Clinical Skills Checklist for Nursing Assistant
A certified nursing assistant goes through clinical skills training during the CNA program he/ she is enrolled into. These skills are taught so that the nurse assistant will be able to perform his/her duties properly and assist patients in their routine healthcare activities. The certification exam has a practical paper during which the applicant has to perform five of these skills to clear the exam.
Below is the CNA clinical skills checklist which will help you in preparing for the clinical skills paper and in taking patient care later when you practice as a CNA.
- Hand washing skills
Hand washing is one very important aspect of CNA job skills as it helps in controlling and spreading of any infection to the resident as well as the nurse aide. Before applying soap you must get your hands and wrists wet and provide proper friction of at least twenty seconds. Clean your hands between fingers, nails, wrists and cuticles; separate them and rinse thoroughly. Turn off tap using a paper towel and discard that towel into a bin. Use another paper towel to dry your hands completely.
- Measuring weight
Measuring weight is another important skill of a nursing assistant and you must ensure that the weighing equipment is in proper working condition before starting the procedure. Set both the scales on zero before you tell the client to stand on the weighing scale. Assist the patient to stand on the scale if necessary and make sure that the client's feet are flat on the scale standing on it. Record the weight and note the difference from the last count. Ensure that the patient does not walk backward but forward to the bed.
- Ambulate patients
Before starting the ambulating procedure the CNA must explain all the procedure to the patients and clear any doubts they may have. Position the gait belt before making the patient stand and snug it below the ribs. Ensure that the resident is at comfort and there is no risk of any injury. Help the client to stand by holding the sides of the patient and ask the him or her to stand with flat feet. Ask the if he/she if feeling dizzy before walking and carefully walk the him or her up to the wheel chair; turn back to the chair and gently lower the patient onto the chair.
- Measuring blood pressure
Find the brachial pulse before you place the cuff on the arm and once again before you place the stethoscope on the arm. While inflating the cuff carefully listen to the heartbeat. The cuff inflation should be a maximum of 180 mm Hg. Control the deflation of the cuff and accurately record the blood pressure. Make sure that you clean the equipment before storing it in the box.
- Recording pulse and respiration
Pulse and respiration count should be taken for exactly sixty seconds; notice your watch carefully while taking the count. You must support the patient by holding the arm on the mattress while you take the count and make a record of the count.
- Oral and dental care
While providing oral and dental care use of gloves is necessary. If the resident is unable to walk up to the basin provide them emesis basin; raise the head of bed and brush the teeth properly along the gums and chewing surface of the teeth. The client can rinse his mouth and spit in the emesis basin; dry the mouth with a clean towel. Dispose the contents of the basin in the wash area and clean, sanitize and dry the basin and store it properly wrapped in a paper towel.
- Feed the patient
Raise the head of bed and sit on the bed while feeding; use a spoon but gloves are not required while feeding. Make sure the meal is according to the diet specified by the physician. Talk politely to the patient and make sure sufficient amount of food intake; encourage a reluctant client in doing so.
- Help in motion exercises
Assisting patients in motion exercises of the upper and lower body parts is an important skill of CNA. The nurse aide must be aware of all the upper body exercises like rotation of wrist and fingers, touching the chest in curls, arm to back wall, snow angel, wiper motion etc. The lower body exercises include ankle rotation, gas pedal, knee into chest, snow angel and long roll. A CNA must be able to assist them in doing these exercises and any other as per the directions of the supervising nurse.
- Use of bedpan
The CNA has to assist patient in use of bedpan and must know how to properly place the bedpan. Place the bedpan flat on the bed and not on the bedside table. Position the bedpan crack to crack and give the resident a call bell before going behind the scene. After the patient is done assist the him or her in washing the hand. Dump the waste in the toilet area and clean and sanitize the bedpan. Store it by wrapping it in a paper towel. Use of gloves while performing this duty is a must.
- Positioning patients
A nurse aide must change the position of bed ridden residents at regular time intervals; or whenever a client requests. Ensure that the head of the bed is lowered and the bed is in flat position. Check the resident's arms and pillows; a half-folded pillow must be place at the back of the patient, one between the knee and ankle and one under the arm. Make sure that the shoulder, hips and ankles are not in a straight line and bend the legs slightly while turning the patient to the other side. Never raise the head of bed when the resident is lying on one side of his body.
These are some of the CNA clinical skills that must be learned in CNA programs apart from reporting health changes to the supervising nurse and importantly you have to perform five tasks during the CNA clinical skills test.