| Question | Answer |
| Handwashing Step 1 | Begin handwashing by wetting hands and applying
soap to hands |
| Handwashing Step 2 | Use friction to distribute soap and create lather
cleansing front and back of hands, between fingers,
around cuticles, under nails, and wrists? |
| Handwashing Step 3 | Provide cleansing friction for a minimum of
20 seconds with hands lathered with soap |
| Handwashing Step 4 | Rinse hands and wrists removing soap |
| Handwashing Step 5 | Use clean paper towel(s) to dry hands and wrists,
and dispose of used paper towel in trash |
| Handwashing Step 6 | End handwashing skill with clean hands avoiding
recontamination of hands (e.g., having direct contact with faucet
handles or sink surfaces once hands washed) |
| Indirect Care checkpoint 1 | Greet resident, address by name, and introduce
self |
| Indirect Care checkpoint 2 | Provide explanations to resident about care before
beginning and during care |
| Indirect Care checkpoint 3 | Ask resident about preferences during care |
| Indirect Care checkpoint 4 | Use Standard Precautions and infection control
measures when providing care |
| Indirect Care checkpoint 5 | Ask resident about comfort or needs during care or
before care completed |
| Indirect Care checkpoint 6 | Promote resident’s rights during care |
| Indirect Care checkpoint 7 | Promote resident’s safety during care |
| Ambulate the resident using a transfer/gait belt 1 | Apply transfer/gait belt before standing resident,
placing around the resident’s waist and over
clothing, secure so that only flat fingers/hand fit
under belt, and the belt does not catch skin or skin
folds (e.g. breast tissue) |
| Ambulate the resident using a transfer/gait belt 2 | Provide signal or cue to resident before assisting to
stand
beginning and during care |
| Ambulate the resident using a transfer/gait belt 0 (IC) | Follow the Indirect Care guidelines |
| Ambulate the resident using a transfer/gait belt 3 | Assist resident to stand while holding onto the
transfer/gait belt without holding belt only at the
front or only at nearest side (if assisting to stand
from the side) |
| Ambulate the resident using a transfer/gait belt 4 | Ask about how resident feels upon standing |
| Ambulate the resident using a transfer/gait belt 5 | Walk resident while standing to the side and slightly
behind resident |
| Ambulate the resident using a transfer/gait belt 6 | Provide support while walking resident with an arm
around resident’s back holding transfer/gait belt |
| Ambulate the resident using a transfer/gait belt 7 | Ask about how resident feels during ambulation |
| Ambulate the resident using a transfer/gait belt 8 | Walk resident at least 10 steps |
| Ambulate the resident using a transfer/gait belt 9 | Assist resident to turn and have back of legs
positioned against the seat of chair before resident
sits |
| Ambulate the resident using a transfer/gait belt 10 | Provide support to sit resident back into chair |
| Ambulate the resident using a transfer/gait belt 11 | Remove transfer/gait belt from resident’s waist
without harming resident (e.g., pulling transfer/gait
belt) when seated in chair after ambulation |
| Ambulate the resident using a transfer/gait belt 12 | Maintain own body mechanics when assisting
resident to stand and sit |
| Ambulate the resident using a transfer/gait belt 13 | Leave resident positioned in chair in proper body
alignment and hips against back of seat |
| Assist resident needing to use a bedpan 0 (IC) | Follow the Indirect Care guidelines |
| Assist resident needing to use a bedpan 1 | Place protective pad on bed over bottom sheet,
under buttocks/upper thigh area, before placing
bedpan, and remove the pad after bedpan is
removed |
| Assist resident needing to use a bedpan 2 | Place and remove bedpan by either having resident
positioned on side to turn on/off back, onto/off
bedpan, or having resident raise hips off bed |
| Assist resident needing to use a bedpan 3 | Position bedpan under resident according to
form/shape of the selected bedpan |
| Assist resident needing to use a bedpan 4 | Position bedpan to allow for collection |
| Assist resident needing to use a bedpan 5 | Raise the head of the bed after positioning the
resident on the bedpan, and lower the head of the
bed before removing bedpan |
| Assist resident needing to use a bedpan 6 | Ask resident to call when finished or if needs help,
leaving call light within the resident’s reach before
leaving resident to use bedpan |
| Assist resident needing to use a bedpan 7 | Leave toilet paper within resident's reach before
leaving resident to use bedpan |
| Assist resident needing to use a bedpan 8 | Wear gloves when removing bedpan and while
emptying and cleaning bedpan |
| Assist resident needing to use a bedpan 9 | Empty contents of bedpan into toilet, rinse bedpan
pouring contents into toilet, and dry bedpan |
| Assist resident needing to use a bedpan 10 | Offer resident damp washcloth or paper towel, or
hand wipe, to cleanse hands after bedpan used,
before end of care |
| Assist resident needing to use a bedpan 11 | Complete skill storing bedpan and toilet paper,
placing soiled linens in hamper, and disposing of
trash |
| Assist resident needing to use a bedpan 12 | Keep resident positioned a safe distance from the
edge of the bed at all times |
| Change bed linen while the resident remains in bed 1 | Keep resident positioned a safe distance from the
edge of the bed at all times |
| Change bed linen while the resident remains in bed 2 | Remove and replace bottom sheet on one side of
the bed, before turning resident to remove and
replace sheet on the other side of the bed |
| Change bed linen while the resident remains in bed 3 | Keep resident positioned on a bottom sheet
throughout procedure |
| Change bed linen while the resident remains in bed 4 | Secure bottom sheet to mattress (e.g., for fitted
sheet secure over all four corners of the mattress;
for flat sheet, tuck at head of bed and on sides and
extend toward bottom of mattress so that resident’s
heels are not against any exposed mattress) |
| Change bed linen while the resident remains in bed 5 | Leave bottom sheet free of creases or folds |
| Change bed linen while the resident remains in bed 6 | Turn or position resident to remove or replace
sheet(s) without pulling sheets in a manner that
creates friction and risks skin shearing |
| Change bed linen while the resident remains in bed 7 | Replace the top sheet over resident with a clean
sheet |
| Change bed linen while the resident remains in bed 8 | Tuck top sheet under foot of mattress leaving sheet
placed loosely, avoiding pressure against toes and
allowing for foot movement |
| Change bed linen while the resident remains in bed 9 | Leave top sheet placed on top of resident to cover
body up to shoulder level, without tucking in along
sides |
| Change bed linen while the resident remains in bed 10 | Keep pillow positioned under resident’s head
throughout and at the end of the procedure, except
when removed briefly to replace pillowcase |
| Change bed linen while the resident remains in bed 11 | Complete procedure with resident positioned
between the top and bottom sheet |
| Change bed linen while the resident remains in bed 11 | Complete skill placing soiled linens in hamper and
disposing of trash |
| Change resident’s position to a
supported side-lying position 1 | Assist resident with turning onto side before placing
positioning devices |
| Change resident’s position to a
supported side-lying position 2 | Keep resident positioned a safe distance from the
edge of the bed at all times |
| Change resident’s position to a
supported side-lying position 3 | Use positioning device/padding or pillow under or
against resident’s back that maintains side-lying
position |
| Change resident’s position to a
supported side-lying position 4 | Leave resident positioned on side with upper knee
bent in front of the lower leg |
| Change resident’s position to a
supported side-lying position 5 | Support resident’s top leg by placing device(s)/
padding or pillow(s) between legs |
| Change resident’s position to a
supported side-lying position 6 | Position device(s)/padding or pillow(s) placed
between legs so that bony prominences of the
knees and ankles are separated |
| Change resident’s position to a
supported side-lying position 7 | Leave the resident positioned on side without lying
on the shoulder, arm, and hand |
| Change resident’s position to a
supported side-lying position 8 | Leave pillow placed under head positioned to also
support the resident’s neck and chin |
| Change resident’s position to a
supported side-lying position 9 | Place device/padding or pillow positioned to support
the resident’s upper arm, supporting both the
shoulder and arm |
| Dress a resident who has a weak arm 1 | Include resident in decision-making about clothing
to wear |
| Dress a resident who has a weak arm 2 | Collect all garments before removing hospital gown |
| Dress a resident who has a weak arm 3 | Support affected arm while undressing and
dressing |
| Dress a resident who has a weak arm 4 | Remove hospital gown |
| Dress a resident who has a weak arm 5 | Dress affected arm first |
| Dress a resident who has a weak arm 6 | Gather up sleeve to ease pulling over affected arm |
| Dress a resident who has a weak arm 7 | Dress resident by putting on pants, shirt with
sleeves, and socks |
| Dress a resident who has a weak arm 8 | Move resident’s extremities gently without overextension
or force when undressing and dressing |
| Dress a resident who has a weak arm 9 | Apply clothing correctly (e.g. front of shirt in front),
adjust clothing for comfort, neatness, alignment,
and close fasteners |
| Dress a resident who has a weak arm 10 | Place dirty gown in hamper |
| Dress a resident who has a weak arm 11 | Keep resident positioned a safe distance from the
edge of the bed at all times |
| Msr & Rcrd Urine output from drainage bag 1 | Wear gloves while handling the urinary drainage
bag, graduate, and bedpan (if used), and remove
gloves before documenting I&O |
| Msr & Rcrd Urine output from drainage bag 2 | Set graduate or bedpan on barrier placed on
floor and empty full contents of drainage bag into
the graduate or bedpan |
| Msr & Rcrd Urine output from drainage bag 3 | Empty contents of urinary drainage bag without
contaminating drainage tube (e.g., touching
container) and close and protect drain (e.g.,
clamp and tuck drain into pocket) after emptying
drainage bag |
| Msr & Rcrd Urine output from drainage bag 4 | Set graduate on flat surface protected with
barrier to read, obtaining measurement by
reading graduate at eye level, and if urine
poured into graduate from a bedpan, complete
task over toilet pouring the full amount of urine
into the graduate |
| Msr & Rcrd Urine output from drainage bag 5 | Empty urine in graduate into toilet after
measuring, rinse and dry container, pouring rinse
water into toilet |
| Msr & Rcrd Urine output from drainage bag 6 | Record output with clean hands |
| Msr & Rcrd Urine output from drainage bag 7 | Record output within +/- 50cc's of nurse’s
measurement |
| Msr & Rcrd Urine output from drainage bag 8 | Record output as urine and indicate the correct
time on the I&O form |
| Msr & Rcrd Urine output from drainage bag 9 | Leave bag hanging from bed frame (not side
rail), and drainage bag and tubing off (not
touching) the floor |
| Msr & Rcrd Urine output from drainage bag 10 | Keep urinary drainage bag positioned lower than
bladder throughout care |
| Msr & Rcrd Urine output from drainage bag 11 | Complete skill having stored equipment, placing
soiled linens in hamper, and disposing of trash |
| Feed resident sitting in a chair 1 | Assist or cue resident to sit upright in chair before
feeding |
| Feed resident sitting in a chair 2 | Offer and assist resident to wash hands before
feeding using a damp washcloth, paper towel, or
hand wipe |
| Feed resident sitting in a chair 3 | Sit while feeding the resident |
| Feed resident sitting in a chair 4 | Offer to protect resident’s clothing with a barrier
before feeding, and if used, remove barrier at end
of feeding |
| Feed resident sitting in a chair 5 | Use spoon to feed |
| Feed resident sitting in a chair 6 | Offer fluids to drink throughout feeding; at least
every 2-3 bites of food |
| Feed resident sitting in a chair 7 | Allow resident the opportunity to swallow before
feeding the next bite |
| Feed resident sitting in a chair 8 | Converse with resident during meal
(e.g., encourage intake) |
| Feed resident sitting in a chair 9 | Leave area around resident’s mouth clean and dry
when care completed |
| Feed resident sitting in a chair 10 | Complete skill placing any used linen in hamper,
disposing of trash, and leaving overbed table dry |
| Feed resident sitting in a chair 11 | Record the amount of the resident’s food intake on
the Food and Fluid Intake Form within 25% of the
nurse’s measurement |
| Feed resident sitting in a chair 12 | Record the amount of the resident’s fluid intake on
the Food and Fluid Intake Form within 25% of the
nurse’s measurement |
