

• Ask resident about preferences, comfort and needs during care

• Maintain own body mechanics when assisting resident to sit and stand

• Step 1: Knock on the door and introduce yourself, explain the procedure and ask if it is okay with the resident to start the procedure.

• Step 2: Close curtain and wash hands

• Step 3: Grab the gait belt, make sure their feet are flat on the floor and make sure they are wearing shoes that are nonskid

• Step 4: Ask the resident to raise their arms and place the belt flat on their waist. When placing the gait belt in the side with the tag should be inside and take the other part of the belt and push it through the teeth. After pushing through the teeth, place 2-3 fingers behind the buckle and start to tighten the belt. Once tightened, place thumb on teeth where you fed the belt through and loop it to secure it. Tuck the remaining in the belt

• Step 5: Once you have the belt on the resident, place your foot in between their feet and grab them by belt on the side of their body.

• Step 6: Say “at the count of three, I am going to help you stand up, you can use my shoulders for support.”

• Step 7: Lift the resident up, after lifting make sure to ask are you dizzy? After asking, you can tell them to lower their arms.

• Step 8: Adjust yourself to where your hand is still on the side of the resident and the other hand is on their back holding the belt, this is where we help them walk now.

• Step 9: State to the resident that you are going to help them to take 5 steps (or however many needed to take) and tell them to start. Make sure the resident steps ahead of you first.

• Step 10: After the 5 steps, check in with the resident and ask how they are doing or if they are dizzy. Tell them we are going to turn around now and proceed to take 5 steps back to the chair.

• Step 11: Tell the patient to turn around and make sure their legs are close enough, hold the resident by the sides of the gait belt and sit them down. Ask if they are comfortable after seating.

• Step 12: Tell them you are going to remove the belt, you can say I hope you feel better after the walk. Make sure to tell them to sit all the back in the chair with hips and back touching the back of the chair and feet flat on the floor. Wrap gait belt up away from clothes and put it away.

• Now you can end the skill by saying: I have left some ice water for you on the table and bring them the call light. Open curtain and wash hands to end skill.

ROM Exercises- Shoulder

Key Points:

• Exercise correct joints and only correct side when performing ROM.

• Support the arm through ROM exercise, providing smooth, slow, no forceful movement

• Do not cause pain

• Ask during the exercise about pain and discomfort

• Ask resident about comfort or needs during care or before care is completed

Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

Step 2: Close the curtain and wash hands. Ask how are they doing etc. ALSO MAKE SURE TO LOWER HEAD OF BED BEFORE STARTING THE ROM EXERCISE, all ROM exercises need to be the low HOB position

Step 3: Explain to the resident what type of ROM exericse you are doing (in this case the shoulder) and state what arm you doing the exercise on only.

Step 4: Uncover the arm you are only working on and grab the arm and support under the wrist and tricep

Step 5: Raise arm straight up and over the head for 3 reps up and down motion, after you finish this, make sure to ask if they feel any pain or discomfort.

Step 6: Now, still supporting in the same area, do the snow angel motion for 3 reps, arm should be side to side. Ask about pain or discomfort after finishing this step. Raise the HOB.

Step 7: End the skill by saying “can I do anything for you before I leave?” and leave the call light with them by explaining if you need anything please let me know and end skill.

ROM Exercises Elbow and Wrist

Key Points:

• Instructions provided at the test site will indicate whether the exercise is on the left or right side.

• Exercise correct joints and only correct when performing ROM

• Support extremity to protect the working join

• Bend and straighten arm at elbow

• Move wrist by moving hand down and back

• Ask resident about discomfort during ROM

• Exercises should be smooth, slow and non-forceful

• Ask resdient about preferences, comfort and needs during care

Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

Step 2: Close the curtain and wash hands. Ask how are they doing etc. ALSO MAKE SURE TO LOWER HEAD OF BED BEFORE STARTING THE ROM EXERCISE, all ROM exercises need to be the low HOB position

Step 3: State which side of the elbow and wrist they are exercising (testing site will say if it is left or right) and ask the resident “let me know if you feel any discomfort during the exercise.”

Step 4: Support under the elbow and wrist, then bend the elbow in for 3 reps. Ask if they feel any discomfort or pain after completing this step

Step 5: Move onto the wrist, support at the wrist and hand. Bend back and forth, when you bend foward that counts as 1 rep, do this for 3 reps. Ask the resident if they are feeling any pain or discomfort aftwards.

Step 6: Raise HOB and give the resisdent the call light and tell them “if you need anything please let me know”

Step 7: Open the curtain and wash hands. End skill

ROM Exercises Hip, Knee, and Ankle

Key Points:

• Exercise the correct joints and correct side

• Support leg above and below joints throughout ROM exercises

• Support extremity to protect heel friction against mattress during ROM

• Do not cause pain

• Do exercises slowly, gently, and smoothly

• Ask resident abotu pain and discomfort. Ask about comfort and needs during care or before care completed.

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash hands. Ask how are they doing etc. ALSO MAKE SURE TO LOWER HEAD OF BED BEFORE STARTING THE ROM EXERCISE, all ROM exercises need to be the low HOB position

• Step 3: Uncover the leg you are working with. Tell them “let me know if feel any pain”

• Step 4: Support the leg at the thigh and near the foot. Bend the leg for 3 reps. Ask if they are in pain

• Step 5: Support the foot at the ankle and ball of the foot. Bend the foot foward and back for 3 reps and make sure the foot is above the bed (no friction). Ask if they are in pain.

• Step 6: Cover the leg back up and tuck in the sheet (hospital corner). Leave the call light with them. End skill

Measure and record radial pulse

Key points:

• Support resident’s arm in a manner to avoid dangling while pulse is taken

• Use fingers, avoid thumb since the thumb has a pulse

• Count pulse for one minute. Record the pulse twice with each nurse

• Ask resident about preferences, comfort and needs during or before care is completed.

• Record pulse with ±4 beats of the nurse’s result

• Normal pulse is 60 to 100 a minute

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash hands. Ask how are they doing etc. Lower HOB as needed

• Step 3: Place a chair next to resident and find the pulse (runs in line with thumb on the wrist)

• Step 4: Let the nurse know you are ready and begin counting for 1 minute

• Step 5: When 1 minute is up, tell the nurse finish. Record this on the sheet provided and repeat again with the second nurse.

• Step 6: Raise HOB and ask resident if they need anything else before you leave, give them the call light and open the curtain and wash hands. End skill

Measure and record respirations

Key points:

• Measure rate of respirations without providing instructions about how to breathe

• Count respirations for one minute

• Ask resident about comfort, needs, and preferences during the skill

• Record the measurement on the paper within ±2 of the nurse’s measurement

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it. For this, say you are taking vitals so the resident does not change up their breathing pattern

• Step 2: Close curtains and wash hands. Ask how are they doing etc. Lower HOB

• Step 3: Place your hand on the resident like you are taking their pulse

• Step 4: When ready, tell the nurse go and count when their chest falls, this counts as 1 respiration, do this for one minute.

• Step 5: When the minute passes, say finish and record on the paper

• Step 6: Raise HOB and ask the resident if you can do anything else for them. Open curtain and wash hands. End skill

Urinary Drainage Recording

Key Points:

• Record in cc’s on the form with clean hands

• Time IS written in military format (0000)

• Ask resident about preferences, comfort, and needs during care

• Set the container on a barrier (this barrier will be a paper towel)

• Keep the urine bag positioned lower than the bladder during care

• Record output within ±50 cc’s of the nurse’s measurement

Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

Step 2: Close curtain and wash hands. Grab the materials needed, gloves, the container, paper towel, and alcohol swab

Step 3: Place the paper towel on the floor by the drainage bag

Step 4: Place the graduated and alcohol pad on the paper towel (make sure your materials DO NOT touch the bag that is CROSS CONTAMINTION)

Step 5: Once you have all the materials, put the gloves on and open the alcohol swab and place it down for later.

Step 6: Remove the urine bag from the bed and take tube out of the protective pocket. Make sure the tube is pointing down in the container

Step 7: Open the tube by flicking the white tab and let the urine drain into the container. Close the white tab on the tube. Make sure the bag is empty before hanging it back on the bed.

Step 8: Grab the alcohol swab from earlier and use it to wipe the tub around the sides and tip of tube. Place it back into the protective slot.

Step 9: Grab the container and the paper towel to dispose in the trash.

Step 10: Set the barrier on the sink table and place container on top. Get down to eye level with the container to measure the cc’s. Remember the number.

Step 11: Grab towel and throw it away, container can now be washed. Dump all bodily fluids into the toilet and grab another paper towel to turn the sink on, rinse the container without having it touch the sink or faucet. Anything that is in the container while rinsing MUST BE DUMPED INTO THE TOILET! Do not forget to rinse the back of the container as well. Dry off container as well with new towel

Step 12: Turn faucet off and dispose the paper towel, sanitize the container and grab another paper towle to open the drawer and place it back where you got it from.

Step 13: Now take off your gloves and wash your hands, now that we have clean hands, we can now record the amount of urine on the paper given to us and sign. Urine needs to recorded ONLY ON OUTPUT!

Step 14: Fix the linen and ask if you can do anything for the resident before you, you could also say I left some water for you and provide the resident with the call light.

Step 15: Open the curtain and wash hands once more. End skill

Feeding the resident (Resident is sitting in a slouched position in the chair)

Key Points:

• Assist or cue resident to sit upright in chair before feeding

• Offer and assist resident to wash hadns before feeding using a damp washcloth

• CNA sits down while feeding resident

• Offer fluids every 2-3 bites

• Allow resident to swallow before feeding the next bite

• Converse during meal, encourage intake

• Record food and fluid on the intake form

• Ask preference, comfort and needs during care or before care is completed.

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: snack, spoon, washcloth make sure it’s half wet half dry, a cup of water (hold at the base of the cup not at the tip), 2 napkins, and the clothing protector. Make sure the cup of water, snack, and spoon are on the first napkin and the second napkin is for wiping their mouth.

• Step 3: Make sure to tell the resident to sit all the back, hips and back touching the back of the chair and feet are flat on the floor. Ask if they are comfortable.

• Step 4: Ask if it is okay to place the clothing protector on them. Make sure to open it away from your body no cross contamintion

• Step 5: Now ask the resident to wipe their hand on the wet side of the washcloth and ask them to dry their hands with the dry side.

• Step 6: Ask the resident to take a sip of water to wet their mouth. Open the snack and feed the resident the first bite. When feeding them a bite, make sure to ask them a question, this is to see if they have swallowed the food or not.

• Step 7: If there is no food in their mouth, feed them the next bite, ask another question. Feed them another bite, after 2-3 bites have the resident take a sip of water.

• Step 8: Repeat until the resident refuses, if they do, try to enourage them, “are you sure? the next snack is not for a couple of hours.” After they say they do not want a snack, wipe their mouth and remove the clothing protector.

• Step 9: Place protector and cloth in the hamper, record the results on the form (check snack, etc.)

• Step 10; Clean up by throwing water in the toilet and the cup in the trash. Throw snack and napkisn in trash

• Step 11: Return to resident and if you can do anything else for them, leave the call light with them. Open curtains and wash hands. End skill

Mouth care to a resident who has teeth

Key points:

• Wear gloves

• Raise HOB ( 60 to 90 dregrees, resident should be upright)

• Wet toothbrush with water and apply toothpaste before brushing

• Wash all surfaces of teeth and the gum line with a gentle motion

• Rincse mouth using water and emesis basin

• Wash hands 3 times (before, after taking off gloves and leaving the scene)

• Ask about preferences, comfort and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: A towel to spread across the table, another towel, a clean kidney basin, a cup with water, toothbrush, toothpaste, gloves, and a napkin.

• Step 3: Raise the HOB to an upright postion and offer to adjust the pillow for comfort as well. This is for safety reasons.

• Step 4: Take the other towel from earlier and cover the top portion of the resident with it.

• Step 5: Put gloves on

• Step 6: Give the resident a sip of water to wet their mouth before doing anything else.

• Step 7: Wet toothbrush, then apply a small amount of toothpaste to the brush.

• Step 8: Grab napkin and ask resident to smile, once they smile, start brushing the front teeth up and down. Ask them to open their mouth, stick the brush on the side (tell them to close their mouth) and brush up and down on the sides. After, ask them to open and brush the crowns bottom and top, brush the backside of the bottom teeth and top teeth. Brush the lower gums by swipping the brush across the gums and the top as well. Brush the back gums and roof of the mouth as well as the tongue.

• Step 9: As soon as you finish, take the water and ask them to rinse their mouth, tell them to gently spit into the basin and pat their mouth after.

• Step 10: Ask if they would like to rinse their mouth again.

• Step 11: Remove the towel from their chest, place the cup of water in the basin and throw items in the trash.

• Step 12: Place a barrier on the sink when rinsing the basin and toothbrush. Grab another paper towel to turn the sink on, empty the basin in the toilet and rinse toothbrush and place it in the trash.

• Step 13: Rinse basin inside and empty into the toilet. Rinse back of the basin. Grab a new paper towel and dry off as well sanitize the basin.

• Step 14: Grab a new paper towel to open the drawers and place the toothpaste and basin in a respective places. Clean up the area and take off gloves (this is where you wash hands)

• Step 15: Lower the HOB, fix the linen on the resident, ask if they need anything before you leave, hand them the call light. End skill

Mouth care to a resident who has dentures

Key Points:

• Wear gloves

• Transport dentures in denture container

• Line sink with wash cloth or paper towels to reduce risk of denture breakage

• Use cold water to clean and rinse dentures

• Brush all surfaces of dentures

• Store clean dentures in denture container filled with clean water

• Ask resident about preferences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Step 2: Close the curtain and wash your hands. Grab the materials needed: Gloves, 2 towels (one will be spread across the table), oral swab, toothpaste, kidney basin, cup of a water (hold the cup at the bottom not the top), dentures, and dentures brush, and a napkin as well.

• Step 3: Place towel on resident to protect their clothes (across the chest)

• Step 4: Put gloves on

• Step 5: Give the resident a sip of water to wet their mouth before you start the mouth care process

• Step 6: Open the oral swab and wet it in the kidney basin with the cup of water, ask the resident to open their mouth and tell them you are going to clean their gums now.

• Step 7: Wipe each side of the gum very gently to clean, top and bottom gums. After that, proceed to clean their inner gums on the top and bottom as well. Cleaning the tongue is optional

• Step 8: Now grab the cup of water and tell the resident you are giving them the water to rinse (make sure to state this so they do not swallow the water). Now tell them “swish the water gently in the mouth and spit into the empty basin gently” (make sure the basin has the dip facing the resident).

• Step 9: After they spit, take the napkin and PAT DRY around the area. Ask if they would like to rinse again.

• Step 10: Remove the towel from the resident and make sure any material or towel does not touch your body during the skill.

• Step 11: Empty the water in the basin and take it to the sink to clean. Empty the water into the toilet and clean the basin without touching it to the sink. When rinsing inside the basin, the water in there should be thrown into the toilet. Don’t forget to turn the sink on with a paper towel. Sanitize the basin as well after drying

• Step 12: Open the drawer with a paper towel to place the basin back in its correct spot. Grab the denture cup, toothpaste, and denture brush to the sink.

• Step 13: Grab a paper towel for a barrier and place it the collected items on the towel.

• Step 14: Now grab a few paper towels to create a barrier in the sink (this is where the dentures will sit while we are cleaning them)

• Step 15: ONLY USE COLD WATER TO CLEAN THE DENTURES. Turn the cold water on with a paper towel and place dentures in the sink on those paper towels we lined earlier.

• Step 16: Empty the denture container into the sink and proceed to rinse, make sure to throw that rinsed water into the toilet as well. Rinse the back of the cup as well and put in fresh cold water into the cup and place back on the barrier.

• Step 17: Wet the dentures brush, apply toothpaste to both sides of the brush and brush all sides of the dentures. Brush the gums, teeth, the inside of the teeth, EVERYWHERE! Use the small side of the brush to brush the side where the denture fits into the mouth.

• Step 18: Now, rinse and brush at the same time under the water. Place the dentures back into the container and dry off brush.

• Step 19: Turn the water off, with the towel you used to turn off the sink, grab the other paper towels INSIDE the sink to clean up.

• Step 20: Grab a new paper towel to close the denture containter, MAKE SURE TO NOT TOUCH THE CONTAINER ANYMORE THAT IS CROSS CONTAMINATION!

• Step 21: Grab toothpaste and brush, throw away the barrier towel and take collected items back to the resident. Ask if they would like their dentures now, if not place it back on the table next to them. The paper towel we used to hold the dentures, throw it away and grab a new one to place the toothpaste and brush back into its correct spot. After that, clean up and throw the white towel into the hamper and remove gloves. After removing gloves make sure to wash hands.

• Step 22: Tell the resident you are done for today and ask if they would like anything else before you leave. Make sure to leave the call light with them. Open the curtain and wash hands. End skill

Assisting the resident to use a bedpan

Key points:

• Wear gloves

• Kepp resdient positioned at a safe distance from the edge of the bed at all times

• Raise HOB after placing the resident on bedpan

• Lower HOB before removing bedpan

• Place toilet paper within resident’s reach

• Wash hands 3 times

• Ask resident about preferences, comfort and needs during care

• Offer resident wash cloth to wipe hands after using bedpan

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: Gloves, bed protector, bedpan, wash cloth (half wet half dry), and toilet paper.

• Step 3: Grab the wash cloth and tell the resident you are going to wet the cloth. Grab a paper towel to turn on the sink and wet ONLY HALF OF THE CLOTH. place the cloth on the table with the dry side up.

• Step 4: Tell the resident you are going to lower the HOB now. Go to the side of the patient and uncover them and bring the gown up. Put gloves on now

• Step 5: Grab bed protector and unfold it on the residents legs (make sure the waterproof side is facing up) and place bedpan in the middle. After this, fold up the bed protector with pan in it.

• Step 6: Ask the resident to bend their knees and them them “at the count of 3, I want you to raise your hips.” When they raise their hips, push the bed protector and pan under, make sure the bedpan is positioned under the butt. Cover the patient and place toilet paper next to their hand.

• Step 7: Raise HOB until they are comfortable. Give them the call light and tell them “ I am going to give you privacy now, you can call me when you are done.” Go behind the curtain to give them proper privacy.

• Step 8: When they say they’re done, come back in and give them the wash cloth to wipe their hands. Throw that into the hamper.

• Step 9: Lower HOB to a flat position and uncover them, remove the toilet paper and place by the end of the bed. Ask them to raise their hips like before and remove the bedpan and protector together. Tell them to lower their hips and cover once again.

• Step 10: Place protector into hamper, place the contents of the bedpan into the toilet and turn the sink on (paper towel barrier) and rinse the bedpan. Like before, water that is inside the bedpan, dump into the toilet, Rinse outside of pan and do not touch the sink or faucet. Turn water off and dry off bedpan and sanitize

• Step 11: Place toilet paper in bedpan and grab a new paper towel to open the drawer to place the bedpan in its corect spot.

• Step 12: Remove gloves and wash hands

• Step 13: Lower the gown on the resident and tidy up the blanket on the resident.

• Step 14: Raise HOB and ask if they are comfortable, after, ask if they need anything else from you before you leave. Give them the call light, check in once again if they need extra pillows or blankets or whatever they need. Open the curtain and wash hands. End skill

Hand and Nail care

Key Points:

• Place fingers or full hand into basin of water to soak before removing residue from under nails. Apply soap to fingers then to the washcloth

• Use orange wood stick to clean under the nails (use flat edge)

• Leave nails smooth (filing)

• Dry hand after soaking

• Apply lotion after nails are cleaned and shaped

• Ask resident if water temp is ok

• Ask resident about preferences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 2 towels, wash basin (the top basin is for nail care), orangewood stick, emery board nail file, soap, and washcloth

• Step 3: Place the one towel on the table for the spread

• Step 4: Grab a paper towel to act as a barrier for the sink, turn on the sink with another paper towel barrier. Check temp of water, use warm water and fill basin. Check temp of water while you are filling up basin.

• Step 5: The instruction card during the test will tell you which hand you are working with. Ask resident for their hand to check the water temp

• Step 6: If temp is okay with them, submerge their hand in the water to wet it. While that is happening, grab the washcloth and wet it in the basin. Apply a small amount of soap to the cloth and clean the resident’s hand. It is important to note that the soapy cloth DOES NOT go back into the water.

• Step 7: Wash the residents hand with the soapy cloth, wash the palm, the back of the hand, in between the fingers, and cuticles

• Step 8: Rinse the resdents hand after washing

• Step 9: Grab the towel and open it to PAT DRY the residents hand.

• Step 10: Take the orangewood stick now and use the DULL FLAT EDGE to clean under the residents nail. This is to get dirt out of the nail. Do this with each nail, each time you take dirt out, make sure to dip the stick in water to clean it then repeat. Don’t forget to check in resident as well

• Step 11: After cleaning under the nail, make sure to PAT DRY the hand again

• Step 12: Take the emery board file and ask the resident if they would like their nails square or round and proceed to file the nails, dont’ forget to check in

• Step 13: After filing each nail, PAT DRY the hand again to get rid of dust on the hand. After this, apply lotion to the hand, warm it up in the hand again

• Step 14: After applying the lotion and rubbing it in, PAT DRY the hand to get rid of excess lotion, check in

• Step 15: Place the resident’s hand back in their lap and proceed to clean up

• Step 16: Place the towel and wash cloth in hamper and put the lotion and soap back in its respective location, throw away the stick and file in the trash

• Step 17: Empty the basin IN THE TOILET, grab a paper towel to turn water on, rinse the inside and outside of basin. Do not touch the basin to the walls of the sink. Any water that is inside the basin must be dumped into the toilet.

• Step 18: Dry off basin and sanitize

• Step 19: Place basin back in its respective location

• Step 20: Throw the towel on the table in the hamper, ask resident if they need anything else before you leave. Give them the call light. Open curtain and wash hands. End Skill

Foot care (Resident sitting in a chair)

Key Points:

• Ask the resident if the water temp is okay

• Place basin on floor on the towel

• Do not add soap directly to water in basin. Add soap to your fingers and then to washcloth

• Wash top and bottom of the foot and in between the toes

• Do not place resident’s foot on floor before, during, and after foot care

• Provide support to lower extremity throughout procedure as needed to avoid strain

• Ask resident about preferences, comfort and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 2 towels, foot basin, wash cloth, soap, and lotion

• Step 3: Place the first towel on the floor near the resident’s feet (instruction card will tell you what foot you are working with)

• Step 4: Place a towel barrier on the sink where you are going to rest the basin to fill it up. Grab another towel barrier to turn on the faucet and fill the basin up with WARM water. Check temp while you are filling up the basin as well

• Step 5: Once back, place a paper towel on the floor for your knees, this will act as the barrier.

• Step 6: Cuff the resident’s pants a little and remove their sock and shoe. Be sure to support the foot by holding the heel as you are taking the sock off. This is when you need to start supporting the foot for the rest of the skill when the foot is not in the basin.

• Step 7: Dip the resident’s toes in the water to check the temp. Submerge the foot in the water and wet the wash cloth

• Step 8: Take the soap and dispense a small amount into your hand and rub it on the cloth. This is where the cloth WILL NOT enter the basin for the rest of th skill.

• Step 9: Take the foot out of the basin and clean the foot with the washcloth. Clean the top of the foot, bottom of the foot, the sides of the foot, the back of the foot, and in between the toes. Check in with the resident as well

• Step 10: Dip the foot back into the basin to rinse the soap off. After rinsing the soap, take it out of the basin and support the foot while doing this.

• Step 11: Move the basin out of the way and grab the other towel to PAT DRY the foot and in between the toes as well.

• Step 12: Get a small amount of a lotion in your hand and warm it up. Rub the lotion all over the foot EXCEPT in between the toes. DO NOT RUB IT IN BETWEEN THE TOES.

• Step 13: PAT DRY the excess lotion off the foot. Put the resident’s sock back on the foot and support their foot while putting their shoe back on. Roll the pants back down

• Step 14: Stand up now and check in with the resident and ask if they are doing okay. (Grab paper towel from the floor as well)

• Step 15: Take the washcloth and towel and throw it away in the hamper. Put away the lotion and soap in its respective spot.

• Step 16: Grab the basin and empty the water into the toilet. Grab a paper towel barrier to turn on the sink and rinse basin in the sink, any water that gets into the basin, dump into the toilet. Rinse the outside of the basin. REMEMBER TO NOT TOUCH THE BASIN TO THE SINK

• Step 17: Turn off the sink with that paper towel you left and dry off the basin and, sanitize it

• Step 18: Grab that towel on the floor and throw it into the hamper. Place the basin back into the drawer. THE FOOT CARE BASIN GOES ON THE BOTTOM OF THE OTHER BASIN!

• Step 19: Tell the resident you are done for today and ask if they need anything else from you before you leave. Hand the call light to the resident as well. Open the curtain and wash hands. End skill

Transfer from bed to Wheelchair

Key Points:

• Place wheelchair near resident’s bed

• Move foot rests out of the way before standing resident up to transfer

• Lock wheelchair before and during transfer

• Place gait belt around waist

• Brace one or both of the resident’s legs during transfer, while assiting them to stand, turn, and sit

• Resident’s feet must be flat on the floor before transferring

• Transfer resident as a pivot completed without having the resident take steps to reach wheelchair, and before assisting him to sit in the wheelchair, positions with the back of resident’s legs against seat of wheelchair

• Leave resident poitioned in wheelchair in proper body alighment, hips against back of the seat and feet on the foot rests

• Remove gait belt gently

• Ask resident about preferences, comfort, and needs during care

• Maintain own body mechanics when assisting to resident to stand, turn, and sit

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: wheelchair and gait belt

• Step 3: To open the wheelchair, grab it from the arm rests and place it near the bed, grab gait belt as well

• Step 4: Position the wheelchair at an angle near the bed so we can pivot the resident into the wheelchair. (make sure to not touch the bed) Swing the footrests out fully.

• Step 5: Now move the wheelchair closer since the footrests have been swung out. Lock both wheels on the chair

• Step 6: LOWER THE WHOLE BED BY THE WAY and raise the HOB to 60 to 90 degrees. Uncover the resident’s body

• Step 7: Grab the resident’s legs and shoulder and explain to them “On the count of 3, I am going to swing your body out and make sure your feet are flat on the floor.” Proceed to swing them out, ask if they are dizzy and okay

• Step 8: Tell them to make sure their feet are flat on the floor and put their shoes on

• Step 9: Grab the gait belt and place it around their waist. Make sure the part with the extra belt is facing inside and the buckle is facing you. As before, feed the belt through the teeth and place 2-3 fingers behind to gauge the tightness of the belt and tuck in

• Step 10: Ask the resident to put their feet together and make sure the wheelchair is close and almost touching the patient (do not touch them with it), make sure the wheels are locked.

• Step 11: Place your foot against the resident’s feet and grab them by the sides of the belt, say “You can use my shoulder for support, on the count of 3, I’m going to move you to the wheelchair.” Pivot them to the wheelchair, ask if they dizzy and okay

• Step 12: Swoing one of the footrests out and place their foot on it. Cross the other over and place the foot on top of the foot that is resting

• Step 13: Unlock the wheels and move them away from the bed, lock the wheels again and swing the other foot rest out to place the other foot on the rest

• Step 14: Grab the gait belt by their back and say “at the count of 3, I’m going to help you sit all th way back.” Ask if they are comfortable

• Step 15: Remove gait belt from their waist and put it away

• Step 16: Lower HOB just a little, make bed and tidy it up. Make conversation with them, “do you have any plans for today, etc.” and leave the call light with them. Open curtain and wash hands. End skill

Change of Positon (to the side)

Key Points:

• Position and align resident for safe turning

• Position pillow rolled and tucked against resident’s back

• Leave resident positioned on side with upper leg bent in front of lower leg

• Position pillow betwen legs, under had, one to support upper shoulder, arm and hand

• Place pillow t osupport upper arm, supporting shoulder and arm

• Keep resident always positioned a safe distance from edge of the bed

• Do no expose resident during care

• Ask resident about preferences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 3 pillows and a one towel to cover the table

• Step 3: Lower HOB to a flat postion and ask resident to place their abdomen,

• Step 4: The side you working on, uncover the their leg a little and explain to them you are going to move them over the right side of the bed. Grab their shoulder and leg for support and scoot them over.

• Step 5: Uncover their leg and bend their leg at the knee, cover them back up.

• Step 6: Walk to the other side of the bed and place their arm up for safety and uncover them. “At the count of 3, I am going to roll you over on your side.” Make sure to support their hip and shoulder and roll them over. Ask if they are okay and make sure they are covered with the blanket and make sure they are not too close to the edge of the bed

• Step 7: Walk to the other side of the bed and uncover their back. This is where we place the pillows on their body now.

• Step 8: Grab the first pillow, fold it into a hamburger and tuck it into their back (make sure to tell them they are going to feel pressure on their back) and roll them back a little

• Step 9: Uncover their arm now and grab the second pillow. Place the pillow under their arm, make sure to check in with them and ask if they are comfortable. Cover them up

• Step 10: Uncover their leg now and bend the top leg a little and place the last pillow in between their knees and feet. Make sure the knees do not touch each other. Check in with them and cover them back up (do the hospital tuck)

• Step 11; Place towel in hamper, ask if you can do anything for th resident before you leave and adjust the pillow on their head to where the shoulder is touching the bed. Hand them the call light, open the curtain and wash hands. End Skill

Change an occupied bed

Key Points:

• Always keep resident a safe distance from the edge of the bed

• Remove and replace the botom sheet on oneside of the bed before turning resident to remove and replace sheet on the other side of the bed

• Leave bottom sheet free of wrinkles

• Legs or heels are not against any exposed mattress

• Tuck top shee under foot of mattress leaving sheet placed loosely avoiding pressure on toes and allowing for foot movement

• Ask resident about preferences, comfort, and needs during care

• Do not shake linens, unfold them gently

• Raise HOB when you finish

• Roll linens up away from you, dirty side in

• Do not touch sheets with clothing

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: top sheet, fitted sheet, towel for table, and pillowcase

• Step 3: Make sure that the HOB is flat, go to the left side of the bed and raise the patients arm up for safety. Uncover the left side of the patient a little and explain to them you are going to roll them over. When they are rolled over, make sure they are not close to the edge of the bed.

• Step 4: Walk to the other side of the bed and uncover the patient a little, start to remove the corners of the bedsheet and make sure to that patient does not touch the exposed mattress. Be sure to roll the sheets inward and tuck the sheet into the patient

• Step 5: Roll the patient a little mroe and grab the fitted sheet to place on the bed. Do not shake the sheet open, line the corners up with each side of the bed and put the sheet on. Tuck the new sheet in under the patient right next to the old sheet.

• Step 6: Lift their feet up and push the old sheet away and put their feet on the new sheet. Make sure there is no wrinkles in the bed sheet before you roll the patient back down

• Step 7: Ask them to raise the arm while you are still on the same side and roll the patient on the other side now

• Step 8: Uncover the other side of the patient and remove the old sheet by rolling it up in a ball, as you are removing the old sheet be sure to pull the new sheet through, finish placing the new sheet on the bed and make sure to not get any wrinkles left behind. Roll the patient back and make sure they are in the middle of the bed

• Step 9: Take the top sheet now and unfold it gently on top of the patients old blanket. Ask the patient to hold the new sheet with their hands and go to the end of the bed and pull the old sheet out from under by balling it up.

• Step 10: Ask the patient if they want their hands in or out and fix the sheet. Form the cuff at the top near their chest, check each side of the bed to see if the sheet is even on both sides.

• Step 11: Once you are the end of the bed near the side, tuck in the edge under the mattress, and make the hospital corners. To do this: Grab the end of the sheet that farthest from the edge and pull it towards the patient, once that is done tuck the sheet under the bed and drop the corner. After tucking in the sheet, go to the end of the bed and pull up the sheet by the patients sheet to give them room for their feet (make sure to can you wiggle your toes after you do this)

• Step 12: Tell the patient you are going to change the pillow case now and ask if they want the HOB raised or not. Remove the pillow and place the pillow on the table. Place the new pillow case on the bed for now and remove the old sheet by rolling it away from you. Make sure the tag is facing the opening of the new pillow case, fold the pillow into a hotdog and stick it into the new case (match up the corners of the pillow with the case) and smooth it out

• Step 13: Place the towel in the hamper and put the table at the edge of the bed, Hand the patient the call light, open the curtains and wash hands. End Skill

Perineal Care (Female)

Key Points:

• Wear Gloves

• Place a clean bed protector under resident’s butt before cleaning

• Make sure water temp is safe and comfortable

• Apply soap to fingers and then to wet washcloth

• Use a different corner of the washcloth for each wipe

• Wash hands 3 times (before, after taking off gloves, and after care is over)

• Avoid unnecessary exposure of resident during procedure

• Clean inner sides first and then outer sides

• Ask resident about preferences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: Gloves, 2 towels, 2 washcloths, 2 bed protectors, wash basin, and soap

• Step 3: Fill basin with water, do the same as before with the barriers for the faucet and sink.

• Step 4: Put gloves on, remove the soiled bed protector by walking to the left side of the patient and rolling them over on one side. Raise the patients arm up for safety and support them by their shoulder and hip to roll them over. Make sure to push them back a little from the edge.

• Step 5: Go to the other side of the bed now and start rolling up the soiled bed protector in. Tuck it under the patient

• Step 6: Grab the 2 new protectors and place on the bed on top of each other. Fold both in towards you (to create a hamburger almost), then fold them in on each other to start the roll. The new protectors will be rolled UNDERNEATH the soiled protector. Roll the patient back to the middle of the bed

• Step 7: Head to the othe side of the bed, roll up the old bed protector and throw it in the hamper. Unroll the new protectors and cover the patient back up

• Step 8: Wet one washcloth and check the water temp with the patient, apply a small amount of soap on the four corners you are using to wipe the patient with.

• Step 9; Uncover the patient and lift up their gown to expose the vagina. Wipe down the middle, change the corner, wipe down the middle again, change the corner, wipe the inner fold once, change the corner, and wipe the other inner fold once

• Step 10: Rinse the soapy wash cloth again and apply another small amount of soap to the 4 corners to wash the outer parts. Wipe one outer side, change the corner, wipe the other outer side, change the corner, wipe the inner thigh, change the corner, and wipe other inner thigh

• Step 11: Place the soapy washcloth next to the soap bottle on the basin. Grab the other washcloth to rinse the patient now

• Step 12: Check the temp again with patient, do the same steps again from the soapy washcloth. Wipe down the middle, change the corner, wipe down the middle again, change the corner, wipe the inner side, change the corner, and wipe the other inner side

• Step 13: Rinse the same washcloth again, wipe the outer side, change the corner, wipe the other outer side, change the corner, wipe the inner thigh, change the corner, and wipe the other inner thigh

• Step 14: Take the towel and pat dry the patient, front to back. Dry each side of the thigh

• Step 15: Cover the patient back up. Go to the left side and uncover the patients arm and raise the arm for safety. Roll the patient on their side by supporting their hip and shoulder and make sure they are not too close to edge of the bed.

• Step 16: Grab the washcloth that has soap on it and rinse it in the basin, apply a small amount of soap to each of the corners.

• Step 17: Uncover the patient, check the temp with the patient by touching the cloth to their back. Wipe from the butthole to the crack, change the corner, wipe from butthole to the crack again, change the corner, wipe one cheek, change the corner, and wipe the other cheek, DO NOT PUT THAT WASHCLOTH BACK IN THE WATER

• Step 18: Take the washcloth used for rinsing and wet it in the basin. Rinse the patient with the same steps, wipe from butthole to the crack, change the corner, wipe that area again, change the corner, wipe one cheek, change the corner, and wipe the other cheek

• Step 19: Pat dry the patient now, making sure to change the side of the towel each time you move to a new area

• Step 20: Proceed to remove the top bed protector from earlier. Do this by rolling the proector in and tucking it under the patient, roll the patient back on their back in the middle and cover them

• Step 21: Uncover a litte them on the other side of the bed and raise the gown a little. Remove the old bed protector by rolling it up and placing it in the hamper.

• Step 22: Lower their arm and cover them up. Throw the towel in the hamper along with the washcloths in the hamper. Take the basin to the toilet and throw the water in the toilet, start rinsing in the sink (the water in the basin throw it in the toilet again) and rinse the outside of the basin. Turn the sink off, grab a new paper towel to dry off the basin and sanitize it

• Step 23: Grab a new paper towel to place the basin in its respective spot. Place the soap with that same paper towel in its respective spot as well. Place the table back at the end of the bed and grab the towel to throw into the hamper.

• Step 24: Take gloves off, wash hands. Tell the patient you are done for now and hand them the call light. Open the curtains, wash hands. End Skill

Catheter Care

Key Points:

• Wear gloves

• Place bed protector before starting care

• Water temp should be safe and comfortable

• Change the corner of washcloth for each clean and rinse wiping the labia from front to back

• Clean catheter

• Leave tubing free of kinks or obstructions and keep tubing and urinary bag off the floor

• Do not pull on the catheter

• Ask resident about water temp

• Ask resident about prefereences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 2 towels, gloves, 2 washcloths, bed protector, wash basin, soap

• Step 3: Don’t forget one towel is the table to spread. Fill the basin like before, placing the barrier for the sink and the facuet. Make sure to check water temp to see if its warm, after filling the basin, lower the HOB to the flat position

• Step 4: Put gloves on. Roll the patient towards the urinary bag, uncover their arm and raise it for safety, supporting the shoulder and hip, roll them over towards you and make sure they are not too close to the edge. You might have to push the dummy back a bit so they are not going to fall off the edge

• Step 5: Go to the other side of the bed and uncover the patients back. Place the bed protector on the bed by lining it up with the edge of the bed and roll it up and tuck it under the patient. When you tuck it in near the catheter, you have to hold the catheter out of the way while you are tucking. Roll the patient back on their back

• Step 6: Go back to the other side and grab the tube line to roll out the clean bed protector. Lower their arm

• Step 7: Grab one of the washcloths and wet it check water temp with patient, apply a small amount of soap to all 4 corners of the washcloth

• Step 8: Hold the cathter now and clean the inner sides. Wipe one inner side, change the corner, wipe the same side, change the corner, wipe the other inner side, change the corner, and wipe the same inner side again

• Step 9: Rinse that washcloth again, apply another small amount of soap to the 4 corners again. Hold the catheter once again and wash the outer sides, wash one side, change the corner, wipe the other outer side, change the corner, wash the catheter 2-4 inches down, change the corner and wipe the catheter again. Place that same soapy washcloth next to the bottle resting on the basin. This is to remember which cloth has soap

• Step 10: Grab the other clean washcloth and rinse it now. Check the water temp with patient. Rinse the inner sides, hold the cathter, wipe the inner side, change the corner, wipe the same side, change the corner, wipe the other inner side, change the corner, and wipe the same side again. Rinse the washcloth again in the basin and wash the outer sides. Hold the catheter and wipe the outer side, change the corner, wipe the other outer side while still holding the catheter, change the corner, make the corner bigger to rinse the catheter 2-4 inches down, change the corner, and rinse the catheter again.

• Step 11: Take the towel dry off the patient, pat dry them changing the side of the towel when you move to a new area. Hold the catheter, dry one side, change the side of the towel again and dry the other side. Change the towel side again and dry the catheter. Cover the patient back up

• Step 12: Remove the bed protector now, go to the side where the urine bag is and roll the patient over like before. Don’t forget to raise the arm before rolling and push them back from the edge. Go to the other side of the bed and uncover them, roll the protector towards them and tuck it under them, when tucking near the legs, don’t forget to hold the catheter to tuck. Roll them on their back

• Step 13: Go back to the other side and hold the line for support and remove the bed protector, roll it up and throw it into the hamper. Check the line for kinks as well in this stage, lower their arm and cover them back

• Step 14: Clean up by throwing the towel and washcloths into the hamper, go empty the basin in the toilet. When rinsing the basin, any water that gets into the basin, you dump it into the toilet. Rinse the outside of the basin without touching it to the sink then dry it off and sanitize. Use the paper towel barrier

• Step 15: Grab a paper towel to open the drawer and place the basin on top in its respective drawer. Take that same paper towel to put the soap back and throw it away. Throw towel into the hamper and place table back near the end of the bed. Take gloves off and wash hands

• Step 16: Tidy up the blanket and tell the patient you are done for now and hand them the call light. Ask if they want the HOB flat or up and open the curtains and wash hands again. End Skill

Partial Bed Bath

Key Points:

• Water temp should be safe and comfortable (110-115 degrees)

• Expose area being washed only, then cover again when done with the area

• Do not use soap on eyes and face

• Replace gown with a clean one

• Use a small amount of soap, applyimg soap on fingers and then to washcloth

• Protector bed linen from becoming wet during bath

• Ask resident about comfort with water temp

• Ask resident about prefereneces, comfort and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 3 towels (one will be spread on the table), 2 washcloths, wash basin, soap, lotion, and clean gown

• Step 3: Fill basin with water as before using the paper barriers for the sink and facuet. Be sure to check the water temp every few minutes while filling up the basin and lower the HOB flat

• Step 4: Uncover the patients left arm and keep the CHEST COVERED AT ALL TIMES FOR PRIVACY! Lift the patients head and untie their gown.

• Step 5: Supporting that same left arm now, proceed to slide down the patients gown and ball it up to the other side of the patient. Walk to the other side of the bed now and support the right arm to take off the patients gown by sliding it down their arm. Ball up the gown and throw it into the hamper

• Step 6: Take one towel and place it under the patients head and uncover the one arm, raise the arm and unfold the towel and place it under the arm

• Step 7: Grab the clean washcloth and wet it in the basin. Check the water temp with the patient by touching it to their arm and asking if its okay. Make the 4 corners and tell the patient to close their arms to wipe their eyes to clean it. Clean one eye inside to outside, change the corner, wipe the other eye, change the corner, wipe the head to ear to chin on one side, change the corner, and wipe the head to ear to chin. Place the washcloth on the side that is NOT near the soap and pat dry the patients face

• Step 8: Grab the other washcloth to apply a small amount of soap to the cloth, uncover the patients chest and wipe from the neck to the breasts (do a figure 8 motion) and to the abdomen, place that washcloth next to the soap bottle and grab the other washcloth to rinse in the same motion as before. Take the towel near the arm and open it to pat dry the chest and abdomen

• Step 9: Cover the patient back up and uncover the arm, grab the soapy washcloth again and apply another small amount of soap to the cloth to start washing the arm. Support the arm while washing from the armpit to the bicep to the forarm hands and in between fingers. Place the soapy washcloth back next to the soap bottle and grab the regular washcloth to rinse the arm in the same fashion. Take the towel near the arm and pat dry that arm off. After this, ball up the towel and throw it into the hamper. Cover that arm up again

• Step 10: Grab the clean gown now and spread it open on the blanket. Uncover the arm and keeping the blanket covered on the chest, feed the gown through the arm. Go to the other side and do the same thing as well

• Step 11: Hold the gown now, pull down the blanket so that the gown falls onto the patients body and cover them back up. On that same side you pulled the blanket, lift their arm up for safety and support the patient by the hips and shoulder to roll them towards you, make sure they are not too close to the edge and push them back.

• Step 12: Go back to the other side grab the towel and spread it across the patients back. Grab the soapy washcloth now and rinse it again, check the temp with the patient once again and apply a small amount of a soap to the cloth. Tell the patient you are going to wash their back now. Go from the top and wipe all the down. Place the soapy washcloth next to the soap bottle again and grab the other washcloth to rinse the patients back. Take the towel now and pat dry

• Step 13: Pump a small amount of lotion in your hand and warm it up. Tell the patient you are going massage some lotion into their back and go from the bottom up in a circular motion up. Pump another small amount of lotion into your hand and do the same thing. Pat dry the back and throw that towel into the hamper. Tie the gown now and roll the patient back onto their back and lower their arm on the other side. Fix their bed now and ask if they are comfortable and ask if they want the HOB flat or up.

• Step 14: Clean up everything now, use the paper towel barrier to turn on the sink and empty the basin in the toilet and rinse the inside of the basin and throw that water into the toilet and rinse the outside and turn off the faucet. Dry off the basin now and sanitize

• Step 15: Put the basin back in its respective spot along with the soap and lotion. Take the towel and washcloths and throw them into the hamper. Put the table back near the end of the bed and hand the patient the call light, ask if they need anything else from you before you leave or if they need any blankets or pillows. Open the curtains and wash hands. End Skill

Dressing a resident with a weak arm

Key Points:

• Give resident choice about what to wear

• Collect clothes before removing gown

• Undress strong side first

• Dress the weak side first

• Do not expose the resident

• Do all zippers and buttons

• Keep resident positioned a safe distance from the edge of the bed at all times

• Ask resident about preferences, comfort, and needs during care

• Step 1: Knock on the door, introduce yourself and explain what you are doing today to the resident and if they are okay with it.

• Step 2: Close the curtain and wash your hands. Grab the materials needed: 1 pair of socks, 2 shirts, and 2 pants, lower the HOB to the flat position

• Step 3: Show the patient the 2 choices of outfits and ask what would they like to wear. Depending where, you are first going to ungown the patient on their STRONG side first then go to the weak. Bring the blanket all the way to their chest for privacy and bring their head up to unite the gown. Now uncover their STRONG arm first and supporting the arm, slide the gown down their arm to take it off and ball it up to the other side. Cover their arm again

• Step 4: Uncover the weak side now and do the same as before to take off the gown and ball the patients gown away from you and throw it into the hamper. Cover that arm back up now

• Step 5: Tell the patient you are going to uncover their feet to put their socks on now. Take one sock and scrunch it up to make putting it on easier. Slide the sock onto the foot and smooth out any wrinkles. Do the same for the other sock

• Step 6: Now grab the pants and unfold it on the bed, place your arm through one sleeve of the pants, grab the patients foot and slide the pants onto the leg, bend the knee on the other leg a little and place the other pant sleeve on in the same fashion.

• Step 7: Go to the side of bed now and uncover the legs more and pull the pants up the leg. Make sure to unscrunch the pants by the ankles as well while you are pulling it up the legs

• Step 8: Uncover them a little more to get the pants up to the pelvis, tell the patient “at the count of 3, I’m going to raise your hips.” While the hips are raised, slide the pants up to the hips. Do the same on the other side, if there is a zipper and button, do those as well

• Step 9: Cover the patient back up. UNCOVER THE WEAK ARM NOW! Grab the shirt and slip your arm through it like you did with the pants. (fold the shirt in a hotdog type way where the one sleeve is on the top and one sleeve is on the bottom) Take the half of the shirt now and bring it over the patients chest above the blanket now. If there are cuff buttons, do those

• Step 10: Bring the other half of the shirt near the patients head and tell them “at the count of 3, I am going to lift your head up.” and place the other half of the shirt on the other side of bed.

• Step 11: Go to the STRONG side side now and uncover it. Place your arm through the sleeve again, raise the patients head a little and bring as much of the shirt as you can to the back. Raise the patients arm now and gently slide down the sleeve and place their arm back down. Place the other half of the shirt on the blanket. Raise the patients head to fix the collar and smooth down the shirt to make sure there are no wrinkles on the patients back (you can do this by pulling the bottom on the shirt down to bring the wrinkles out) and do the same to the other side and bring the 2 halves together, snap the cuff buttons together

• Step 12: Now button up the shirt on top of the blanket. Gently remove the blanket from the shirt and make sure it looks smooth and not wrinkly.

• Step 13: Make the bed and make sure both sides are even (no blanket touching the floor), tuck the end of the bed and do the hospital corners for each side of the bed near the patients feet. Give wiggle room to patients feet. Ask if the patient wants the HOB raised or flat. Give the patient the call light and ask them if they need anything from you before you leave. Open the curtains and wash hands. End Skill