Overview
This lecture outlines the required clinical skills and evaluation criteria for Certified Nursing Assistant (C.N.A.) certification, emphasizing safe, competent, and resident-centered care.
Clinical Skills Test Overview
- Candidates are tested on 5 clinical skills, including handwashing and required essential skills (RES).
- Three additional random skills are assigned, with scenarios or care plans provided.
- Skills must be performed as instructed; mistakes can be verbally corrected before completing the skill.
- Proctor observes and records performance; results provided at the end.
Required Essential Skills (RES)
- RES are evaluated during every skill and cover Standard Precautions, Resident Rights, Safety, and Communication.
- Handwashing is performed at the start, then verbalized as needed.
- Safety must be maintained throughout; failure in safety results in immediate failure.
Handwashing Protocol
- Wet hands, apply soap, lather with friction for 20 seconds, rinse with fingers down.
- Avoid contact with sink, dry hands, use towel to turn off faucet.
- Evaluate own performance before declaring the skill complete.
Measurement Skills
- Pulse: Measure for 1 minute; record within 4 bpm of proctor.
- Respirations: Count for 1 minute; record within 2 breaths of proctor.
- Blood pressure: Measure manually; record within 4 mmHg of proctor.
- Always explain procedure, provide privacy and support, maintain safety.
Movement & Transfer Skills
- Ambulate resident with gait belt; check for non-slip footwear and use proper body mechanics.
- Transfer from bed to wheelchair with pivot and gait belt; secure wheelchair, support resident.
- Reposition to side-lying using pillows for support and alignment.
Range of Motion (ROM) Exercises
- Perform passive ROM for elbow/wrist, hip/knee/ankle, and shoulder; three repetitions each, smooth and slow motion, support joint, watch for discomfort.
Personal Care Skills
- Oral care: For teeth or dentures, clean all surfaces, rinse, and maintain resident comfort.
- Foot care: Wash, rinse, dry thoroughly, apply lotion (avoid between toes), put on socks/shoes.
- Bedpan assistance: Proper placement, ensure privacy, promote hygiene after use.
- Change linen on occupied bed: Keep resident safe, maintain privacy, avoid linen shaking.
Hygiene & Dressing Skills
- Partial bed bath: Clean specific areas, use mitt technique, perform back rub.
- Hand and nail care: Soak, clean, smooth nails, apply lotion.
- Dress resident with weak arm: Remove strong arm first, dress weak arm first, gentle movements.
Catheter & Perineal Care
- Catheter care: Clean from urethra outward, one stroke per area, maintain tube and bag position.
- Perineal care: Wash front to back, change pads, clean and dry thoroughly.
Key Terms & Definitions
- RES (Required Essential Skills) — Core areas: Standard Precautions, Resident Rights, Safety, Communication.
- Standard Precautions — Infection control steps to prevent spread of infection.
- Gait Belt — Device for safely assisting residents to stand or walk.
- Range of Motion (ROM) — Exercises to maintain or improve joint mobility.
- Mannequin — Model used as resident for skill practice/testing.
Action Items / Next Steps
- Review each skill’s checklist steps and practice until proficient.
- Prepare for clinical skills test by simulating scenarios and documenting care.
- Visit the LA-NACT website for further test instructions or correction policies.