Skill Steps Flashcards
Common Starting Skill Steps - 4
Knock. Identify yourself by name. Identify Resident. Greet Resident by name.
Wash hands.
Explain procedure to resident
Provide for privacy - door, curtain, screen.
Skill 2: Oral Care flossing - 10
Adjust bed; lock wheels
Put on gloves
Wrap ends of floss around index fingers
Starting with back teeth, clean both edges and gum betw teeth
Unwind/rewind floss to get a new spot, every two teeth
Offer water to rinse, spit into basin
Wipe face, remove towel
Discard floss, clean basin
Dispose of soiled linen; remove gloves; wash hands
Return bed to lowest position
Skill 2: Oral Care toothbrush - 11
Adjust bed; lock wheels Put on gloves Place towel across resident's chest Wet brush; apply toothpaste Clean entire mouth, incl tongue, all surf teeth, gumline. Inner then outer of upper then lower. short strokes. 45 angle. Hold emesis basin to chin, spit out. Rinse and spit water Wipe mouth, remove towel. Empty/clean emesis basin, toothbrush. Dispose linens; remove gloves; wash hands. Return bed to lowest position
Skill 2: Oral Care dentures - 11
Put bed to good position; lock wheels
Put on gloves
Line sink/basin with washcloth and partially fill with tepid water
Remove dentures bottom first and rinse in basin
Apply toothpaste to brush and brush dentures, and rinse
Rinse resident’s mouth
Rinse denture cup and put dentures, water, tablet in labelled cup
If wearing immediately, reinstall dentures top first with adhesive
Clean and dry equipment
Dispose of soiled linens; remove gloves; wash hands
Return bed to lowest position
Skill 2: Oral Care unconscious - 9
Adjust bed to good height; lock wheels
Put on gloves
Place resident on side, head to side, towel under mouth, emesis basin next to cheek
Hold mouth open with tongue depressor
Dip swab in cleaning solution, squeeze out, wipe teeth, tongue, gums, inside of mouth
Rinse with swab dipped in water, squeezed out
Remove towel and basin; pat face dry; apply lip lubricant
Dispose of soiled linens; remove gloves; wash hands
Return bed to lowest position
Skill 3: Shave resident - 12
Adjust bed to good position; lock wheels
Raise bed head; put towel on resident’s chest
Put on gloves
Soften beard with warm wet washcloth; lather face
Hold skin taut; shave in direction of hair growth; rinse blade often
Rinse face with washcloth, dry. Offer mirror
Electric razor - not near water, pacemaker, O2. Clean razor with brush
Electric: Hold skin taut. Shave back and forth or circular. Offer mirror
Apply after-shave
Clean equipment, razor in sharps
Remove towel to linens; remove gloves; wash hands
Return bed to lowest position
Skill 4: Nail care - 11
Adjust bed to good position; lock wheels
Fill basin half with warm water
Put on gloves
Soak all nails 5 minutes
Remove hands, soap wash and dry hands, remove basin
Place hands on towel, clean under each nail with orangewood
Wash hands again and dry
Cut nails if necessary; shape with nail file
Clean equipment
dispose of soiled linens; remove gloves; wash hands
Bed to lowest position
Skill 5: Perineal care - 22
Adjust bed to good position; lock wheels
Put on gloves
Check if resident needs to urinate or defecate; do first
Fill basin halfway with warm water; put all 4 washcloths in water
Put bath blanket over resident, remove linens from under it
Put waterproof pad under hips
Have resident lift knees, feet and knees spread
Put towel between legs to buttocks; Get permission and raise bath blanket
One washcloth in dominant hand, apply soap
Female: two fingers to separate labia majora, wipe front to back middle, left, right, both leg creases; discard washcloth
Male: if uncircumcised pull back foreskin; grasp penis at base and wash head and down shaft in circular motion, scrotum; discard cloth
Use second washcloth to rinse, same as wash; discard washcloth
Use towel to pat dry; If male, return foreskin
Turn resident on left side
Soap on washcloth; wash both butt cheeks, then swipe perineum to anus; discard washcloth
Fourth washcloth, rinse same as wash; discard washcloth
Pat dry
Remove waterproof pad; resident on back
Discard towel to linens; remove gloves; wash hands; fresh gloves
Remove old gown under blanket; add new gown over; remove blanket
Top linens back up; remove gloves; wash hands
Bed to lowest position
Skill 8: Make occupied bed - 18
Adjust bed to good position; lock wheels
Put on gloves
Unfold bath blanket over resident; remove top linen from under blanket
Raise rail on far side; turn resident to face far rail and hold on
Loosen bottom linen/pad/protector on your side; roll to resident and tuck to resident back
Place new mattress pad on corners, against soiled linen
Same with bottom sheet, smooth out; waterproof bed protector; draw
Raise rail on near side, move to far side; roll resident over to hold railing
Loosen soiled linen, look for personal items, roll head to foot, discard
Pull clean linen over, corner/tuck in, straighten any wrinkles
Place resident on back
Unfold new top sheet over resident, pull out bath blanket, discard
Blanket and bedspread, 6 inch cuff at top, hospital corners
Remove pillow, remove pillowcase and discard
Remove gloves
Put on new pillowcase
Return bed to lowest position
Skill 9: Dress resident - 7
Ask resident what they want to wear, and use that
Remove gown; do not completely expose resident, do half at a time
Take clothes off strong side first, put them on weak side first
Gather up sleeve and reach through to grasp weak arm
Same with pants; have them raise buttocks to get clothes to waist
Place bed at lowest position; lock wheels
Put resident in sitting position; put on socks and non-skid shoes
Skill 10: Transfer to wheelchair with belt - 10
Place wheelchair at stronger side head of bed; lock wheels; remove footrests
Adjust bed to same height as wheelchair, head raised; lock wheels
Assist resident to sitting position, feet flat, sit for a minute
Add non-skid footwear
Place belt on resident below ribs over clothing
Both feet in front of resident’s feet, count 3, raise by belt
Move to weak side as resident takes small steps toward chair, help pivot
Resident put arms on wheelchair arms, knees against seat, lower
Reposition resident so hips against back, remove belt
Attach footrests
Skill 11: Transfer with mechanical lift - 10
Position wheelchair; remove footrests
Lock wheels of bed, wheelchair
Raise one bedrail, lower the other.
Help resident turn toward bedrail; spread sling and fanfold; washcloth at neck; roll resident to other side; spread out sling; roll to back
Roll lift to bedside, lift bar above resident; open legs, lock wheels
Attach straps (same on all) to bars; arms folded over chest
Raise resident with coworker supporting resident, and pause
Unlock lift wheels; move resident with coworker support over wheelchair
Slowly lower, push legs down for sitting position; undo straps
Put on non-skid footwear, footrests
Skill 12: Ambulate with Gait belt - 7
Adjust bed to lowest position; lock wheels
Put on non-skid footwear
Put on gait belt below ribs
With feet in front of feet, count of three and lift to standing; pause
Walk slightly behind and to one (weak) side holding onto belt
Weak foot first; your left with their left; resident looking straight ahead
After ambulation, remove gait belt
Skill 13: Feed resident - 14
Check diet card against resident, food on tray
Head of bed to 90, height so your eye levels the same; lock wheels
Tray on overbed table
Wash resident’s hands, put on clothing protector
Sit at eye level on stronger side
Tell resident what foods are there; offer beverage (thickness!)
Let resident pick what they want first, offer bite-sized pieces, alternate foods, alternate with drink, feed to strong side of mouth
Make sure mouth is empty before next bite
Talk with resident during meal
Use washcloth or wipes on mouth/hands during, then after meal
Remove and dispose of clothing protector
Remove tray - check for personal items
Check no crumbs in bed
Return bed to lowest position
Skill 14: Calculate Input - 3
Note on paper the amounts of liquid served
When resident finished, measure amounts not consumed
Subtract and note on sheet with time and date
