Clinical Skills Test Detailed Notes

Handwashing Procedure

  • Steps for Proper Handwashing:
    1. Begins Handwashing:
    • Wet hands with running water.
    • Apply soap to hands.
    1. Use of Friction:
    • Distribute soap and create lather by rubbing hands together.
    • Ensure cleaning of:
      • Front and back of hands.
      • Between fingers.
      • Around cuticles.
      • Under nails and wrists.
    1. Duration of Cleansing Friction:
    • Provide a minimum of 20 seconds of friction with lathered hands.
    1. Rinsing:
    • Rinse hands and wrists thoroughly to remove all soap.
    1. Drying Hands:
    • Use clean paper towel(s) to dry hands and wrists.
    • Dispose of used paper towel in trash.
    1. Ending Handwashing:
    • Ensure hands are clean, avoid recontamination by not touching faucet handles or sink surfaces after washing.

Clinical Skills Test Overview

  • During clinical training, multiple skills are taught, important for resident care.
  • Skills in the Clinical Skills Test:
    • A total of 22 skills are included.
    • The testing process involves a computer randomly selecting five scored skills for each candidate.
    • Every candidate is evaluated on handwashing and indirect care skills.
    • Instructions for skills may differ based on residents' needs.
  • Core Skills Checklist:
    • Each skill under test has checkpoints for evaluation.
    • Evaluator inputs observations post-test into a computer.
    • Results are available on test day barring any technological issues (e.g., printer problems).
    • Familiarity with General Instructions before testing is encouraged.

Testing Environment

  • Candidates receive a tour of the testing facility similar to a resident’s room, with care supplies organized accordingly.
  • Candidates perform skills based on the competencies learned through instruction, textbooks, and other materials.
  • Throughout the test, no direct instruction is provided to candidates regarding handwashing steps or proper timing.

Indirect Care Skills (IC)

  • General Indirect Care Principles:
    • Evaluated continuously throughout skill performance.
    • Behaviors assessed include:
    1. Greeting residents and identifying oneself.
    2. Providing care explanations throughout.
    3. Asking about resident preferences and comfort before tasks are completed.
    4. Following Standard Precautions and infection control measures.
    5. Observing and promoting residents’ rights and safety during care.
    • Not receiving explicit instructions for indirect care while performing skills emphasizes the importance of these behaviors.

Specific Skills Evaluated

Ambulating the Resident Using a Transfer/Gait Belt

  • The candidate must:
    • Greet resident, introduce themselves, and provide care explanation.
    • Ensure proper body mechanics are maintained while assisting the resident.
    • Ask about resident's comfort before and during ambulation.
    • Use a transfer/gait belt correctly.
    • Maintain a safe position while assisting the resident.

Assisting a Resident Needing to Use a Bedpan

  • Steps include:
    • Greeting and explaining process to the resident.
    • Proper placement and removal of the bedpan.
    • Hygiene measures such as wearing gloves during bedpan handling.
    • Asking the resident to signal when assistance is needed or when they are finished with the bedpan.

Changing Bed Linen While the Resident Remains in Bed

  • Candidates must:
    • Communicate with the resident throughout the linen change.
    • Properly remove and replace sheets without pulling or causing friction damage.

Urinary Drainage Bag Handling

  • Candidates are evaluated on:
    • Emptying and measuring urine without contaminating the drainage tube.
    • Recording output accurately on forms.
    • Ensuring safety by keeping the drainage bag off the floor and lower than the bladder during care.

Providing Basic Care Tasks (E.g., Feeding, Mouth Care)

  • Important steps include:
    • Explaining procedures and maintaining resident's comfort and preferences during the process.
    • Ensuring cleanliness of the area post-care.

Range of Motion Exercises

  • Candidates must perform exercises for limbs while supporting the resident to prevent injury.

Conclusion of Test Skills

  • Many skills will end with care completion procedures that include asking about resident preferences and providing a clean environment.
  • Remembering to use Standard Precautions and promoting resident rights and safety is crucial throughout all skills.