Skills

1. Greet pt. by name

2. Introduce yourself (name + title)

3. Explain the specific procedure

4. Pull privacy curtain

1. Grab glove by palm of other hand

2. Remove glove while balling it up in other hand

3. Use thumb of ungloved hand - slip under wrist of gloved hand

4. Pull glove off, while keeping balled up glove inside other glove

5. Dispose of gloves

6. Wash hands

1. Put call light w/in pt. reach

2. Lower bed to lowest position

3. Lock bed brakes

4. Open privacy curtain

5. State you wash your hands before leaving pt. room

6. (for meas. skills) Record

7. State you completed the skill

1. Beginning Steps

2. Find radial pulse

3. Say “start” clearly - Count pt. pulse for 1 full minute - Say “stop” clearly

4. Ending Steps

5. Record

6. State completed skill

1. Beginning Steps

2. Say “start” clearly - Count pt. resp. for 1 full minute - Say “stop” clearly

3. Ending Steps

4. Record

5. State completed skill

1. Beginning Steps

2. Get equipment

3. Position pt. (upright at 90 w/ arm at heart level, or lying flat)

4. Raise sleeve above shoulder & check arm for safety

5. Find brachial artery

6. Check cuff size - state you have the right size cuff - secure cuff

7. Turn machine on - state the machine is ready and on the correct setting

8. Push start button - watch the whole time! 200mmHg safety stop!

   1. If machine hits 200mmHg, stop it and try again on the other arm

9. Ending Steps

10. Record

11. State completed skill

NO BEGINNING STEPS! NOT PATIENT-FACING!

1. Don gloves

2. Place napkin barriers on the counter - Put graduated cyl. on barrier

3. Pour urine into cyl.

4. Rinse bedpan w/ water - DO NOT pour in SINK! Pour in TOILET!!!

5. Dry bedpan & put bedpan in dirty supply

6. Measure urine

7. Dump urine in TOILET, rinse cyl. w/ water - DO NOT pour in SINK! Pour in TOILET!

8. Dry cyl. & put in dirty supply

9. Throw napkins away

10. Remove gloves

11. State wash hands

12. Record

13. State completed skill

1. Beginning Steps

2. Lock bed brakes, lower bed, lower feet flat

3. Put shoes on pt.

4. Ask pt. to walk with you to scale

5. Zero the scale

6. Ask pt. to stand in the center of the scale

7. Measure weight - DO NOT ZERO SCALE WHEN DONE

8. Ask pt. to step off the side of the scale, walk pt. to bed and ask them to get in.

9. Remove pt. shoes and cover with blanket

10. Ending Steps

11. Record

12. State completed skill

1. Gown on

   1. Tie bow behind neck

   2. Close back so fabric overlaps, then tie waist - STRAPS BEHIND YOU!

   3. Turn to show tester back is covered

2. Gloves on OVER SLEEVE BOTTOM - show tester no skin exposed on wrist

3. Remove gloves. Dispose of gloves.

4. Remove gown

   1. Untie neck, then waist

   2. Slip finger of ungloved hand under cuff of sleeve w/o contaminating self - pull sleeve over hand

   3. Use loose sleeve to loosen other sleeve

   4. Roll gown inward towards middle first, then down - all contaminated sides away from you

5. Dispose of gown in biohazard

6. State wash hands

7. State completed skill

GO SLOW!!!

1. Beginning Steps

2. Put head of bed flat

3. Explain 1st motion in detail

   1. Say “Tell me if you have pain during exercise!”

4. Support knee and ankle - move through knee flexion & extension - ask if they felt pain

5. Repeat 2x

6. Explain 2nd motion in detail

   1. Say “Tell me if you have pain during exercise!”

7. Support ankle - move through flexion & extension - ask if they felt pain

8. Repeat 2x

9. Cover pt.

10. Ending Steps

11. State completed skill

GO SLOW!!!

1. Beginning Steps

2. Put head of bed in position where arm won’t hit headboard

3. Explain 1st motion in detail

   1. Say “Tell me if you have pain during exercise!”

4. Support elbow and wrist - move through shoulder flex/extend TO EAR - ask if they felt pain

5. Repeat 2x

6. Explain 2nd motion in detail

   1. Say “Tell me if you have pain during exercise!”

7. Support elbow and wrist - move through abduction/adduction to 90-deg - ask if they felt pain

8. Repeat 2x

9. Cover pt.

10. Ending Steps

11. State completed skill

Minimum Supplies: chair, food tray w/ food, drink, diet card, and 2 wet wipes (gather these yourself)

1. Beginning Steps

2. Sit pt. all the way up - 90-degrees! prevent choking!

3. Put table in front of pt.

4. Put chair in place next to pt.

5. Check diet card - ask pt. to state full name & state you have the right diet for them

6. Position tray on table directly in front of pt.

7. Wipe pt. hands with 1st wet wipe - dispose of wet wipe

8. SIT DOWN ON CHAIR facing the pt. BEFORE feeding them and throughout meal

9. Introduce food AND drink to pt.

10. Ask pt. what they want to eat first, and load a bite of that on to the spoon

11. Ask pt. “if they are ready for” the food they selected, then say “here is the ___” - watch pt. swallow food/drink.

12. Be sure mouth is EMPTY before offering drink! Ask pt. “if they are ready for a drink.” Watch pt. swallow drink.

13. Repeat 11 & 12 two more times

14. Clean pt. mouth with napkin (if present) or wet wipe. Clean pt. hands with wet wipe. Dispose of wet wipe.

15. Take tray away - put in dirty supply area - DO NOT DUMP TRAY!

16. Leave pt. sitting up at 90-degrees

17. Ending steps

1. Beginning Steps

2. Get 2 shirts - show them to pt. - ask pt. to choose one, and put the other in the hamper

Be sure pt. is covered by the blanket to avoid over exposing pt. throughout whole undressing + dressing procedure! Tuck blanket over shoulder so it doesn’t pull off & expose them!

1. Gently assist pt. to sit forward - untie gown at neck and remove it from back before having them sit back. Take gown off LEFT arm. Then gently remove gown from RIGHT side. Put gown in hamper.

2. Put shirt on pt. RIGHT arm. Gently assist pt. to sit forward and put shirt behind back before having them sit back. Then put gown on LEFT arm.

3. Button the shirt over the blanket, then remove the blanket fron under the shirt and cover them up again.

4. Ending Steps

Minimum Supplies: 3 pillows

ONLY UNCOVER parts of body REQUIRED for specific STEPS!

1. Beginning Steps

2. Raise side rail on side of bet that pt. will roll towards

3. Put head of bed flat

4. Move pt. towards you - hands under shoulders & back and 1-2-3 count to have them scoot towards you on their back

5. Roll pt. to side away from you - instruct pt. to grab side rail on 1-2-3 - pt. should be in middle of bed after the roll!

6. Position back pillow (taco, then stuff between shoulder and lower back) - roll pt. shoulder towards you so they’re resting on the back pillow

7. Adjust head pillow (gently lift pt. head up & adjust head pillow for support)

8. Position Leg Pillow (uncover pt. to feet, lift top leg with one arm while placing pillow with other arm - knees & ankles separated by pillow)

9. Position arm pillow (pull pt. bottom shoulder & arm out a touch holding shoulder and elbow joints so pt is not lying on bottom arm - then support top arm with pillow on side of body)

10. Ending Steps

Minimum Supplies: One TED Stocking

NEVER grab stocking FROM THE OUTSIDE AND TWIST IT to get it on properly! ALWAYS PUT FINGERS INSIDE THE STOCKING to reposition & remove wrinkles!

1. Beginning Steps

2. Lower head of bed flat

3. Ensure stocking is right-side out

4. Uncover one leg, and roll pants to above the knee

5. Put stocking on foot & heel - then STOP! Check it’s on properly over the heel and all wrinkles are removed from foot and heel - FIX THIS before proceeding!

6. Slowly & Gently work the stocking the rest of the way up to the knee, working out all wrinkles as you pull it up

7. 2x check that there are no folds / wrinkles, on the foot, calf, and behind the knee

8. State out loud “There should be no wrinkles”

9. Lower pant leg, cover leg with blanket

10. Ending Steps

Supplies: 1 gait belt, patients shoes

1. Beginning steps

2. Safety: lock bed brakes, bed in lowest position, feet are flat, put shoes on pt.

3. Assist pt. to sit at edge of bed (cradle shoulders and knees)

4. Put gait belt around waist OVER GOWN in back

5. WHILE HOLDING BELT, assist pt. to scoot forward on bed so feet are FLAT ON FLOOR

6. WHILE HOLDING BELT, assist pt. to stand on 3-count - knee to knee, toe to toe for safety

7. WHILE HOLDING BELT, rotate standing pt. so you’re behind and to the side of them; walk 10 steps out, 10 steps back; rotate standing pt. so they’re ready to sit

8. WHILE HOLDING BELT, assist pt to sit on bed

9. Remove gait belt; assist pt to lay down (cradle technique); remove shoes

10. Ending steps

Supplies: 1 gait belt, 1 wheelchair, patients shoes

1. Beginning steps

2. Prep wheelchair: open, foot rests swung out of the way, locked

3. Safety: lock bed brakes, bed in lowest position, feet are flat, put shoes on pt.

4. Assist pt. to sit at edge of bed (cradle shoulders and knees)

5. Put gait belt around waist OVER GOWN in back

6. WHILE HOLDING BELT, assist pt. to scoot forward on bed so feet are FLAT ON FLOOR

7. Pull wheelchair close to pt - MUST BE CLOSE ENOUGH FOR PIVOT TRANSFER!

8. WHILE HOLDING BELT, assist pt. to stand on 3-count - knee to knee, toe to toe for safety

9. WHILE HOLDING BELT, rotate standing pt. so their knees touch wheelchair; have them reach back with hands for wheelchair

10. WHILE HOLDING BELT, assist pt to sit in wheelchair

11. Remove gait belt; swing foot rests forward and put pt. feet on them; ensure wheelchair locked

12. Ending steps

1. Beginning steps

2. Move to sink - remove watch & put on counter so you can time yourself

3. Turn on HOT and COLD! Test water temp

4. WIth FINGERS POINTED DOWN and HANDS LOWER THAN ELBOWS:

   1. Wet fingertips, fingers, hands & wrists

   2. Get LIBERAL AMOUNT of soap & lather it

   3. Tell tester to start your 20-seconds - scrub vigorously, make sure to get wrists!

   4. After 20-sec are up, scrub under nails, then DIRECTLY TO RINSE!

   5. Dry all wet skin starting with nails, then fingers, then palms, then wrists - dispose of towel

   6. Grab new towel and use it to turn off faucet WITH ONLY ONE HAND - dispose of towel

Supplies: 1 washcloth for sink bottom, 1 washcloth (or paper towels) for barrier on counter, toothpast, denture brush, emesis basin, denture cup with dentures, gloves

1. Don gloves

2. Cloth in sink, supplies on barrier

3. Teeth care:

   1. Check water temp - warm, NOT HOT

   2. Open cup, dump old water, return to barrier

   3. Wet denture brush, apply toothpaste to brush, cap toothpaste, put in dirty supply

   4. Rinse dentures, brush dentures, rinse dentures

   5. Rinse cup and lid, fill with new water, place dentures in cup, affix lid, put in dirty supply

4. Brush care:

   1. Rinse all toothpaste out of brush without touching bristles

   2. Put in dirty supply NEXT TO toothpaste

5. Shut off water, wring out sink cloth, clean up area & remove counter barrier

6. Remove gloves & STATE YOU WASH YOUR HANDS

Supplies: emesis basin, 2 towels (1 for pt. bib, 1 for clean barrier), toothbrush, toothpaste, cup of water, gloves

1. Beginning steps

2. Safety: head of bed at 90-degrees (prevent aspiration)

3. Don gloves, gather supplies & lay on clean barrier, put towel on pt. chest like bib

4. Wet toothbrush & fill water cup at sink, apply toothpaste to wet brush

5. Brush all teeth & tongue, put toothbrush BRISTLES UP on clean barrier

6. Emesis basin under pt. chin - give water, have them rinse & spit

7. Wipe pt. mouth with bib towel

8. Dump water cup into emesis basin, dispose of cup

9. Carry basin, toothbrush, toothpaste to bathroom. Put brush on CLEAN BARRIER (paper towel)

10. Empty emesis basin IN TOILET, rinse, and empty IN TOILET AGAIN. Dry it and put it in dirty supply NEXT TO TOOTHPASTE

11. Rinse toothbrush without touching bristles, put in emesis basin

12. Remove gloves, STATE WASH YOUR HANDS

13. Return to pt. for ending steps (leave them up at 90-degrees!)

Supplies: 1 bedpan, 1 chux, 2 pairs of gloves, TP roll, 1 wet wipe

1. Beginning steps

2. Lower head of bead flat

3. GLOVES ON + gather supplies (keep dirty supplies - BP and chux - in one hand, and clean supplies - TP and wet wipe - in other hand)

   1. TP and wet wipe go on TABLE, bedpan and chux go on BED (since they’re “dirty” they don’t go on the “clean” table)

4. Uncover pt. to knees. Assist to roll on side w/ 3-count. Place chux and bedpan. Assist to roll back on 3-count w/ bedpan placed correctly. Cover pt. with blanket.

5. STOP AND REMOVE GLOVES - state wash hands

6. Raise head of bed to sitting position (keep feet flat). Then:

   1. provide call light: “Call me when you’re done”

   2. provide TP: “Here is your TP”

   3. provide wet wipe: “Wash your hands w/ wet wipe when done”

7. Step away - pretend pt. has done business and called you back.

8. GLOVES ON

9. Lower head of bead flat

10. Uncover pt. to knees. Assist to roll on side w/ 3-count. Remove chux and bedpan. Assist to roll back on 3-count. Cover pt. with blanket.

11. Cleanup in bathroom area:

    1. TP in dirty supply

    2. Chux in trash

    3. Bedpan dumped in toilet, rinse and dump in toilet, dry and put in dirty supply

    4. Check to make sure everything is cleaned up

12. STOP AND REMOVE GLOVES - state wash hands

13. Lower bed siderails, & ending steps

Supplies: bath basin, chux, 2 washcloths, 2 towels, soap, gloves

(use bath basin as bucket for carrying supplies)

1. Beginning steps

2. GLOVES ON, then gather supplies & lay on barrier

3. Fill basin with warm water. CHECK water temp. HAVE PT. CHECK water temp.

4. Expose pt. to knees only. Roll pt. to side on 3-count. Place chux. Roll pt. back on 3-count.

5. Expose working area - Raise blanket above knee crease, raise gown no higher than pubic area

6. Wet washcloth in basin, then apply soap, then fold in 4ths

7. CLEAN catheter: Pinch catheter at the meatus w/ one hand w/ fingers touching body. CLEAN down length of catheter from meatus away from body 3x, using clean part of washcloth each time.

8. Washcloth in hamper. Wet new washcloth in basin.

9. RINSE catheter: Pinch catheter at the meatus w/ one hand w/ fingers touching body. RINSE down length of catheter from meatus away from body 3x, using clean part of washcloth each time.

10. Washcloth in hamper. Grab clean towel.

11. DRY catheter: Pinch catheter at the meatus w/ one hand w/ fingers touching body. DRY down length of catheter from meatus away from body 1x.

12. Lower gown. Roll pt. to side on 3-count. Remove chux. Chux in trash. Roll pt. back on 3-count.

13. Empty basin in toilet. Rinse & dump in toilet. Dry & put in dirty supply.

14. Clean up: Soap in dirty supply, linens in hamper, chux in trash

15. REMOVE GLOVES - state wash hands

16. Ending steps

Supplies: bath basin, 4 washcloths, 3 towels, chux, soap, gloves

(use bath basin as bucket to carry all supplies)

1. Beginning steps

2. GLOVES ON - then gather supplies & lay on barrier

3. Fill basin with warm water. CHECK water temp. HAVE PT. CHECK water temp.

4. Expose pt. to knees only. Roll pt. to side on 3-count. Place chux. Roll pt. back on 3-count.

5. Expose working area - Raise blanket above knee crease, raise gown no higher than pubic area

6. Wet washcloth in basin, then apply soap, then fold in 4ths

7. WASH FRONT: Wash genital area down the middle 1st, then down the groin 2nd, then the other groin 3rd, CHANGING SURFACES EACH TIME. Washcloth in hamper

8. Wet new washcloth in basin.

9. RINSE FRONT: Rinse genital area down the middle 1st, then down the groin 2nd, then the other groin 3rd, CHANGING SURFACES EACH TIME. Washcloth in hamper.

10. Grab clean dry towel.

11. DRY FRONT: Dry genital area down the middle 1st, then down the groin 2nd, then the other groin 3rd, CHANGING SURFACES EACH TIME. Towel in hamper.

12. Roll pt. to side on 3-count. Tester holds mannequin on side.

13. Wet washcloth in basin, then apply soap, then fold in 4ths

14. WASH BACK SIDE: Wash up the crack (middle) 1st, then up one cheek 2nd, then the other cheek 3rd, CHANGING SURFACES EACH TIME. Washcloth in hamper.

15. Wet new washcloth in basin.

16. RINSE BACK SIDE: Rinse up the crack (middle) 1st, then up one cheek 2nd, then the other cheek 3rd, CHANGING SURFACES EACH TIME. Washcloth in hamper.

17. Grab clean dry towel.

18. DRY BACK SIDE: Rinse up the crack (middle) 1st, then up one cheek 2nd, then the other cheek 3rd, CHANGING SURFACES EACH TIME. Towel in hamper.

19. Remove chux & put in trash.

20. Roll pt. to back on 3-count. Cover pt. before cleaning up.

21. Empty basin in toilet. Rinse & dump in toilet. Dry & put in dirty supply.

22. Clean up: Soap in dirty supply, linens in hamper, chux in trash

23. REMOVE GLOVES - state wash hands

24. Ending steps