Skills Test NAC

Hand Hygiene

1. Wet Hands

2. Apply Soap

   1. Lather wrist, hands, fingers

   2. At least 30 seconds

   3. Keep hands lower than elbows, fingertips down

   4. Clean fingernails against palm of hand

3. Rinse

4. Dry

   1. Start at fingertips and move down

   2. Use new paper towel for each hand

5. Use clean, dry paper towel to turn off faucet

Applies One Knee-High Elastic Stocking

Equipment: 1 stocking

1. Privacy curtain

2. Raise bed

3. Turn stocking inside-out to at least the heel

4. Place on foot

5. Pull up to the knee

6. Opening of toe is above the toe area

7. No twists or wrinkles

8. SD, BL, PC, WH

Assists to Ambulate Using Transfer Belt

Equipment: Gait Belt

1. Privacy curtain

2. Client is assisted to a sitting position with feet flat on the floor: “Scoot to edge”

3. “Please put on your shoes”

4. “bed is at a safe level”

5. put on gait belt (below ribs)

6. Stand facing client, assist them up with both hands, knee to knee

7. Before walking check transfer belt and retighten if necessary

8. Walk client 10 ft while holding onto belt

9. Assist back to bed and leave sitting

10. Remove belt

11. SD, BL, PC, WH

Assists with Use of Bedpan

Equipment: Toilet Paper, Hand Wipes, Bep Pan, Gloves (two pairs)

Before placing bedpan

1. Raises Bed

2. Glove up

3. Place bedpan

4. Remove Gloves

5. Raises HOB, Lower bed

6. TP and wipes within reach; “Clean hands with hand wipe when finished”

7. SD in reach; “signal when finished”

Before removing bedpan:

1. Bed raised, HOB lowered

2. Glove up

3. Remove bedpan

4. Take TP and hand wipes to dirty area

5. Toss waste in toilet

6. Rinse bedpan

7. Pour rinse in toilet

8. Remove gloves - Wash Hands

9. SD, BL, PC

Cleans Dentures

Equipment: Denture setup (cup, dentures, toothpaste, toothbrush), paper towels, gloves

1. Glove up

2. Line counter AND bottom of sink with paper towels

3. Rinse denture cup

4. Fill denture cup to ½

5. Rinse and wash dentures, put into cup when done and put lid on cup

6. Remove paper towels, remove gloves - Wash Hands

Counts and records Radial Pulse

1. SD within reach

2. “Start”, 1 full minute, “Stop”

3. WASH HANDS

4. Record Pulse

May restart up to 4 times

Counts and Records Respirations

1. Intro; “for testing purposes”

2. SD within reach

3. “Start”, 1 full minute, “Stop”

4. WASH HANDS

5. Record Respirations

Donning and Removing PPE

Equipment: PPE gown (yellow), Gloves

1. Don gown, fasten neck and then waist ties

2. Don gloves, gloves cover cuffs of gown

3. Remove gloves, untie gown

4. ONLY TOUCHING CUFF, pull hands inside sleeves

5. Cross arms, grasping sleeve at elbows, pull

6. Hold away from body, roll gown 2 times

7. Dispose

8. WASH HANDS

Dresses Client with Affected Right Arm

Equipment: 2 shirts

1. Privacy curtain, Raise bed

2. Bring TWO shirts, ask which they prefer

3. Assumed that RIGHT arm is weak arm

4. Remove gown from LEFT side first, then Right

5. ASSIST putting shirt on: RIGHT first then Left

6. SD, BL, PC, WH

Feeds Client Who Cannot Feed Self

Equipment: Food tray, hand wipes, napkin

1. Look at name card; Asks client to “Please tell me your name”

2. Asks client to sit on side of the bed

3. Sit in chair facing client

4. Clean hands with hand wipes before feeding

5. Offer choice of what food to eat

6. Ask if they need a drink

After Feeding:

1. Clean clients mouth with napkin

2. Clean clients hands with wipes

3. Remove food tray

4. SD, WH

Gives Modified Bed Bath

Equipment: Gloves, Bath Basin, Soap, Clean gown, 1 bath towel, 1 small towel, 3 wash cloths

1. SD, PC, Raise Bed

2. Remove gown

3. Fill basin, check temp

4. Glove up

FACE:

1. Place Small Towel on neck

2. wet washcloth (NO SOAP), wash eyes → nose → face (different part of washcloth for each stroke)

3. Dry with Small Towel

ARM:

1. Place bath towel under arm

2. wet washcloth (WITH SOAP), wash finger → fingernails → hand → arm → armpit

3. RINSE: wet washcloth, wash finger → fingernails → hand → arm → armpit

4. Dry with bath towel

AFTER:

1. Put clean gown on client

2. Empty basin, rinse, dry

3. Remove gloves - Wash Hands

4. SD, BL, PC

Measure and Record BP

1. Clean with alcohol wipes

2. inflate between 160-180 mmHg

3. Measures BP

4. Remove cuff

5. SD within reach

6. WASH HANDS

7. Record BP

Measures and Records Urinary Output

1. Glove up

2. Pour bedpan urine into measuring container

3. Rinse bedpan, rinse goes into toilet, place bedpan back where you found it

4. Check levels

5. Empty container into toilet, rinse container and empty into toilet

6. Remove gloves - WASH HANDS

7. Record measurement

Measures and Records Weight of Ambulatory Client

1. Asks client to put shoes on before walking to scale

2. Set scale to ZERO before client steps on

3. Obtain Weight

4. WASH HANDS

5. Record weight in lbs

PROM for One knee and One ankle

1. PC, Bed Raised

2. “Let me know if you have any pain”

Knee

1. Support under ANKLE and KNEE

2. Bend knee, keeping foot close to bed (3 times)

3. Ask if there’s pain

PROM Ankle

1. Support Ankle

2. Push/Pull foot forwards/backwards 3 times

3. Ask if there’s pain

SD, PC, BL, WH

PROM for One Shoulder

1. PC, Bed Raised

2. “Let me know if you have any pain”

3. Support wrist and elbow

4. Raise arm to ear level 3 times

5. Ask if there’s pain

6. Abduct arm away 3 times

7. Ask if there’s pain

8. SD, PC, BL, WH

Positions on Side

Equipment: 4 pillows (bring 3)

1. PC, Bed Raised

2. Assist client with ONE hand to slowly roll to side

3. Pillow under head

4. Pillow behind clients back

5. Pillow between legs with top knee flexed

6. Pillow under top arm

7. Untuck shoulder

8. SD, PC, BL, WH

Provide catheter care for Female

Equipment: Basin, Soap, 1 Small Towel, 3 washcloths

1. PC, Bed Raised

2. Fill Basin

3. Have client check water temp

4. Glove up

5. Place small towel under buttocks

Wash Catheter

1. Apply soap to wet washcloth

2. Hold catheter at meatus with hand resting on pubic bone

3. 1 stroke 4 inches

Rinse

1. Wet washcloth

2. Hold catheter at meatus with hand resting on pubic bone

3. 1 stroke 4 inches

Dry

1. Dry washcloth

2. Hold catheter at meatus with hand resting on pubic bone

3. 1 stroke 4 inches

End:

1. Remove small towel

2. Cover client

3. Empty basin, rinse, dry

4. Remove gloves - Wash Hands

5. SD, PC, BL

Provides Foot Care on One Foot

Equipment: Gloves, basin, soap, lotion, 1 bath towel, 3 washcloths

1. PC, Bed Raised

2. Fill basin

3. Client checks water temp

4. Glove up

5. Bath towel is under leg

6. Clients foot is placed in basin

7. Apply soap to wet washcloth

8. Lift foot, wash foot (between toes) - 1 washcloth

9. Rinse foot (between toes) - 1 washcloth

10. Dries foot (between toes) - 1 washcloth

11. Apply lotion (NOT between toes)

    1. Dry excess with bath towel

12. Empty, rinse, dry basin

13. Dispose gloves - Wash hands

14. SD, PC, BL

Provides Mouth Care

Equipment: Gloves, Emesis basin, tooth brush, toothpaste, cup of water, paper towel, 1 small towell

1. PC

2. Instruct client to sit on side of bed

3. Glove up

4. Put paper towel on table

5. Put small towel around neck

6. Wet toothbrush, apply toothpaste

7. Brush teeth and tongue

8. Put toothbrush on paper towel

9. Give client water and spit into emesis basin

10. wipe mouth with cloth

11. Remove towel

AT SINK

1. Rinse toothbrush

2. Empty, rinse, dry basin

3. Remove gloves - Wash hands

4. SD, PC, BL

PeriCare for Female

Equipment: Gloves, bath basin, soap, 1 small towel, 6 washcloths

1. PC, bed raised

2. Fill basin, client checks temp

3. Glove up

4. 1 small towel under buttocks

5. Applies soap to wet washcloth

6. WASH genital area (1 stroke, front-to-back)

7. RINSE genital area (1 stroke, front-to-back)

8. DRY genital area (1 stroke, front-to-back)

9. Turn client onto side

10. WASH rectal area (1 stroke, front-to-back)

11. RINSE rectal area (1 stroke, front-to-back)

12. DRY rectal area (1 stroke, front-to-back)

13. Remove towel under buttocks

14. Empty, rinse, dry basin

15. Dispose of gloves- wash hands

16. SD, PC, BL

Transfers from Bed to Wheelchair using Transfer Belt

Equipment needed: Gait Belt, Wheelchair

1. PC

2. Wheelchair alongside bed, footrests folded or removed

3. LOCK wheelchair

4. Client assisted to sitting position, with feet flat on floor

5. “Please put on your shoes”

6. Push on bed to make sure wheels are locked

7. Say “Bed is at a safe level”

8. Apply Gait Belt

9. Stand facing client and assist with standing (both hands on belt)

10. Have clients legs touch seat of wheelchair.

11. Position client with hips touching back of wheelchair

12. Remove gait belt

13. Feet on foot rests

14. SD, PC, BL, WH