NNAAP Skills

Question 1

SKILL 1 - HAND HYGIENE (HAND WASHING)

Answer 1

1. Address client by name and introduces self to client by name.
2. Turns on water at sink
3. Wets hands and wrists thoroughly
4. Applies soap to hands
5. LATHERS ALL SURFACES OF WRISTS, HANDS, AND FINGERS PRODUCING FRICTION, FOR AT LEAST 20 (TWENTY) SECONDS, KEEPING HANDS LOWER THAN THE ELBOWS AND THE FINGERTIPS DOWN.
6. Cleans fingernails by rubbing fingers against palms of the opposite hand.
7. RINSE ALL SURFACES OF WRISTS, HANDS, AND FINGERS, KEEPING HANDS LOWER THAN THE ELBOWS AND THE FINGERTIPS DOWN.
8. Uses clean, dry paper towel/towels to dry all surfaces of fingers, hands, and wrists starting at the fingertips then disposes of paper towel/towels into waste container or uses knee/foot control to turn off faucet
9. Does not touch inside of sink at any time.

Question 2

SKILL 2 - APPLIES ONE KNEE-HIGH ELASTIC STOCKING

Answer 2

1. Explains procedure speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible.
2. Privacy is provided with a curtain, screen, or door
3. Client is in supine position (lying down in bed) while stocking is applied
4. Turns stocking inside-out, at least to the heel
5. Places foot of stocking over toes, foot, and heel
6. Pulls top of stocking over foot, heel and leg
7. Moves foot and leg gently and naturally, avoiding force and over-extension of limb and joints
8. FINISHES PROCEDURE WITH NO TWISTS OR WRINKIELS AND HEEL OF STOCKING, IF PRESENT, IS OVER HEEL AND OPENING IN TOE AREA (IF PERSENT) IS EITHER OVER OR UNDER TOE AREA; IF USING MANNEQUIN, CANDIDATE MAY STATE STOCKING NEEDS TO BE WRINKLE-FREE.
9. Signaling device is within reach and bed is in low position
10. After completing skill, wash hands

Question 3

SKILL 3 - ASSISTS TO AMBULATE USING TRANSFER BELT

Answer 3

1. Explains procedure, speaking clearly, slowly, and directly maintaining face-to-face contact whenever possible.
2. Privacy is provided with a curtain, screen, or door
3. BEFORE ASSISTING TO STAND, CLIENT IS WEARING NON-SKID SHOES/FOOTWEAR
4. Before assisting to stand, bed is at a safe level
5. Before assisting to stand, checks and/or locks bed wheels
6. BEFORE ASSISTING TO STAND, CLIENT IS ASSISTED TO SITTING POSITION WITH FEET FLAT ON THE FLOOR
7. Before assisting to stand, applies transfer belt securely at the waist over clothing/gown
8. Before assisting to stand, provides instructions to enable client to assist in standing including prearranged signal to alert client to begin standing
9. Stand facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing
10. On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidate’s hands are in upward position), and maintaining stability of client’s leg by standing knee to knee, or toe to toe with client
11. Walks slight behind and to one side of client for a distance of ten (10) feet, while holding onto the belt
12. Assists client to bed and removes transfer belt
13. Signaling device is within reach and bed is in low position
14. After completing skill, wash hands

Question 4

SKILL 4 - ASSISTING WITH USE OF BEDPAD

Answer 4

1. Explains procedure speaking clearly, slowly, and directly maintaining face-to-face contact whenever possible
2. Privacy is provided with a curtain, screen, or door
3. Before placing bedpan, lowers head of bed
4. Puts on clean gloves before placing bedpan under client
5. Places bedpan correctly under client’s buttocks
6. Removes and disposes of gloves (without contaminating self) into waste container and washes hands
7. After positioning client on bedpan and removing gloves, raises head of bed
8. Toilet tissue is within reach
9. Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished
10. Signaling device within reach and client is asked to signal when finished
11. Puts on clean gloves before removing bedpan
12. Head of bed is lowered before removing bedpan
13. Ensures client is covered except when placing and removing bedpan
14. Empties and rinses bedpan and pours rinse into toilet
15. Places bedpan in designated dirty supply area
16. Removes and disposes of gloves (without contaminating self) into waste container and washes hands
17. Signaling device is within reach and bed is in low position.

Question 5

SKILL 5 - CLEANS UPPER OR LOWER DENTURE

Answer 5

1. Puts on clean gloves before handling denture
2. bottom of sink is lined and/or sink is partially filled with water before denture is held over sink
3. Rinses denture in moderate temperature running water before brushing them
4. Applies denture toothpaste to toothbrush
5. Brushes all surfaces of denture
6. Rinses all surfaces of denture under moderate temperature running water
7. Rinses denture cup and lid
8. Places denture in denture cup with moderate temperature water/solution and places lid on cup
9. Rinses toothbrush and places in designated toothbrush basin/ container
10. Maintains clean technique with placement of toothbrush and denture
11. Sink liner is removed and disposed of appropriately and /or sink is drained
12. Removes and disposes of gloves (without contaminating self) into waste container and washes hands

Question 6

SKILL 6 - COUNTS AND RECORDS RADIAL PULSE

Answer 6

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
2. Places fingertips on thumb side of client’s wrist to locate radial pulse
3. Count beats for one full minute
4. Signaling device is within reach
5. Before recording, washes hands
6. RECORD PULSE RATE WITHIN PLUS OR MINUS 4 BEATS OF EVALUATOR’S READING

Question 7

SKILL 7 - COUNTS AND RECORDS REPIRATIONS

Answer 7

1. Explains procedure (for testing purposes), speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
2. Counts respirations for one full minute
3. Signaling device is within reach
4. Before recording, washes hands
5. RECORDS RESPIRATION RATE WITHIN PLUS OR MINUS 2 BREATHS OF EVALUATOR’S READING

Question 8

SKILL 8 - DONNING AND REMOVING PPE (GOWN AND GLOVES)

Answer 8

1. Picks up gown and unfolds
2. Facing the back opening of the gown places
3. Picks up gown and unfolds
4. Secures gown at waist making sure that back of clothing is covered by gown (as much as possible)
5. Puts on gloves
6. Cuffs of gloves overlap cuffs of gown
7. BEFORE REMOVING GOWN, WITH ONE GLOVED HAND, GRASPS THE OTHER GLOVE AT THE PALM, REMOVE GLOVE
8. SLIPS FINGERS FROM UNGLOVED HAND UNDERNEATH CUFF OF REMAINING GLOVE AT WRIST, AND REMOVES GLOVE TURNING IT INSIDE OUT AS IT IS REMOVED
9. Disposes of gloves into designated waste container without contaminating self
10. After removing gloves, unfasten gown at waist and neck
11. After removing gloves, removes gown without touching outside of gown
12. While removing gown, holds gown away from body without touching the floor, turns gown inward and keeps it inside out
13. Disposes of gown in designated container without contaminating self
14. After completing skill, washes hands

Question 9

SKILL 9 - DRESSES CLIENT WITH AFFECTED (WEAK) RIGHT ARM

Answer 9

1. Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
2. Privacy is provided with a curtain, screen, or door
3. Asks which shirt he/she would like to wear and dresses him/her in shirt of choice
4. Avoids overexposure of client by ensuring client’s chest is covered
5. Removes gown from the left (unaffected) side first, then removes gown from the right (affected/weak) side
6. Before dressing client, disposes of gown into soiled linen container
7. ASSISTS TO PUT THE (AFFECTED/WEAK) ARM THROUGH THE RIGHT SLEEVE OF THE SHIRT BEFORE PLACING GARMENT ON LEFT (UNAFFECTED) ARM
8. While putting on shirt, moves body gently and naturally, avoiding force and over-extension of limbs and joints
9. Finishes with clothing in place
10. Signaling device is within reach and bed is in low position
11. After completing skill, washes hands

Question 10

SKILL 10 - FEEDS CLIENT WHO CANNOT FEED SELF

Answer 10

1. Explains proce