Lecture Notes: Nursing Skills Training

Introduction

• Speaker: Nina Justiniano, Director of Nursing at Tia Allied Health School
• Presenter: Mrs. Manive Simon
• Purpose: Training on essential nursing skills required by the health department and Prometric.

Hand Washing Skill

• Uniform and Hands: Ensure uniform and hands do not touch the sink.
• Water: Use warm water, adjust for comfort.
• Washing Time: State requires 30 seconds of hand washing.
• Procedure:
  • Wet hands thoroughly.
  • Use two tablespoons of soap.
  • Lather both hands, interlock fingers, clean between fingers, and wash thumbs.
  • Remove jewelry and clean nails.
  • Rinse from wrist to fingertips.
  • Dry hands with a paper towel, avoid shaking.
  • Use a dry towel to turn off the faucet.

Indirect Care

• Explanation: Essential part of CNA training, involved in each skill.
• Key Points:
  • Greet and address the resident by name, introduce yourself.
  • Explain the care before and during the process.
  • Use standard precautions and infection control measures.
  • Ensure resident comfort and privacy.
  • Provide resident rights and safety.

Skills Demonstration

Walking a Patient

• Equipment: Gait belt, chair.
• Procedure:
  • Introduce yourself, explain the activity.
  • Check ID, lock bed, provide privacy.
  • Assist patient with sitting and putting on non-skid footwear.
  • Use gait belt to help patient stand and walk.
  • Support patient, guide safely.
  • Sit patient down, remove gait belt.

Using a Bed Pan

• Equipment: Fracture bed pan, standard bed pan, blue pad.
• Procedure:
  • Introduce yourself, lock bed, and provide privacy.
  • Use a blue pad to protect the sheet.
  • Place bed pan under the patient using proper technique.
  • Assist patient with sitting up.
  • Ensure proper hygiene after use.

Changing Occupied Bed

• Equipment: Fitted sheet, top sheet, pillowcase.
• Procedure:
  • Knock, introduce, and explain the process.
  • Provide privacy, lock bed.
  • Change sheets using clean-to-dirty method.
  • Keep patient covered and comfortable.

Sideline Position

• Purpose: Prevent pressure ulcers, blood clots, and pneumonia.
• Equipment: Three pillows.
• Procedure:
  • Turn patient gently, use pillows for support.
  • Ensure alignment and comfort.

Dressing a Weak Arm

• Procedure:
  • Knock, introduce, explain the process.
  • Offer clothing choice.
  • Dress weak arm first, support with slack.
  • Ensure comfort and proper fit.

Emptying a Drainage Bag

• Equipment: Blue pad, gloves, alcohol pads, graduate, intake/output sheet.
• Procedure:
  • Introduce, check ID, lock bed.
  • Place blue pad, empty bag into graduate without contamination.
  • Record output accurately.

Feeding a Resident

• Equipment: Food and fluid intake form, spoon, water, bib.
• Procedure:
  • Introduce, check ID, sit resident up.
  • Engage in conversation, feed using spoon.
  • Monitor and assist with swallowing.
  • Record intake.

Taking Pulse

• Procedure:
  • Introduce, check ID, provide comfort.
  • Use two fingers (not thumb) to count pulse for one minute.
  • Record accurately, ensure within acceptable range.

Checking Respirations

• Equipment: Watch with second hand.
• Procedure:
  • Introduce, check ID, count respirations for one minute.
  • Do not inform resident to avoid altered breathing.

Catheter Care

• Equipment: Washcloth, basin, soap, gloves, towel.
• Procedure:
  • Introduce, check ID, provide privacy.
  • Use proper cleaning technique, avoid contaminating catheter.
  • Ensure comfort and hygiene.

Foot Care

• Equipment: Towel, washcloth, blue pad, basin, soap, lotion.
• Procedure:
  • Introduce, check water temperature.
  • Wash foot, dry properly, apply lotion (avoid between toes).

Denture Care

• Procedure:
  • Introduce, secure clothing.
  • Clean dentures securely, ensure proper handling.
  • Provide oral care.

Mouth Care

• Equipment: Toothbrush, toothpaste, two cups, gloves.
• Procedure:
  • Introduce, protect clothing.
  • Brush teeth, provide rinse and spit options.
  • Clean mouth corners.

Incontinent Care

• Equipment: Basin, gloves, towels, blue pads.
• Procedure:
  • Introduce, check ID, provide privacy.
  • Change soiled pads, provide thorough cleaning.

Nail Care

• Equipment: Towel, washcloth, orange stick, emery board, soap, lotion.
• Procedure:
  • Introduce, check water temperature.
  • Clean nails, file edges, apply lotion.

Partial Bed Bath

• Equipment: Basin, washcloth, towels, gown, soap, lotion.
• Procedure:
  • Introduce, check ID, provide privacy.
  • Wash face, one arm, and back.
  • Provide lotion, ensure comfort.

ROM Exercises

• Equipment: None specified.
• Procedure:
  • Introduce, check ID, explain exercise.
  • Perform passive exercises for shoulder, elbow, and lower extremity.

Pivot Transfer

• Equipment: Gait belt, wheelchair.
• Procedure:
  • Introduce, check ID, provide privacy.
  • Assist patient to sit, use gait belt for transfer.
  • Ensure wheelchair is secure.
  • Remove gait belt, provide call light.