NA Skills Performance Checklist for Contract 8.2.2024 For Contract.docx

Office of Health Facility Licensure and Certification - NATCEP Competency Skills Checklist

Attachment B. WEST VIRGINIA NATCEP COMPETENCY SKILLS CHECKLIST During the West Virginia Nurse Aide Training and Competency Evaluation Program (NATCEP), there are 30 competency evaluation skills taught to proficiency. Each NATCEP will teach more than these 30 skills during the course of the training programs’ curriculum. However, the 30 skills taught to proficiency are the most critical to entry-level nurse aides. These are the foundational skills nurse aides must master prior to working as a nurse aide. These 30 skills will be integral to the nurse aide gaining experience and learning new skills during the course of their career.

During the competency skills evaluation, all candidates will be required to perform the Hand Hygiene Skill. Each tester will perform the Hand Hygiene Skill first. You will not be required to perform the skill during the performance of the rest of the evaluation skills. However, you will be required to indicate verbally when you would wash your hands during your performance of skill throughout the competency evaluation.

The Introduction Skill and Completion Skill will be performed at the beginning of the competency evaluation. You will perform both skills with the first randomly chosen skill of the competency test. However, you will be required to indicate verbally when you would perform these skills during your performance of subsequent skills throughout the competency evaluation.

Each candidate will perform five randomly selected skills from the skills listed in the checklist. The Hand Hygiene, Introduction and Completion skills do not count toward the five randomly selected skills.

#1 – Introduction Skill

The Initial skill must be carried out each time you initiate contact with a resident. These are the steps you take to ensure each resident is treated with dignity and respect.

1. Get all the necessary equipment and supplies prior to beginning.

2. Knock before entering any resident’s room. If the door is open, simply knock on the door frame or any other part of the door that is convenient. If the resident doesn’t hear you, speak a little louder to get their attention. Wait to be addressed by the resident before entering the resident’s room whenever possible.

3. Greet each resident by name and verify the resident’s identity.

4. Identify yourself and your job title.

5. Explain procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.

6. Perform Hand Hygiene

7. Privacy is provided with a curtain, screen, or door.

8. Maintain respectful, courteous interpersonal interaction at all times.

9. Let the resident assist as much as possible and honor expressed wishes and preferences.

#2 – Completion Skill

The Completion skill must be carried out each time you end contact with a resident. These are the steps you take to ensure each resident is treated with dignity and respect.

1. Position resident in a comfortable position in good body alignment.

2. Make sure the resident has everything he/she needs and thank them.

3. Leave the resident’s room in a manner according to their wishes (i.e., close/open door or privacy screen, open/close window covering).

4. Clean up the area and remove/discard any used equipment or supplies.

5. Check safety of the environment, including ensuring call light is within the resident’s reach.

6. Observe and report any unusual findings, problems, complaints related to the procedure to the nurse.

7. Observe and report changes in the resident’s physical, mental or emotional abilities or responses.

8. Observe and report changes in skin condition.

9. Perform Hand Hygiene.

10. Document observations, actions and procedures according to policy.

11. Maintain respectful, courteous interpersonal interaction at all times.

#3 – Hand Hygiene (Hand Washing)

Must be performed at the beginning of every skill performed.

1. Perform Introduction Skill.

2. Turn on the water.

3. Wet all surface areas of the hands and wrists thoroughly.

4. Apply liquid soap to your hands.

5. Lather all surfaces of wrists, hands, and fingers producing friction, for at least 20 seconds, keeping hands lower than the elbows and the fingertips down. Lather away from direct contact with running water.

6. Clean fingernails by rubbing fingertips against palms of the opposite hand and the fingertips down.

7. Interlace fingers pointing downward producing friction.

8. Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows with fingers pointing downward.

9. Use clean, dry paper towel/towels to dry all surfaces of fingers, hands, and wrists starting at fingertips then dispose of paper towel/towels into waste container.

10. Use another clean, dry paper towels/towel to turn off faucet then dispose of paper towel/towels into waste container or uses knee/foot control to turn off faucet.

11. Do not touch the inside of the sink at any time.

12. Do not re-contaminate hands at any point during the procedure.

13. Perform Completion Skill.

#4 – Apply and Remove Personal Protective Equipment (Gown and Gloves)

2. Pick up gown and let it unfold, do not shake gown.

3. Facing the back opening of the gown place arms through each sleeve.

4. Fasten the neck opening.

5. Secure gown at waist making sure that back of clothing is covered by gown (as much as possible).

6. Put on gloves.

7. Cuffs of gloves should overlap cuffs of gown.

8. Before removing the gown, with one gloved hand, grasp the other glove at the palm, remove glove.

9. Slip fingers from ungloved hand underneath cuff of remaining glove at wrist and removes glove turning it inside out as it is removed.

10. Dispose of gloves into designated waste container without contaminating self.

11. After removing glove, unfastens gown at waist and neck.

12. Removes gown without touching outside of gown.

13. While removing the gown, hold gown away from body without touching the floor, turn gown inward and keep it inside out.

14. Dispose of gown in designated container without contaminating self.

15. Perform Completion Skill.

#5 – Make Occupied Bed

2. Gather clean linen and transport correctly.

3. Place clean linen on top of bedside stand, on over-bed table, over back of chair or drape over foot of bed.

4. Raise the side rail opposite the working side of the bed.

5. Raise the bed between mid-thigh and waist level.

6. Resident is to remain covered, at all times.

7. Assist the resident to roll onto side toward raised side rail. The side rail always remains up on the opposite side of the candidate during the task.

8. Roll or fan fold soiled linen, soiled side inside, to the center of the bed.

9. Place clean bottom sheet along the center of the bed and roll or fan fold linen against resident's back and unfold remaining half.

10. Secure two fitted corners of the clean bottom sheet.

11. Raise the second side rail opposite working side of the bed and assist the resident to roll over the bottom linen, preventing trauma and avoid pain to resident.

12. Remove soiled linen without shaking, and place in hamper.

13. Avoid touching linen to uniform.

14. Pull through and smooth out the clean bottom linen.

15. Secure the other two fitted corners.

16. Place clean top linen and blanket or bedspread over covered resident. Remove used linen making sure the resident is not exposed at any time.

17. Tuck in top linen and blanket or bedspread at foot of the bed.

18. Make mitered corners at the foot of the bed.

19. Apply clean pillowcase, with zippers and/or tags to inside.

20. Gently lift the resident’s head when replacing the pillow.

21. Lower bed.

22. Return side rails to lowered position.

23. Perform Completion Skill.

#6 – Measure and Record Radial Pulse

Measure Radial Pulse:

2. Place fingertips on the thumb side of resident’s wrist to locate radial pulse. (Do not use thumb)

3. Count beats for one full minute.

4. Ensure the call light is within reach.

5. Before recording radial pulse, perform hand hygiene.

6. Record pulse rate within plus or minus 4 beats of evaluator’s reading.

7. Perform Completion Skill.

#7 – Measure and Record Respirations

Measure Respirations:

2. Perform hand hygiene

3. Count respirations for one full minute.

4. Before recording respirations, perform hand hygiene

5. Record respiration rate within plus or minus 2 breaths of evaluator’s reading.

6. Perform Completion Skill.

#8 – Measure and Record Blood Pressure

Measure Manual Blood Pressure:

2. Before using a stethoscope, wipe the bell/diaphragm and earpieces of the stethoscope with alcohol.

3. Resident’s arm is positioned with the palm up and the upper arm is exposed.

4. Feel for brachial artery on inner aspect of the arm, at the bend of the elbow.

5. Place blood pressure cuff snugly on resident’s upper arm, with sensor/arrow over brachial artery site.

6. The earpieces of the stethoscope are in ears and bell/diaphragm is over the brachial artery site.

7. Candidate inflates the cuff between 160 mm Hg to 180 mm Hg. If beat heard immediately upon cuff deflation, completely deflate cuff. Re-inflate cuff to no more than 200 mm Hg.

8. Deflate cuff slowly and note the first sound (systolic reading), and last sound (diastolic reading) (If rounding needed, measurements are rounded UP to the nearest 2 mm of mercury). Respiration is a full inspiration and full expiration.

9. Remove cuff.

10. Before recording blood pressure, perform hand hygiene.

11. After obtaining reading using BP cuff and stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading.

12. Perform Completion Skill.

#9 – Measure and Record Oral Temperature

Measure Oral Temperature:

2. Correctly turn on digital oral thermometer and place probe cover on the thermometer.

3. Gently insert the bulb end of the thermometer in mouth under tongue.

4. Hold thermometer in place for appropriate length of time.

5. Remove thermometer and read the temperature.

6. Before recording oral temperature, perform hand hygiene.

7. Candidate's recorded temperature varies no more than .1 degree.

8. Perform Completion Skill.

#10 – Measure and Record Weight of Ambulatory Resident

2. Ensure that resident has non-skid shoes/footwear on before walking to scale.

3. Before the resident steps on scale, the candidate sets the scale to zero.

4. Ask the resident to step on the center of scale and obtain the resident's weight.

5. Ask the resident to step off scale.

6. Before recording weight, perform hand hygiene.

7. Record weight based on indicator on scale within plus or minus 2 pounds of evaluator’s reading.

8. Perform Completion Skill.

#11 – Provide a Modified Bed Bath

2. Fill the basin with comfortably warm water. (No hotter than 105 degrees Fahrenheit)

3. Before washing, check the water temperature for safety and comfort and ask the resident to verify the comfort of water.

4. Cover the resident with a bath blanket.

5. Fanfold bed linens at least down to waist or move lines to opposite side.

6. Remove resident’s clothing from the waist up without exposing the resident and place it into a soiled linen hamper.

7. Put on clean gloves before washing the resident.

8. Beginning with eyes, wash eyes with wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face.

9. Dry face with dry cloth towel/washcloth.

10. Expose one arm and place a cloth towel underneath the arm.

11. Apply soap to wet washcloth.

12. Wash fingers (including fingernails), hand, arm, and underarm keeping the rest of the body covered.

13. Rinse and dry fingers, hand, arm, and underarm.

14. Move body gently and naturally, avoiding force and over-extension of limbs and joints.

15. Put clean gown or clothing on the resident.

16. Empty, rinse, and dry basin.

17. Place basin in designated dirty supply area.

18. Dispose of linen into soiled linen container.

19. Avoid contact between candidate clothing and used linens.

20. Remove and dispose of gloves (without contaminating self) into waste container and wash hands.

21. Perform Completion Skill.

#12 – Feed Dependent Resident

2. Look at the name card on the tray and verify the identity of the resident.

3. Position resident in an upright seated position (75-90 degrees).

4. Place a tray where the food can be easily seen by resident.

5. Ask the resident if he/she prefers to use a clothing protector.

6. Wash and dry the resident's hands.

7. Position yourself at eye level sitting down and facing the resident while feeding him/her.

8. Describe the foods and beverages on the tray.

9. Ask the resident what he/she would like to eat first.

10. Offer beverages throughout the meal.

11. Offer food in small amounts at a reasonable rate, allowing resident time to chew and swallow.

12. Ask the resident if they are ready for the next bite of food or sip of beverage.

13. At the end of the meal, wipe the resident's face and hands.

14. Leave the resident clean and in a comfortable upright position with the head of bed left at least 30 degrees after completion of the meal.

15. Discard soiled linen in the appropriate container.

16. Record intake in percentage of total solid food eaten on recording sheet.

17. Record the sum of the intake of fluid in cc/ml on recording sheet.

18. Recorded reading is within 25% of the solids and within 60 cc/ml of the fluids consumed.

19. Remove food tray.

20. Perform Completion Skill.

#13 – Provide Hair Care

2. Gather needed supplies (comb, brush, towel, and/or styling products).

3. Raise head of bed so resident is in an upright seated position.

4. Drape towel over pillow if resident is confined to the bed. If a resident is sitting in a chair, place the towel around the resident's shoulders.

5. Remove resident’s glasses and any objects in hair.

6. Comb, brush and style hair gently and completely.

7. Discard linen in appropriate container.

8. Return supplies to storage area.

9. Leave hair neatly combed, brushed or styled.

10. Perform hand hygiene.

11. Offer mirror to see completed hair care.

12. Perform Completion Skill.

#14 – Provide Mouth Care

2. Gather equipment and supplies.

3. Position resident in an upright seated position (75-90 degrees).

4. Put on clean gloves before cleaning the resident’s mouth.

5. Place a cloth towel across the chest before providing mouth care.

6. Wet toothbrush.

7. Apply a small amount of toothpaste to the toothbrush.

8. Brush resident’s teeth, including the inner, outer and chewing surfaces of all upper and lower teeth. If available, toothettes may be utilized instead of a toothbrush, as long as all the surfaces listed above are cleaned.

9. Clean tongue.

10. Assist the resident in rinsing mouth.

11. Wipe the resident's mouth, remove the soiled towel and place it in the appropriate container.

12. Empty, rinse and dry basin. Rinse toothbrush. Return basin and toothbrush to storage.

13. Turn gloves inside out as they are removed.

14. Dispose of gloves in the appropriate container.

#15 – Clean Dentures

It is best to clean a resident’s dentures when they are not being worn. This way the resident’s routine or activity is not interrupted while you are cleaning their dentures.

2. Line bottom of the sink with a protective lining that would help prevent damage to the dentures. (no paper towels)

3. Put on gloves and remove dentures from the cup.

4. Handle dentures carefully to avoid damage or contamination.

5. Rinse the dentures in moderate temperature running water before brushing them.

6. Wet toothbrush.

7. Apply a small amount of nonabrasive denture cleaner and thoroughly brush dentures including the inner, outer, and chewing surfaces of upper and/or lower dentures. Toothettes may be utilized instead of a toothbrush as long as all the required surfaces listed above are cleaned.

8. Rinse dentures using clean cool water.

9. Place dentures in a rinsed denture cup.

10. Add cool clean water to the rinsed denture cup.

11. Clean and dry equipment and return to storage.

12. Discard protective lining in an appropriate container.

13. Remove gloves and dispose of them in an appropriate container.

14. Perform Completion Skill.

#16 – Provide Nail Care

Skill performed on one hand only.

2. Gather supplies (water basin, washcloth, hand towel, protective barrier, soap, lotion, nail file

3. Before washing, check the water temperature for safety and comfort and ask the resident to verify the comfort of water.

4. Basin is in a comfortable position for resident and on a protective barrier.

5. Put on clean gloves before washing the residents’ hands.

6. Immerse nails in comfortably warm water and soak for at least five (5) minutes. The five minutes may be verbalized.

7. Dry hands thoroughly, being careful to dry the whole hand and between fingers.

8. Gently clean under nails with an orange stick.

9. Trim the fingernails using the nail clipper, clipping straight across.

10. File each fingernail to remove the sharp edges with a nail file or emery board.

11. Apply lotion to the hands, gently massaging from fingertips to wrists to stimulate circulation.

12. Empty, rinse and dry equipment.

13. Discard linen in linen hamper.

14. Discard orange stick in the designated sharp container.

15. Return equipment to storage.

16. Perform Completion Skill.

#17 – Provide Foot Care

Skill performed on one foot only.

2. Before washing, check the water temperature for safety and comfort and ask the resident to verify the comfort of water. (No hotter than 105 degrees Fahrenheit)

3. Basin is in a comfortable position for resident and on protective barrier.

4. Put on clean gloves before washing the resident’s foot.

5. Resident’s bare foot is placed into the water.

6. Apply soap to wet washcloth.

7. Lift foot from water and wash foot (including between the toes).

8. Foot is rinsed (including between the toes).

9. Dry foot (including between the toes) with dry cloth towel/washcloth.

10. Apply lotion to top and bottom of foot (excluding between the toes) removing excess with a towel/washcloth.

11. Support foot and ankle during procedure.

12. Empty, rinse, and dry basin.

13. Place basin in designated dirty supply area.

14. Dispose of used linen into soiled linen container.

15. Remove and dispose of gloves (without contaminating self) into the waste container.

#18 – Dress Resident with Affected (Weak) Arm

2. Raise the bed between mid-thigh and waist level.

3. Assist the resident (if needed) to choose what clothing they would like to wear for the day.

4. Keep resident covered while removing the gown (nightwear). Avoid overexposure of resident by ensuring the resident's chest is covered.

5. Remove the gown from the unaffected side first.

6. Place a used gown in the laundry hamper.

7. When dressing the resident in a shirt or blouse, insert their hand through the sleeve of the shirt or blouse and grasp the hand of the resident, dressing from the affected side first.

8. When dressing the resident in pants, assist the resident to raise buttocks or turn the resident side to side and draw the pants over the buttocks and up to the resident’s waist, always dressing from the weak side first.

9. While putting on a shirt, move body gently and naturally, avoiding force and over-extension of limbs and joints.

10. Apply non-skid slippers or shoes depending on the resident’s activity after getting dressed.

11. Perform Completion Skill.

#19 – Apply One Knee-High Elastic Stocking

2. Resident is in a supine position (lying down in bed) while stocking is applied.

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

4. Place the foot of the stocking over toes, foot, and heel.

5. Pull the top of the stocking over the foot, heel, and leg.

6. Move the foot and leg gently and naturally, avoiding force and over-extension of limb and joints.

7. Finish procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in the toe area (if present) is either over or under the area; if using a mannequin, candidate may state stocking needs to be wrinkle-free.

8. Perform hand hygiene.

9. Perform Completion Skill.

#20 – Assist Resident to Use Bedpan

2. Gather supplies.

3. Ensure the resident is covered except when placing and removing bedpan.

4. Lower head of bed.

5. Put on gloves.

6. Place the bedpan in the correct orientation under the resident's buttocks using method 1 or 2.

METHOD 1

a. Ask the resident to raise the hips (bending at the knees and pushing with the feet may make this easier).

b. Slide the bedpan under the resident’s buttocks.

METHOD 2

a. Turn the resident onto the side facing away from you.

b. Place the bedpan against the resident’s buttocks.

c. Roll the resident back onto the bedpan.

7. Remove and dispose of gloves (without contaminating self) into waste container.

8. Perform hand hygiene.

9. Raise the head of the bed to a comfortable level.

10. Leave toilet tissue within the resident's reach.

11. Ensure the call light is within the resident’s reach and instruct the resident to signal when finished.

12. Step away from the resident to provide privacy, if applicable and safe.

13. Perform hand hygiene.

14. Put on gloves.

15. Lower head of bed.

16. Gently remove the bedpan.

17. Empty and rinse bedpan and pour the rinse into the toilet.

18. Place the bedpan in the designated dirty supply area.

19. Remove and dispose of gloves (without contaminating self) into the waste container.

#21 – Provide Incontinence Care for Resident Wearing a Brief

2. Gather supplies.

3. Raise bed between mid-thigh and waist level.

4. Raise the side rail opposite the working side of the bed (if applicable).

5. Put on gloves.

6. Place a waterproof incontinent pad under the resident by rolling the resident side to side.

7. Unfasten the wet brief on both sides and assist resident to raise buttock or roll side to side to remove soiled brief.

8. Discard soiled brief in the appropriate container.

9. Wash, rinse and dry soiled areas.

10. Verbalize that brief “should be checked every two hours.”

11. Apply new brief by rolling resident side to side or raising buttocks.

12. Pull brief through and be sure that it is even on both sides and fasten the brief securely on both sides.

13. Remove waterproof pad from under buttocks by turning resident side to side or raising buttocks to remove pad without friction.

14. Dispose of soiled linen in an appropriate container.

15. Lower bed and side rail.

16. Dispose of gloves in the appropriate container.

17. Perform Completion Skill.

#22 – Provide Perineal Care

2. Before washing, check the water temperature for safety and comfort and ask the resident to verify the comfort of water.

3. Put on clean gloves before washing the perineal area.

4. Place pad/ linen protector under perineal area including buttocks before washing.

5. Expose perineal area (only exposure between hips and knees).

6. Apply soap to wet washcloth.

7. Wash genital area, moving from front to back, while using a clean area of the washcloth for each stroke.

8. Using clean washcloth, rinse soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke.

9. Dry genital area moving from front to back with dry cloth towel/washcloth.

10. After washing the genital area, turn to side, then wash rectal area moving from front to back using a clean area of washcloth for each stroke.

11. Using clean washcloth, rinse soap from rectal area, moving from front to back, while using a clean area of the washcloth for each stroke.

12. Dry rectal area moving from front to back with dry cloth towel/washcloth.

13. Reposition resident.

14. Empty, rinse, and dry basin.

15. Place basin in designated dirty supply area.

16. Dispose of used linen into a soiled linen container and dispose of the linen protector appropriately.

17. Avoid contact between candidate clothing and used linen.

18. Remove and dispose of gloves (without contaminating self) into the waste container.

19. Perform Completion Skill.

#23 – Provide Continence Care for Resident Using a Urinal

2. Place gloves on your hands.

3. Gather needed supplies.

4. If the resident is able to stand, assist him to a standing position. If needed, provide support to the resident while standing.

5. If the resident is unable to stand, place the head of the bed as upright as tolerated.

6. Give the urinal to the resident or, if needed, position and hold the urinal in place.

7. Leave the room while the resident uses the urinal, if you can safely do so.

8. Place the call signal within reach.

9. Give the resident a hand wipe and ask them to clean their hands when finished.

10. Tell the resident to call when finished or if help is needed.

11. Return to the room promptly when the resident calls, or check on the resident as appropriate, knocking on the door before entering.

12. Wash hands and put on gloves prior to contact with urine.

13. Remove the urinal when the resident is finished.

14. Assist the resident back to bed if standing.

15. Provide perineal care if needed.

16. Measure and record urine, if applicable to the resident.

17. Collect specimen if indicated.

18. Show unusual urine to nurse, as a specimen may be needed.

19. Empty, rinse, clean and replace the urinal following facility policy.

20. Remove gloves and dispose.

21. Perform Completion Skill.

#24 – Measure and Record Urinary Output

2. Put on clean gloves before handling bedpan.

3. Pour the contents of the bedpan into a measuring container without spilling or splashing urine outside of the container.

4. Rinse bedpan and pour rinse into toilet.

5. Measure the amount of urine at eye level with container on flat surface (if between measurement lines, round up to nearest 25 milliliter or cubic centimeter (ml/cc).

6. After measuring urine, empty the contents of the measuring container into the toilet.

7. Rinse measuring container and pour rinse into toilet.

8. Before recording output, remove and dispose of gloves (without contaminating self) into a waste container.

9. Record contents of container within plus or minus 25 ml/cc of evaluator’s reading.

10. Perform Completion Skill.

#25 – Empty Urinary Drainage Bag

2. Raise side rails on both sides of the bed.

3. Raise bed between mid-thigh and waist level.

4. Put on gloves.

5. Place a barrier on the floor under the drainage bag.

6. Place the graduate on the previously placed barrier.

7. Open the drain to allow the urine to flow into the graduate until the bag is empty.

8. Avoid touching the graduate with the tip of the tubing.

9. Close the drain.

10. Wipe the drain with antiseptic wipe after emptying the drainage bag.

11. Replace drain in holder.

12. Lower bed and lower side rails.

13. Place graduate on flat surface at eye level to measure output.

14. Empty graduate into the toilet. Rinse and dry equipment.

15. Return equipment to storage.

16. Turn gloves inside out as they are removed. Dispose of gloves in the appropriate container.

17. Perform hand hygiene.

18. Record the output in cc/ml on a signed recording sheet.

19. Recorded measurement from the recording pad is within 25 ml/cc of the evaluator’s measurement.

#26 – Provide Passive Range of Motion (PROM) with One Hip and Knee

2. Position bed between mid-thigh and waist level.

3. Position resident supine (bed flat) and maintain good body alignment.

4. Instruct resident to inform candidate if pain experienced during exercise.

5. Throughout exercise ask the resident if he/she is experiencing any pain or discomfort. If the resident says yes, discontinue exercise.

6. Correctly support joints at all times by placing one hand under the knee and the other hand under the ankle.

7. Move the entire leg away from the body (abduction).

8. Move the entire leg back toward the body (adduction).

9. Correctly complete abduction and adduction of the hip three times.

10. Perform Completion Skill.

#27 – Provide PROM with One Shoulder

2. Position bed between mid-thigh and waist level.

3. Position resident supine (bed flat) and maintain good body alignment.

4. Instruct resident to inform candidate if pain is experienced during exercise.

5. Throughout exercise ask the resident if he/she is experiencing any pain or discomfort. If the resident says yes, discontinue exercise.

6. Correctly support the resident’s joint by placing one hand under the elbow and the other hand under the resident’s wrist.

7. Raise resident’s arm up and over the resident’s head (flexion).

8. Bring the resident’s arm back down to the resident’s side (extension).

9. Correctly complete full range of motion for shoulder flexion and extension three times.

10. Continue supporting joints correctly and move the resident’s entire arm out away from the body (abduction).

11. Return the resident’s arm to the side of the resident’s body (adduction).

12. Correctly complete full range of motion for shoulder through abduction and adduction three times.

#28 – Provide Ambulation Assistance with Transfer/Gait Belt

Ambulation skill is for a one-person technique unless otherwise designated.

2. Lock any and all bed and/or wheelchair brakes to ensure resident safety, if applicable.

3. Lower bed to a position so the resident’s feet rest comfortably on the floor, if applicable.

4. Ensure that the resident is wearing non-skid shoes/footwear.

5. Resident is assisted to a sitting position with feet flat on the floor.

6. Place the gait belt over clothing and around waist to stabilize the truck.

7. Tighten gait belt. Check gait belt for tightness by slipping fingers between gait belt and resident, adjust as needed.

8. Provide instructions to enable resident to assist in standing including prearranged signal to alert resident to begin standing.

9. Stand facing resident positioning self to ensure safety of candidate and resident during transfer. Count to three (or says another prearranged signal) to alert resident to begin standing.

10. On signal, gradually assist the resident to stand by grasping transfer belt on both sides with an upward grasp (candidate’s hands are in upward position) and maintaining stability of resident’s legs by standing knee to knee, or toe to toe with resident.

11. Walk slightly behind and to one side of resident for ten (10) feet, while holding onto the belt.

12. Assist resident to bed and remove transfer belt.

#29 – Stand Pivot Transfer Resident from Bed to Wheelchair with a Transfer/Gait Belt

Positioning skill is for a one-person technique unless otherwise designated.

2. The wheelchair is positioned alongside the bed, at the head of bed facing foot or foot of bed facing head.

3. Footrests are folded up or removed.

4. Wheels on the wheelchair and/or bed are locked.

5. Bed is at a safe level for the resident's feet to be flat on the floor.

6. Resident is assisted to a sitting position with feet flat on the floor.

7. Ensure that the resident is wearing non-skid footwear or shoes.

8. Apply the transfer belt securely at the waist over clothing.

9. Provide instructions to enable resident to assist in transfer including prearranged signal to alert when to begin standing.

10. Stand facing resident positioning self to ensure safety of candidate and resident during transfer. Count to three (or say another prearranged signal) to alert resident to begin standing.

11. On signal, gradually assist resident to stand by grasping the transfer belt on both sides with an upward grasp (candidates’ hands are in upward position) and maintaining stability of resident’s legs by standing knee to knee, or toe to toe with the resident.

12. Assist resident to pivot and assist them to sit in the wheelchair, in a controlled manner that ensures resident safety.

13. Position resident with hips touching back of wheelchair

14. Remove gait/transfer belt.

15. Position feet on footrests.

#30 – Position Resident on Their Side in Bed

Positioning skill is for a one-person technique unless otherwise designated.

2. Position bed so it is flat and between mid-thigh and waist level.

3. Raise the side rail on the side to which the body will be turned.

4. Move the resident’s head, upper body, hips and legs toward self to provide room on the bed that will be used to safely turn the resident on their side.

5. Assist/turn resident to slowly roll onto side toward raised side rail. Ensure the resident’s face never becomes obstructed by the pillow.

6. Place or adjust the pillow under head for support.

7. Reposition arm and shoulder so that the resident is not lying on arm.

8. Support top arm with supportive device.

9. Place a supportive device behind the resident's back.

10. Place supportive device between legs with top knee flexed; knee and ankle supported.

11. Protect bony prominences, under head, upside arm, behind back, and between knees by placing support devices such as pillows, wedges, blankets, etc.

12. Reposition the bed to a comfortable position and replace any covers or blankets over the resident.

13. Lower side rails.

14. Maintain correct body alignment for the resident.

During clinicals, instructors must always keep a copy of this document to timely record student performance.

Student Name:

Facility Name:

By completing the Name, Date and Signature below, I certify the record accurately reflects the students’ performance of competency skills.

Instructor Name:

Instructor Signature:

Date of Signature:

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