What do I need?
What more do I need?
Pass....
or Fail
Misc
100

Applying an Anti-embolic Stocking to One Leg

One knee high anti-embolic stocking

100

Gait belt

Non-skid footwear

wheelchair 

(2)

Assist Resident to Ambulate using a gait belt

Assist Resident to Transfer to wheelchair using a gait belt

100

Leave resident with a stocking that is smooth and wrinkle free

Applying an Anti-embolic stocking

100

Transfer a resident from bed to a wheelchair using a gait bed, Assist a resident to ambulate using a gait belt (2 pass/ fails)

Lock the bed brakes, lock the wheelchair brakes

100

What you do at the beginning and end of every skill

Hand hygiene

200

Making an occupied bed

fitted sheet, flat sheet, bedspread, pillow case

200

4 pillows

Position a dependent resident in bed on their side

200

Wash from front to back

Perineal Care for a Female Resident

200

Vital signs (2)

Record radial pulse on the previously signed recording form, record respirations on the previously signed recording form

200

What is the second step in all (but 1) of the skills?

Explain the procedure to the resident.

300

Assisting a resident with the use of a Bedpan, measure and record urine output with handwashing

gloves, bedpan, toilet paper, call light, 1 wet and 1 dry washcloth, graduate, recording form & pen, laundry hamper, toilet or commode

300

button up shirt, pants, socks (optional bath blanket)

Dressing a resident with an affected side

300

Direct the RN test observer to stand on the side of the bed opposite the working side of the red, or raise the side rails on the bed opposite the working side to provide for safety

Position a dependent resident in bed on side

300

PROM on one shoulder, PROM on one leg

Ask the resident at least once if there is any pain or discomfort

300

What do you do if you forget a step while testing?

Say you missed a step and go back and complete it as soon as possible

400

Catheter care for a female resident with Hand Washing

gloves, basin with warm water, soap, 3 wash clothes, laundry hamper

400

2 towels, toothbrush, toothpaste, emesis basin, gloves, cup of water, laundry hamper

Mouth Care

400

Put on gloves (2 skills)

mouth care, denture care

400

Dressing a resident and an Affected Side

Always dress the affected side first

400

What information can be recorded on the recording form? (at least 4 things)

candidate's name, candidate's signature, output in mL, respirations, pulse, food intake as a %, fluid intake in mL

500

Perineal Care for a Female Resident with Hand washing

gloves, 4-6 wash clothes, towel, waterproof pad, basin with comfortably warm water, soap, laundry hamper (optional: bath blanket)

500

Isolation gown, gloves, barrier, graduate, alcohol wipe, recording form & pen, toilet or commode, trash can

Emptying a Urinary Drainage bag

500

Scrub hands for 20 seconds (4 skills)

Perineal Care, catheter care, emptying a urinary drainage bag, bedpan

500

Feeding a dependent resident (3)

position the resident upright before feeding, record intake as a percentage of solid food on the previously signed recording form, record intake as the sum of total fluid consumed on the recording form

500

Name the 2 skills WITHOUT a Pass/ Fail item

Making an occupied bed and Nail Care