Certified nursing assistants (CNAs) are vital elements of a hospital unit. This position can be a turning point in your career. In Florida, Prometric administers the state exam in which students are tested upon the five skills on site from the list of 22 skills learned during CNA classes. CNAs must have full command of the complete list of skills. In this article, we have included all the 22 skills and a summary of each skill.
Why CNA Skills Are Important?
As a CNA, you will work in a health care environment and deliver physical and medical assistance to the patients. So you must have expertise in interpersonal skills, medical skills, and empathy. These skills will help you to perform your duties with greater efficiency.
22 CNA Skills: Comprehensive Detail About Each skill
Here is a list of 22 skills with a brief overview of which you must master to pass the CNA state exam.
1. Indirect Care
Indirect care is critical and includes your behavior while performing the task. Like how well you communicate with the patient and prioritize the patient’s rights, security, and safety. Do you explain the procedure, ask about the resident’s preferences during the care, and whether you use standard infection control measures and precautions while performing the task?
Indirect care affects the overall performance of the test because of its separate score ratings. The practice test is vital to developing this professional approach.
During the CNA skills examination, handwashing is regarded as a distinct skill that is accomplished along with other skills. Other skills are specified haphazardly. It is vital to grasp this skill because you will nearly certainly be ordered during or after other skills or before you initiate any task to wash your hands. Make sure to apply soap on all hand exteriors, including wrists.
3. Ambulation Using Transfer Belt
CNAs can also be asked to ambulate or walk the patient with the help of a gait or transfer belt. CNA should motivate the patient and assist him in walking. The CNA should maintain an upward tension while guiding the subject. Before aiding the patient, the candidate confirms that the patient is wearing shoes, the bed level is secure, and its wheels are locked.
Afterward, they must apply a transfer belt over a gown or clothing and give the patient instruction to help them stand. Then assist them in standing by grasping the transfer belt on both sides (on both sides). And help them to walk for a distance of 10 feet. After that, assist the patient to bed and remove the gait belt.
4. Shift Patient’s Positon to Side-Lying Position
CNAs may require to shift the patient to a side-lying position during typical procedures. These procedures enclose altering linen, bedpan placement, weight measurement, etc.
Lift the bed, grab the draw sheet, and pull it towards yourself and slightly upwards. It will help the patient to roll onto their side.
5. Moving Patient from Mattress to Chair (Using Gait Belt)
While moving the subject from a mattress or bed to a wheelchair, the use of a gait belt is necessary. Position the wheelchair alongside the bed, remove or fold the footrest and lock the wheels of the wheelchair. After that patient is helped to sit, and a gait belt is applied.
Now help them to stand wheelchair with their back facing the wheelchair using a gait belt and allow them to sit in the wheelchair.
6. Helping with Bedpans
Immobile patients use a bedpan to relieve themselves. CNA should do it in a very hygienic manner as it involves bodily matter. You should know how to use the bedpan to help your client, especially when one side of their body is weak.
During the exam, the examiner can ask you to perform this skill for a bedridden patient. Help the client to roll on their side and place a bedpan under the patient’s buttocks.
7. Making an Occupied Mattress/Bed
Examiners can ask CNAs to make the patient’s bed while the client is on the bed. The candidate can do this task by repositioning the client to one side. Now change the linens with a fresh one, and the used linen is disposed into a linen container.
8. Dressing The Patient with Paralyzed or Weak Arm
It is tough to change the clothes of patients having weak or paralyzed arms. The CNA has to assist such patients. First, undress the mobile side of the patient and then from the frail side and help the patient put on the dress gently and move the body smoothly.
9. Measuring and Recording Patient’s Urine Output
In this skill, CNAs have to measure and note the patient’s urine output by pouring the bedpan contents into a measuring receptacle (without splashing or spilling the urine). Put the container flatter and calculate the urine amount at eye level. After rinsing the equipment, note the contents of the container between plus/minus 25CC (evaluator’s reading).
10. Feeding Patients (Paralyzed Sitting On a Chair)
Paralyzed patients need help in drinking and eating. It is the responsibility of the CNA to feed such patients. Firstly, wash their hands and confirm they can watch the meal by putting them upright. It is essential to give them a beverage or water. Start feeding the client and wait until they chew their food before giving them the next bite.
11. Radial Pulse Measurements
You can also be asked to take the subject’s pulse and other vital signs. The number of heartbeats/minute is known as pulse rate. Pulse measurement is used to check the heart’s strength and rhythm. CNA should be able to take the pulse using fingertips. Locate the radial artery and count the number of pulses in one minute using your fingertips.
12. Recording Respiration Rate
The number of breaths/minute is known as the respiration rate. Respiration rate is used to determine the ease of breathing, calculated by counting the rise and fall of the chest. While recording respiration rate, don’t tell the client that you are determining the number of their breaths because it may affect the usual breathing rhythm. 12 or 16 breaths/minute is the standard respiration rate.
13. Hand and Nail Care of Resident
Patients may need to trim their fingernails because if nails get long, patients can accidentally scratch themselves. So CNAs must trim their nails and make their edges smooth if needed. Submerge the client’s fingernails in a water basin for a period and then cut their nails.
14. Foot Care of the Resident
Providing foot care to immobile patients is also an essential skill that CAN must learn. Before washing foot:
- Put on gloves.
- Use a wet washcloth to apply soap, and then wash the foot in the basin.
- After washing, dry the foot (including between toes) and apply ointment to the top and bottom of the foot.
15. Perform PROM (Passive Range of Motion) For One Wrist & Elbow
PROM exercises help patients to keep their joints flexible. The degree or range of motion is how far a patient’s joints can be rotated or moved in various directions. CNAs can be asked to provide PROM for one wrist and elbow for the immobile patient. In this task, the elbow of the patient is extended and flexed, and the wrist is hyperextended and flexed. Must repeat both exercises three times.
16. Perform PROM (Passive Range of Motion) For One Shoulder
PROM for one shoulder helps the patient to mobilize their shoulder. While performing PROM for the shoulder, provide support to the client’s arm at the wrist and elbow. Ask the client to inform you if they feel any pain during the exercise.
From the side position, raise the patient’s arm towards the head and then to ear level, and after that, reposition the arm down to the side of the body. Repeat this procedure three times. Move the joints slowly throughout this procedure.
17. Perform PROM (Passive Range of Motion) For One Ankle, Hip & Knee
It will help clients locomote their lower body, including the ankle, knee, and hip. For each joint, follow the proper pattern, including extension, adduction, flexion, and rotation. Ask the client to report pain if they feel any during the procedure.
Bend the knee of the patient and then reposition the leg; repeat this three times. For the knee, pull or push the foot towards the head. Hip exercise is performed by bending the knee halfway, and another activity is turning the knee towards the chest.
18. Deliver Subject Back Rub & Partial Bed Bath
For unconscious or immobile patients, a partial bed bath is essential to make them clean. During this task, CNA uses a clean washcloth and warm water to wash the patient’s face and other upper body parts. Begin with the hips and cleanse the remaining lower body for lower body parts. A back rub or massage after the bath is helpful to lower the physical discomfort.
19. Deliver Female Subject Perineal Care (Suffering Urine Incontinent)
CNAs can also be asked to deliver Peri-care to females suffering from incontinent urine. CNAs must ask the patient whether they can clean their private areas. If the answer is No, put on gloves, help the patient to lay back with legs bent and knees apart to expose their genital area, and put a towel under their hips. Clean the private parts (genitals) outside and wash the vaginal opening with a washcloth.
20. Indwelling Urinary Catheter Care of the Female Patient
Patients can’t move on their own after cancer treatment or surgery. They are equipped with a urinary catheter to drain urine out of their body. Patients having blocked urethra can also have a urinary catheter. CNAs will have to supply catheter care to such female patients.
Use a wet soapy washcloth to wash the body area where the catheter enters the urethra of the female, and also clean the vaginal opening to stop germs from spreading.
21. Mouth Care of Subject (Having Teeth)
To avoid plaque, cavities, and mouth infections, proper dental and oral care is essential, and it involves cleaning the teeth and mouth after every meal. For this, CNA must position the patient upright and then put a shielding cloth over their shoulders and chest. Use the correct brushing method to clean the tongue & teeth of the patient.
22. Mouth Care of Subject (Having Denture)
Mouth care is also vital for patients having dentures. It would be best if you placed dentures in a denture cup. To brush it, CNA should use denture cleaner & warm water. The certified nursing assistant has to ensure the cleanliness of the gums areas of the patient.
As a CNA, you are responsible for providing essential care to patients. This includes delivering perineal care to female patients with incontinent urine, washing the patient’s face and upper body parts in a partial bed bath, and brushing the patient’s teeth and tongue. You must also be aware of how to properly clean dentures using denture cleaner and warm water. By mastering these skills, you will be able to provide quality care that helps your patients feel more comfortable and relaxed.