Clinical Skills Test Checklist PDF

Clinical Skills Test Checklist During training, you learn many skills that are important materials. The procedure for any skill may include more in caring for residents. There are 22 skills that are part detail about important requirements than are shown in of the Clinical Skills Te...

Clinical Skills Test Checklist During training, you learn many skills that are important materials. The procedure for any skill may include more in caring for residents. There are 22 skills that are part detail about important requirements than are shown in of the Clinical Skills Test. When you are registered to the checkpoints. Your performance may include more test, a computer will decide which skills will be on your detail than is included in the checkpoints. test. A description of the instructions given to candidates for A Clinical Skills Test consists of five scored skills. each skill is provided below before the checkpoints for All candidates taking this test are scored on the each skill. This description includes if a person or Handwashing and Indirect Care skills. When you take mannequin is used for the resident. Usually another your test, you will be given instructions for the other candidate will play the role of the resident when a three skills that are part of your test. Because you learn person is used. In special situations, the nurse may to perform skills in different ways for different residents’ need to play the resident. needs, you are given instructions that describe how the While you are waiting to take the test, you will be given skill is being tested. For example, if you test on the General Instructions to read. These are the basic rules feeding skill, you will feed a resident positioned in a for the Clinical Skills Test. For example, these chair. Remember, you are still responsible for knowing instructions explain what you need to do when you how to feed residents who are positioned in other ways. want to make a correction to a skill you are performing. The Knowledge (Written) Test may also ask questions These General Instructions are also available on the about feeding residents in other different positions. Web site for your state at Each skill in the test has checkpoints. The nurse(s) www.prometric.com/nurseaide. You are encouraged to giving your test will use these checkpoints to rate your review them before you arrive at the test site. performance. After you complete your test, the nurse When you are called into the testing room to take your will enter his/her observations into a computer. test, you will be shown around the room so you can see Prometric’s system will then determine your results. where equipment and supplies are located. The testing Your results are provided on the day of testing, unless a room will be set up similar to a resident’s room. For technology issues, such as a printer problem at the test example, personal care supplies such as the resident’s site, prevents the nurse from providing your results. If toothbrush, toothpaste, basins, and bedpan will be in you are not provided a score report on the day of the resident’s bedside cabinet. testing, see the candidate bulletin for information on accessing your results online. When you are taking your Clinical Skills test, you are required to actually perform the skills. This means you The checkpoints for each of the skills are listed on the must really give care to the actor or mannequin. If the pages that follow. It is important that you understand skill requires water to give care, you must really use that the checklists are not written as procedures. These water.The Clinical Skills test is timed, and the amount of checkpoints are not provided to help you learn skills, time is based on the combination of skills on your test. but to help you understand what the nurse will look for The nurse is not allowed to answer any questions about when you perform a skill. how skills are performed at any time. The procedures for skills are learned from your instructor, nurse aide textbooks, and other training Handwashing Handwashing When taking the test, candidates are not given Does the candidate: instructions about when to wash their hands. This is 1 Begin handwashing by wetting hands and applying because nurse aides are expected to know that their soap to hands? hands should be washed before any physical contact with 2 Use friction to distribute soap and create lather a resident. Candidates are evaluated on how well they cleansing front and back of hands, between fingers, wash their hands (technique) during the first skill. In around cuticles, under nails, and wrists? Florida, where two nurses will be observing your performance throughout the test, one nurse will observe 3 Provide cleansing friction for a minimum of your handwashing at the beginning of the first skill, and 20 seconds with hands lathered with soap? the other nurse will observe your handwashing at the end 4 Rinse hands and wrists removing soap? of first skill. 5 Use clean paper towel(s) to dry hands and wrists, and dispose of used paper towel in trash? After the first skill is completed, for the remainder of the 6 End handwashing skill with clean hands avoiding test, handwashing is evaluated as a part of Indirect Care recontamination of hands before procedure with the checkpoint, “Use Standard Precautions and completed (e.g., having direct contact with faucet Infection Control Measures when providing care.” handles or sink surfaces once hands washed)? Copyright © 2014 Prometric Inc., a Delaware 1 20140101 corporation. All Rights Reserved. CLINICAL SKILLS TEST CHECKLIST Indirect Care Ambulate the resident using a transfer/gait belt Indirect Care is a skill that is evaluated while you perform 13 Remove transfer/gait belt from resident’s waist each skill. This skill evaluates behaviors that are common without harming resident (e.g., pulling transfer/gait to any resident care such as: infection control, safety, belt) when seated in chair after ambulation? communication, and resident preferences, needs, comfort 14 Maintain own body mechanics when assisting and rights. You are not given instructions to perform the resident to stand and sit? Indirect Care skill. The nurse watches for these behaviors 15 Leave resident positioned in chair in proper body while you perform each skill. In the checkpoints provided alignment and hips against back of seat? for each skill below, Indirect Care checkpoints are identified with an “(IC)” at the end. Indirect Care is one 16 Ask resident about preferences during care? (IC) of the five skills scored in every Clinical Skills Test. The 17 Use Standard Precautions and infection control Indirect Care checkpoints are: measures when providing care? (IC) Does the candidate: 18 Ask resident about comfort or needs during care or 1 Greet resident, address by name, and introduce before care completed? (IC) self? (IC) 19 Promote resident’s rights during care? (IC) 2 Provide explanations to resident about care before 20 Promote resident’s safety during care? (IC) beginning and during care? (IC) 3 Ask resident about preferences during care? (IC) 4 Use Standard Precautions and infection control Assist resident needing to use a bedpan measures when providing care? (IC) The candidate is asked to help a resident who has asked 5 Ask resident about comfort or needs during care or for a bedpan. The role of the resident is played by a before care completed? (IC) person who will be wearing a hospital-style gown over clothing. For the purposes of testing, the candidate will 6 Promote resident’s rights during care? (IC) pretend that the resident (actor) is not wearing 7 Promote resident’s safety during care? (IC) underpants. Does the candidate: 1 Greet resident, address by name and introduce self? Ambulate the resident using a transfer/gait belt (IC) The candidate is asked to walk a resident who needs 2 Provide explanations to resident about care before some assistance to stand. A transfer/gait belt is used beginning and during care? (IC) while walking the resident. The role of the resident is played by a person. 3 Place protective pad on bed over bottom sheet, under buttocks/upper thigh area, before placing Does the candidate: bedpan, and remove the pad after bedpan is 1 Greet resident, address by name and introduce self? removed? (IC) 4 Place and remove bedpan by either having resident 2 Provide explanations to resident about care before positioned on side to turn on/off back, onto/off beginning and during care? (IC) bedpan, or having resident raise hips off bed? 3 Apply transfer/gait belt before standing resident, 5 Position bedpan under resident according to placing around the resident’s waist and over form/shape of the selected bedpan? clothing, secure so that only flat fingers/hand fit 6 Position bedpan to allow for collection? under belt, and the belt does not catch skin or skin folds (e.g. breast tissue)? 7 Raise the head of the bed after positioning the resident on the bedpan, and lower the head of the 4 Provide signal or cue to resident before assisting to bed before removing bedpan? stand? 8 Ask resident to call when finished or if needs help, 5 Assist resident to stand while holding onto the leaving call light within the resident’s reach before transfer/gait belt without holding belt only at the leaving resident to use bedpan? front or only at nearest side (if assisting to stand from the side)? 9 Leave toilet paper within resident's reach before leaving resident to use bedpan? 6 Ask about how resident feels upon standing? 10 Wear gloves when removing bedpan and while 7 Walk resident while standing to the side and slightly emptying and cleaning bedpan? behind resident? 11 Empty contents of bedpan into toilet, rinse bedpan 8 Provide support while walking resident with an arm pouring contents into toilet, and dry bedpan? around resident’s back holding transfer/gait belt? 12 Offer resident damp washcloth or paper towel, or 9 Ask about how resident feels during ambulation? hand wipe, to cleanse hands after bedpan used, 10 Walk resident at least 10 steps? before end of care? 11 Assist resident to turn and have back of legs 13 Complete skill storing bedpan and toilet paper, positioned against the seat of chair before resident placing soiled linens in hamper, and disposing of sits? trash? 12 Provide support to sit resident back into chair? 2  CLINICAL SKILLS TEST CHECKLIST Assist resident needing to use a bedpan Change bed linen while the resident remains in bed 14 Keep resident positioned a safe distance from the 18 Promote resident’s rights during care? (IC) edge of the bed at all times? 19 Promote resident’s safety during care? (IC) 15 Ask resident about preferences during care? (IC) 16 Use Standard Precautions and infection control measures when providing care? (IC) Change resident’s position to a 17 Ask resident about comfort or needs during care or supported side-lying position before care completed? (IC) The candidate is asked to change the position of a 18 Promote resident’s rights during care? (IC) resident who is lying on his/her back, to a side-lying position. The resident requires support to remain 19 Promote resident’s safety during care? (IC) positioned on the side. The role of the resident is played by a person. Change bed linen while the resident remains in bed The candidate is asked to change the top and bottom Does the candidate: sheets and pillowcase on the bed while the resident stays 1 Greet resident, address by name, and introduce in the bed. The role of the resident is played by a person. self? (IC) Does the candidate: 2 Provide explanations to resident about care before 1 Greet resident, address by name and introduce self? beginning and during care? (IC) (IC) 3 Assist resident with turning onto side before placing 2 Provide explanations to resident about care before positioning devices? beginning and during care? (IC) 4 Keep resident positioned a safe distance from the 3 Keep resident positioned a safe distance from the edge of the bed at all times? edge of the bed at all times? 5 Use positioning device/padding or pillow placed 4 Remove and replace bottom sheet on one side of under or against resident’s back (e.g., rolled and the bed, before turning resident to remove and tucked) to maintain resident in a side-lying replace sheet on the other side of the bed? position? 5 Keep resident positioned on a bottom sheet 6 Leave resident positioned on side with upper knee throughout procedure? bent in front of the lower leg? 6 Secure bottom sheet to mattress (e.g., for fitted 7 Support resident’s top leg by placing device(s)/ sheet secure over all four corners of the mattress; padding or pillow(s) between legs? for flat sheet, tuck at head of bed and on sides and 8 Position device(s)/padding or pillow(s) placed extend toward bottom of mattress so that resident’s between legs so that bony prominences of the heels are not against any exposed mattress)? knees and ankles are separated? 7 Leave bottom sheet free of creases or folds? 9 Leave the resident positioned on side without lying 8 Turn or position resident to remove or replace on the shoulder, arm, and hand? sheet(s) without pulling sheets in a manner that 10 Leave pillow placed under head positioned to also creates friction and risks skin shearing? support the resident’s neck and chin? 9 Replace the top sheet over resident with a clean 11 Place device/padding or pillow positioned to support sheet? the resident’s upper arm, supporting both the 10 Tuck top sheet under foot of mattress leaving sheet shoulder and arm? placed loosely, avoiding pressure against toes and 12 Ask resident about preferences during care? (IC) allowing for foot movement? 13 Use Standard Precautions and infection control 11 Leave top sheet placed on top of resident to cover measures when providing care? (IC) body up to shoulder level, without tucking in along 14 Ask resident about comfort or needs during care or sides? before care completed? (IC) 12 Keep pillow positioned under resident’s head 15 Promote resident’s rights during care? (IC) throughout and at the end of the procedure, except when removed briefly to replace pillowcase? 16 Promote resident’s safety during care? (IC) 13 Complete procedure with resident positioned between the top and bottom sheet? 14 Complete skill placing soiled linens in hamper and disposing of trash? 15 Ask resident about preferences during care? (IC) 16 Use Standard Precautions and infection control measures when providing care? (IC) 17 Ask resident about comfort or needs during care or before care completed? (IC) 3 CLINICAL SKILLS TEST CHECKLIST Dress a resident who has a weak arm Empty contents of resident’s urinary drainage bag, The candidate is asked to put a long-sleeved button-front and measure and record urine output on an shirt, pants, and socks on a resident who is lying in bed. Intake and Output (I&O) form The resident is not able to help with the dressing and has 4 Set graduate or bedpan on barrier placed on a weak arm. A mannequin is used for the role of the floor and empty full contents of drainage bag into resident. the graduate or bedpan? Does the candidate: 5 Empty contents of urinary drainage bag without 1 Greet resident, address by name, and introduce contaminating drainage tube (e.g., touching self? (IC) container) and close and protect drain (e.g., clamp and tuck drain into pocket) after emptying 2 Provide explanations to resident about care before drainage bag? beginning and during care? (IC) 6 Set graduate on flat surface protected with 3 Include resident in decision-making about clothing barrier to read, obtaining measurement by to wear? reading graduate at eye level, and if urine 4 Collect all garments before removing hospital gown? poured into graduate from a bedpan, complete 5 Support affected arm while undressing and task over toilet pouring the full amount of urine dressing? into the graduate? 6 Remove hospital gown? 7 Empty urine in graduate into toilet after 7 Dress affected arm first? measuring, rinse and dry container, pouring rinse water into toilet? 8 Gather up sleeve to ease pulling over affected arm? 8 Record output with clean hands? 9 Dress resident by putting on pants, shirt with 9 Record output within +/- 50 mL/cc's of nurse’s sleeves, and socks? measurement? 10 Move resident’s extremities gently without over- 10 Record output as urine and indicate the correct extension or force when undressing and dressing? time on the I&O form? 11 Apply clothing correctly (e.g. front of shirt in front), 11 Leave bag hanging from bed frame (not side adjust clothing for comfort, neatness, alignment, rail), and drainage bag and tubing off (not and close fasteners? touching) the floor? 12 Place dirty gown in hamper? 12 Keep urinary drainage bag positioned lower than 13 Keep resident positioned a safe distance from the bladder throughout care? edge of the bed at all times? 13 Complete skill having stored equipment, placing 14 Ask resident about preferences during care? (IC) soiled linens in hamper, and disposing of trash? 15 Use Standard Precautions and infection control 14 Ask resident about preferences during care? (IC) measures when providing care? (IC) 15 Use Standard Precautions and infection control 16 Ask resident about comfort or needs during care or measures when providing care? (IC) before care completed? (IC) 16 Ask resident about comfort or needs during care 17 Promote resident’s rights during care? (IC) or before care completed? (IC) 18 Promote resident’s safety during care? (IC) 17 Promote resident’s rights during care? (IC) 18 Promote resident’s safety during care? (IC) Empty contents of resident’s urinary drainage bag, and measure and record urine output on an Feed a resident who is sitting in a chair Intake and Output (I&O) form The candidate is asked to feed a snack to a resident who The candidate is asked to empty the resident’s urinary is not able to feed him/herself. The resident is sitting in a drainage bag into a graduate container and to measure the amount of urine. An Intake and Output (I&O) Form chair in an inappropriate position for feeding. A Food and (see sample on website) is provided to record the Fluid Intake Form (sample provided on the website) is measurement. The output should be recorded as urine provided to record the resident’s estimated food and fluid and the correct time recorded for the measurement. The intake. The role of the resident is played by a person. role of the resident is played by either a person or Does the candidate: mannequin. 1 Greet resident, address by name, and introduce Does the candidate: self? (IC) 1 Greet resident, address by name, and introduce 2 Provide explanations to resident about care before self? (IC) beginning and during care? (IC) 2 Provide explanations to resident about care 3 Assist or cue resident to sit upright in chair before before beginning and during care? (IC) feeding? 3 Wear gloves while handling the urinary drainage 4 Offer or assist resident to wash hands before bag, graduate, or any urine-filled container, and feeding using a damp washcloth, paper towel, or remove gloves before documenting I&O? hand wipe? 4  CLINICAL SKILLS TEST CHECKLIST Feed a resident who is sitting in a chair Measure and record a resident’s radial pulse 5 Sit while feeding the resident? 11 Promote resident’s rights during care? (IC) 6 Offer to protect resident’s clothing with a barrier 12 Promote resident’s safety during care? (IC) before feeding, and if used, remove barrier at end of feeding? 7 Use spoon to feed? Measure and record a resident’s respirations 8 Offer fluids to drink throughout feeding; at least The candidate is asked to count the resident’s every 2-3 bites of food? respirations. The respirations should be counted for one 9 Allow resident the opportunity to swallow before full minute. During the test, since this skill is tested feeding the next bite? separately from the measure and record pulse skill, candidates are allowed to tell the resident that his/her 10 Converse with resident during meal pulse is being counted or vital signs taken, instead of (e.g., encourage intake)? stating that respirations are being counted. A 11 Leave area around resident’s mouth clean and dry Measurement Form (sample provided on the website) is when care completed? provided to record the resident’s respiration rate. The 12 Complete skill placing any used linen in hamper, role of the resident is played by a person. disposing of trash, and leaving overbed table dry? Does the candidate: 13 Record the amount of the resident’s food intake on 1 Greet resident, address by name, and introduce the Food and Fluid Intake Form within 25% of the self? (IC) nurse’s measurement? 2 Provide explanations to resident about care before 14 Record the amount of the resident’s fluid intake on beginning and during care? (IC) the Food and Fluid Intake Form within 25% of the 3 Measure rate of respirations without providing nurse’s measurement? instructions to resident about how to breathe? 15 Ask resident about preferences during care? (IC) 4 Count respirations for one full minute? 16 Use Standard Precautions and infection control 5 Record resident’s respiration rate on Measurement measures when providing care? (IC) Form within +/- 2 breaths per minute of nurse’s 17 Ask resident about comfort or needs during care or measurement? before care completed? (IC) 6 Ask resident about preferences during care? (IC) 18 Promote resident’s rights during care? (IC) 7 Use Standard Precautions and infection control 19 Promote resident’s safety during care? (IC) measures when providing care? (IC) 8 Ask resident about comfort or needs during care or before care completed? (IC) Measure and record a resident’s radial pulse 9 Promote resident’s rights during care? (IC) The candidate is asked to take the resident’s radial pulse, 10 Promote resident’s safety during care? (IC) measured at the wrist. The pulse should be counted for one full minute. A Measurement Form (sample provided on the website) is provided to record the resident’s pulse rate. The role of the resident is played by a person. Provide catheter care to a female resident who has an indwelling urinary catheter Does the candidate: The candidate is asked to provide catheter care to a 1 Greet resident, address by name, and introduce female resident who has an indwelling urinary catheter. self? (IC) Soap and water should be used for the catheter care. For 2 Provide explanations to resident about care before testing purposes, only the cleansing of the front perineal beginning and during care? (IC) area and catheter are evaluated; cleansing of the rectal 3 Support resident’s arm in manner to avoid dangling area and buttocks is not tested in this skill. A mannequin while pulse is taken? is used for the role of the resident. 4 Use fingers (not thumb) to take pulse? Does the candidate: 5 Places fingers on wrist at radial pulse to measure 1 Greet resident, address by name, and introduce pulse rate? self? (IC) 6 Count pulse for one full minute? 2 Provide explanations to resident about care before beginning and during care? (IC) 7 Record resident’s pulse rate on Measurement Form within +/- 4 beats per minute of nurse’s 3 Wear gloves while providing catheter care, cleaning measurement? equipment, and handling soiled underpads, washcloths, and towels? 8 Ask resident about preferences during care? (IC) 4 Position towel or underpad under buttocks/thigh 9 Use Standard Precautions and infection control area before cleansing, and when care completed measures when providing care? (IC) remove towel or underpad, or leave resident on a 10 Ask resident about comfort or needs during care or dry underpad? before care completed? (IC) 5 CLINICAL SKILLS TEST CHECKLIST Provide catheter care to a female resident who has Provide foot care to a resident who is an indwelling urinary catheter sitting in a chair 5 Use water of safe temperature for washing and 9 Dry entire top and bottom of foot including between rinsing? toes? 6 Use soapy washcloth to clean inside labia? 10 Warm lotion before applying to foot (e.g., warming 7 Change spot on soapy washcloth for each washing in hands, placing bottle in warm water)? stroke, wiping from front to back when cleansing 11 Apply lotion to top and bottom of foot, excluding inside labia? between toes? 8 Hold catheter near meatus to prevent pulling when 12 Remove visible excess lotion from foot if present handling, and cleanse catheter using clean area of after applying? washcloth, washing away from body and down the 13 Apply sock to foot leaving sock smooth, and replace catheter at least 3-4 inches? shoe; leaving any fasteners, such as ties, secured? 9 Use clean soap-free wet washcloth to remove soap? 14 Provide support to lower extremity throughout 10 Change spot on washcloth for each rinsing stroke, procedure as needed to avoid strain? wiping front to back inside labia, and away from 15 Avoid placing resident’s barefoot directly on floor body when rinsing catheter? before, during or after foot care? 11 Dry perineal area, from front to back after 16 Complete skill having rinsed, dried and stored completing cleansing and rinsing? basin, placing soiled linens in hamper, and 12 Leave tubing free of kinks or obstructions, and keep disposing of trash? tubing and urinary drainage bag off floor? 17 Ask resident about preferences during care? (IC) 13 Keep urinary drainage bag positioned lower than 18 Use Standard Precautions and infection control bladder throughout procedure? measures when providing care? (IC) 14 Complete skill having rinsed, dried and stored 19 Ask resident about comfort or needs during care or basin, placing soiled linens in hamper, disposing of before care completed? (IC) trash, and leaving overbed table dry? 20 Promote resident’s rights during care? (IC) 15 Keep resident positioned a safe distance from the 21 Promote resident’s safety during care? (IC) edge of the bed at all times? 16 Ask resident about preferences during care? (IC) 17 Use Standard Precautions and infection control Provide mouth care to a resident measures when providing care? (IC) who has a denture 18 Ask resident about comfort or needs during care or A resident is sitting at an overbed table and the before care completed? (IC) resident’s denture is in a denture cup. The resident is not 19 Promote resident’s rights during care? (IC) able to provide own mouth or denture care. The 20 Promote resident’s safety during care? (IC) resident’s denture needs to be cleaned and the resident needs mouth care. The denture is stored in a denture cup after cleaning. The role of the resident is played by a person. Provide foot care to a resident who is sitting in a chair Does the candidate: The candidate is asked to provide foot care to a resident. 1 Greet resident, address by name and introduce self? Soap and water is used and foot care is provided to only (IC) one foot. The resident is sitting in a chair. The resident’s 2 Provide explanations to resident about care before sock and shoe are replaced at the end of the skill. The beginning and during care? (IC) resident role is played by a person. 3 Wear gloves when handling denture, providing Does the candidate: mouth care, and rinsing equipment after use? 1 Greet resident, address by name and introduce self? 4 Protect denture from damage while cleaning by (IC) lining sink, filling sink with water, or holding 2 Provide explanations to resident about care before denture directly over basin? beginning and during care? (IC) 5 Protect denture from contamination (e.g., use a 3 Place water filled basin on protective barrier on floor barrier when setting denture on surfaces, avoid to prepare for foot care? placing or rinsing denture in sink water)? 4 Use water of safe temperature for soaking foot? 6 Use cool or tepid running water to clean and rinse denture? 5 Soak resident’s foot in basin of water? 7 Brush all surfaces of the denture using a toothbrush 6 Use soapy washcloth to wash foot without adding or denture brush with toothpaste? soap directly to basin of water? 8 Rinse denture to remove toothpaste? 7 Wash top and bottom of foot and between toes? 8 Remove soap from foot including between toes? 6  CLINICAL SKILLS TEST CHECKLIST Provide mouth care to a resident Provide mouth care to a resident who has teeth who has a denture 8 Offer resident cup of water to rinse mouth after 9 Handle clean denture maintaining cleanliness after brushing? brushed, placing denture in denture cup filled with 9 Provide resident an emesis basin or disposable cup clean cool or tepid water? to use for spitting as needed, such as after rinsing 10 Leave denture cup on resident’s bedside cabinet or mouth? overbed table unless following resident’s preference 10 Leave area around resident’s mouth clean and dry about where denture cup should be stored? when care completed? 11 Protect resident’s clothing before providing mouth 11 Complete skill having rinsed, dried and stored care and remove protective cover when care is basin, placing soiled linens in hamper, storing or completed? disposing of used toothbrush, disposing of trash, 12 Provide mouth care cleaning upper and lower gums, and leaving overbed table dry? using moistened foam-tipped applicator or 12 Ask resident about preferences during care? (IC) toothbrush with toothpaste? 13 Use Standard Precautions and infection control 13 Offer resident cup of water to rinse mouth after measures when providing care? (IC) mouth care? 14 Ask resident about comfort or needs during care or 14 Provide emesis basin or disposable cup to resident before care completed? (IC) to use for spitting as needed? 15 Promote resident’s rights during care? (IC) 15 Leave area around resident’s mouth clean and dry 16 Promote resident’s safety during care? (IC) when care is completed? 16 Complete skill having rinsed, dried and stored basin (if used), emptying sink of water and removing Provide perineal care to a female resident barrier from sink (if used), placing soiled linens in who is incontinent of urine hamper, storing or disposing of used toothbrush, disposing of trash, and leaving overbed table dry? The candidate is asked to provide perineal care to a resident who is incontinent of urine. The resident is lying 17 Ask resident about preferences during care? (IC) in bed on an underpad and is wearing a hospital-style 18 Use Standard Precautions and infection control gown that is dry. A mannequin is used for the role of the measures when providing care? (IC) resident. 19 Ask resident about comfort or needs during care or Does the candidate: before care completed? (IC) 1 Greet resident, address by name and introduce self? 20 Promote resident’s rights during care? (IC) (IC) 21 Promote resident’s safety during care? (IC) 2 Provide explanations to resident about care before beginning and during care? (IC) 3 Wear gloves while providing perineal care, cleaning Provide mouth care to a resident who has teeth equipment, and handling soiled underpads, A resident who has his/her natural teeth is lying in bed washcloths and towels? and needs mouth care. The resident is not able to 4 Remove soiled underpad and replace with dry provide own mouth care. The role of the resident is underpad before beginning cleansing? played by a person. 5 Use water of safe temperature for washing and Does the candidate: rinsing? 1 Greet resident, address by name, and introduce 6 Use soapy washcloth to wash front perineum to self? (IC) include genital and skin fold areas of groin? 2 Provide explanations to resident about care before 7 Change spot on washcloth for washing and rinsing beginning and during care? (IC) strokes when cleansing inside the vulva? 3 Assist resident to sitting position in bed by raising 8 Wipe from front to back with all washing and rinsing HOB and using pillows as needed to position strokes when cleansing the front perineum, to resident upright at 60° to 90° before offering fluid include the genital and skin fold areas of groin? or brushing teeth? 9 Use clean, soap-free, wet washcloth to remove soap 4 Protect resident’s clothing before providing mouth from resident’s skin on front perineum? care and remove protective cover when care 10 Dry front perineum after washed and rinsed, using completed? towel to pat dry, moving from front to back? 5 Moisten toothbrush with water and apply toothpaste 11 Replace water in basin during care if it becomes before brushing teeth? cold or soapy? 6 Wear gloves when brushing resident’s teeth and 12 Position resident on side to prepare for cleansing of wear throughout mouth care including when rinsing buttocks and rectal area? basin and toothbrush after use? 13 Wash, rinse, and dry buttocks and rectal area? 7 Brush sides and biting surfaces of teeth and the gum line with a gentle motion? 7 CLINICAL SKILLS TEST CHECKLIST Provide perineal care to a female resident Provide resident hand and nail care who is incontinent of urine 15 Use Standard Precautions and infection control 14 Wipe from front to back with all washing and rinsing measures when providing care? (IC) strokes when cleansing the rectal area? 16 Ask resident about comfort or needs during care or 15 Leave resident on dry underpad at completion of before care completed? (IC) procedure? 17 Promote resident’s rights during care? (IC) 16 Complete skill having rinsed, dried and stored 18 Promote resident’s safety during care? (IC) basin, placing soiled linens in hamper, disposing of trash, and leaving overbed table dry? 17 Keep resident positioned a safe distance from the Provide resident a partial bed bath and back rub edge of the bed at all times? The candidate is asked to bathe a resident who is in bed 18 Ask resident about preferences during care? (IC) and who is not able to help with his/her bathing. For 19 Use Standard Precautions and infection control testing purposes only, the candidate is asked to wash measures when providing care? (IC) just part of the body so that technique can be evaluated. 20 Ask resident about comfort or needs during care or Instructions ask the candidate to wash the resident’s before care completed? (IC) face, neck, back, one hand and arm, and the chest and abdomen. Soap and water should be used for the 21 Promote resident’s rights during care? (IC) bathing. The resident also needs a back rub. When 22 Promote resident’s safety during care? (IC) completing the skill, the mannequin is dressed in a clean hospital-style gown. A mannequin is used for the role of the resident. Provide resident hand and nail care Does the candidate: The candidate is asked to provide hand and nail care to 1 Greet resident, address by name and introduce self? one hand. The role of the resident is played by a person. (IC) Does the candidate: 2 Provide explanations to resident about care before 1 Greet resident, address by name, and introduce beginning and during care? (IC) self? (IC) 3 Use water of safe temperature for washing and 2 Provide explanations to resident about care before rinsing? beginning and during care? (IC) 4 Cleanse eyes by using soap-free washcloth wiping 3 Use water of safe temperature for soaking fingers eye from the inside corner to the outside corner, or hand? changing to clean area of washcloth before 4 Place fingers or full hand into basin of water to soak returning to inner corner and before cleansing the before removing residue from under nails? other eye? 5 Wash resident’s face using a soap-free wet 5 Clean hand surfaces using wet washcloth, cleaning between fingers, and if soap used, rinse or remove washcloth, unless ascertains resident’s preference soap using a clean, soap-free, wet washcloth or to use soap before washing face? using basin water if not soapy? 6 Leave face dry after washing? 6 Use flat edge of orangewood stick to remove 7 Contain corners of washcloth while washing and residue under tips of each fingernail, and remove rinsing (e.g., forming mitt)? residue from edge of orangewood stick, if present, 8 Protect bed linen from becoming wet during before using again to clean under another washing and rinsing of body (non-face)? fingernail? 9 Wash resident’s body (non-face) using a wet 7 Rest resident’s hand on barrier such as a dry towel washcloth with small amount of soap? once removed from basin while providing nail and 10 Use clean, soap-free, wet washcloth to remove soap hand care? from resident’s skin? 8 Dry hand before completing care? 11 Wash and rinse resident’s neck, hand, arm, chest, 9 Leave nails smooth (e.g., free of jagged edges)? and abdomen? 10 Apply lotion to cleaned hand after nail care 12 Dry neck, hand, arm, chest, and abdomen? finished? 13 Support arm if raised off bed to wash, rinse, and 11 Support resident’s arm if raised off table when dry the back side of arm? providing nail and hand care? 14 Assist resident to turn onto side before cleansing 12 Remove visible excess lotion from hand if present at back? completion of hand care? 15 Wash, rinse, and dry back? 13 Complete skill having rinsed, dried and stored 16 Replace basin of water during task if it becomes basin, placing soiled linens in hamper, disposing of cold or soapy? trash, disposing of or storing emery board and orangewood stick, and leaving overbed table dry? 17 Warm lotion before applying to resident’s back (e.g., warming in hands, placing bottle in warm 14 Ask resident about preferences during care? (IC) water)? 8  CLINICAL SKILLS TEST CHECKLIST Provide resident a partial bed bath and back rub Provide resident with passive range of motion 18 Use lotion to provide back rub with long gliding and (ROM) exercises to one shoulder circular motions? The candidate is asked to provide range of motion 19 Place clean hospital gown on resident and secure exercise to a resident who is not able to help with the gown in back? exercises. The resident needs his/her shoulder flexed and extended, and abducted and adducted. For testing 20 Complete skill having rinsed, dried and stored purposes, the resident needs three repetitions of both basin, placing soiled linens in hamper, disposing of exercises. The instructions provided at the test site will trash, and leaving overbed table dry? indicate whether the exercise is to the left or right side. 21 Keep resident positioned a safe distance from the The role of the resident is played by a person, although edge of the bed at all times? in special situations a mannequin may be used. 22 Ask resident about preferences during care? (IC) Does the candidate: 23 Use Standard Precautions and infection control 1 Greet resident, address by name, and introduce measures when providing care? (IC) self? (IC) 24 Ask resident about comfort or needs during care or 2 Provide explanations to resident about care before before care completed? (IC) beginning and during care? (IC) 25 Promote resident’s rights during care? (IC) 3 Exercise only correct joints and only correct 26 Promote resident’s safety during care? (IC) side when performing range of motion (ROM)? 4 Support extremity to protect the working joint throughout ROM exercises? Provide resident with passive range of motion 5 Move shoulder through ROM, raising and lowering (ROM) exercises to one elbow and wrist arm along side, toward head of bed (HOB) and back The candidate is asked to provide range of motion to mattress (flexion/extension)? exercise to a resident who is not able to help with the 6 Move resident’s shoulder through ROM taking arm exercises. The resident needs his/her elbow flexed and away from side and back to side (abduction/ extended, and the wrist flexed and hyperextended. For adduction)? testing purposes, the resident needs three repetitions of 7 Ask resident to report discomfort during ROM or both exercises. The instructions provided at the test site ask if resident has discomfort during ROM will indicate whether the exercise is to the left or right exercises? side. The role of the resident is played by a person. 8 Control extremity throughout ROM exercises Does the candidate: providing smooth, slow, non-forceful movement? 1 Greet resident, address by name, and introduce 9 Ask resident about preferences during care? (IC) self? (IC) 10 Use Standard Precautions and infection control 2 Provide explanations to resident about care before measures when providing care? (IC) beginning and during care? (IC) 11 Ask resident about comfort or needs during care or 3 Exercise only correct joints and only correct before care completed? (IC) side when performing range of motion (ROM)? 12 Promote resident’s rights during care? (IC) 4 Support extremity to protect the working joint throughout ROM exercises? 13 Promote resident’s safety during care? (IC) 5 Bend and straighten arm at elbow through ROM (flexion/extension)? Provide resident with passive range of motion 6 Move wrist through ROM by bending wrist to move (ROM) exercises to one hip, knee and ankle hand down and back (flexion and hyperextension)? The candidate is asked to provide range of motion 7 Ask resident to report discomfort during ROM or ask exercise to a resident who is not able to help with the if resident has discomfort during ROM exercises? exercises. The resident needs his/her hip and knee flexed 8 Control extremity throughout ROM exercises and extended, and dorsiflexion and plantar flexion to the providing smooth, slow, non-forceful movement? ankle. For testing purposes, the resident needs three 9 Ask resident about preferences during care? (IC) repetitions of both exercises. The instructions provided at 10 Use Standard Precautions and infection control the test site will indicate whether the exercise is to the measures when providing care? (IC) left or right side. The role of the resident is played by a person. 11 Ask resident about comfort or needs during care or Does the candidate: before care completed? (IC) 1 Greet resident, address by name, and introduce 12 Promote resident’s rights during care? (IC) self? (IC) 13 Promote resident’s safety during care? (IC) 2 Provide explanations to resident about care before beginning and during care? (IC) 3 Exercise only correct joints and only correct side when performing range of motion (ROM)? 9 CLINICAL SKILLS TEST CHECKLIST Provide resident with passive range of motion Transfer the resident from the bed into a (ROM) exercises to one hip, knee and ankle wheelchair using a pivot technique and a 4 Support extremity to protect the working joint transfer/gait belt throughout ROM exercises? 10 Lock wheelchair before standing resident to begin 5 Move resident’s hip and knee through ROM, flexing transfer? knee and hip, raising toward torso and returning 11 Apply transfer/gait belt before standing resident, back to mattress (flexion/extension)? placing around the resident’s waist and over 6 Support extremity to prevent heel friction against clothing, secured so that only flat fingers/hand fit mattress during ROM exercises? under belt, and the belt does not catch skin or skin folds (e.g. breast tissue)? 7 Move resident’s foot up toward head and point down toward the mattress through ROM 12 Provide cue or signal to resident before assisting to (dorsiflexion/plantar flexion)? stand? 8 Ask resident to report discomfort during ROM or 13 Stand in front of resident reaching under resident’s ask if resident has discomfort during ROM arms to hold transfer/gait belt at sides or around exercises? back throughout transfer? 9 Control extremity throughout ROM exercises 14 Brace one or both of resident’s legs during transfer providing smooth, slow, non-forceful movement? while assisting to stand, turn, and sit? 10 Ask resident about preferences during care? (IC) 15 Maintain own body mechanics when assisting resident to stand, turn, and sit? 11 Use Standard Precautions and infection control measures when providing care? (IC) 16 Transfer resident as a pivot completed without having resident take step(s) to reach wheelchair, 12 Ask resident about comfort or needs during care or and before assisting resident to sit in wheelchair, before care completed? (IC) positions with the back of resident’s legs against 13 Promote resident’s rights during care? (IC) the seat of wheelchair? 14 Promote resident’s safety during care? (IC) 17 Support resident to provide for controlled gentle lowering into seat of wheelchair? 18 Leave resident positioned in wheelchair in proper Transfer the resident from the bed into a body alignment, hips against back of seat, and feet wheelchair using a pivot technique and a on footrests? transfer/gait belt 19 Remove transfer/gait belt from resident’s waist The candidate is asked to transfer a resident who is lying without harming resident (e.g., pulling transfer/gait in bed, into a wheelchair. A pivot transfer technique is belt) when transfer is complete? required and a transfer/gait belt is required. The resident 20 Ask resident about preferences during care? (IC) is able to stand but cannot take steps. The role of the resident is played by a person. 21 Use Standard Precautions and infection control measures when providing care? (IC) Does the candidate: 22 Ask resident about comfort or needs during care or 1 Greet resident, address by name and introduce self? before care completed? (IC) (IC) 23 Promote resident’s rights during care? (IC) 2 Provide explanations to resident about care before beginning and during care? (IC) 24 Promote resident’s safety during care? (IC) 3 Place wheelchair near resident’s bed before assisting resident to sit at edge of bed? 4 Move wheelchair footrests out of the way before standing resident for transfer (e.g., lift, swing, or remove)? 5 Place nonskid footwear (e.g., shoes) on resident before standing resident for transfer? 6 Provide support to assist resident to sitting position on side of bed, without pulling resident by lower arms or hands? 7 Provide resident opportunity to sit on side of bed to adjust to change in position before beginning transfer? 8 Position resident’s feet flat on the floor before standing to begin transfer? 9 Prepare for transfer by positioning wheelchair with front interior wheel close enough to bed so that transfer can be completed as a pivot? 10