7.1 Skills Test Rules for Both Alabama Vendors and Prometric's Indirect Care
Key Takeaways
Prometric scores five skills on every Alabama skills test: Handwashing, Indirect Care, and three assigned skills, with 31 to 40 minutes allowed depending on the skills.
Credentia's NNAAP skills evaluation gives five randomly selected skills in 30 minutes: hand hygiene, one measurement skill, and three others, and missing any bold Critical Element Step fails that skill.
With either vendor you must pass all five skills; you may correct a step only while still on that skill, by telling the evaluator and actually performing the correction.
Prometric's Indirect Care is scored in every skill except handwashing on seven checkpoints: greet and introduce, explain, ask preferences, use infection control, ask about comfort, promote rights, and promote safety.
Bring the identification each vendor requires and a watch with a second hand; Credentia requires an analog watch with a sweeping second hand, not a digital watch or smartwatch.
7.1 Skills Test Rules for Both Alabama Vendors and Prometric's Indirect Care
The clinical skills test is the hands-on half of the Alabama nurse aide competency evaluation. Your training program chooses the vendor, Prometric or Credentia, and the two vendors run the test differently. Both require you to pass all five skills. This chapter covers each vendor's checklist: Sections 7.2 and 7.3 cover Prometric's skills, and Sections 7.4 and 7.5 cover Credentia's NNAAP skills. Learn the version your program uses, but the core behaviors (clean hands, privacy, explanations, safety, and a call light within reach) are the same.
How Each Vendor Runs the Skills Test
| Rule | Prometric | Credentia (NNAAP) |
|---|---|---|
| Skills you perform | Handwashing and Indirect Care are scored on every test, plus 3 assigned skills chosen by computer when you schedule | Hand hygiene on every test, one measurement skill (blood pressure, radial pulse, respirations, urinary output, or weight), and 3 more randomly chosen skills |
| Total scored skills | 5 | 5 |
| Time | 31 to 40 minutes, based on your skills (includes 3 minutes for handwashing and 5 minutes for transitions) | 30 minutes for all five skills |
| How skills are scored | Each skill has checkpoints; you must show competency, not perfection | Each skill has steps; bold Critical Element Steps must be done correctly, and you must also meet the passing standard for the skill |
| The "resident" | Another candidate (alert and cooperative) or a mannequin; mannequins are used for catheter care, perineal care, the partial bed bath, and dressing | A candidate volunteer acting as a weak older adult, or a mannequin |
| Language | English only, whether you are testing or acting as the resident | Candidate and client must speak English to each other |
| Ending a skill | Say "I am done" | No set phrase; once you begin a new skill you cannot return to the previous one |
| Results | Score report at the site on test day | Online within about 24 hours |
Order, Corrections, and Safety Stops
- Perform skills in the order on your card. Prometric requires it; Credentia strongly encourages it. You may reread the instruction card during the test, and each new skill is treated as a different resident.
- Corrections: With either vendor, if you realize you missed or did a step wrong, tell the evaluator what you are correcting and actually perform it while you are still on that skill. Once you say "I am done" (Prometric) or start the next skill (Credentia), you cannot go back.
- Credentia's exceptions: if the evaluator has to remind you to put on or remove gloves, you get no credit for correcting that step; and if you correct an order-dependent step (one that must happen before or after another step), you must say when it should have been done.
- Prometric safety stops: if the evaluator has a serious safety concern, the skill is stopped and you are told what to fix. Because the evaluator told you, you get no credit for that correction.
- Handwashing after the first wash: Prometric rates your technique at the start of the first skill and then judges hand cleanliness as part of Indirect Care. Credentia's evaluator tells you after your first hand washing that, for the remaining skills, you only need to say when you would wash your hands; every other step must actually be performed, not described.
- Measurements: Prometric gives you a form to record your measurement, which you sign when it is handed to you. Credentia has you enter the measurement on a digital device, and once entered it cannot be changed.
- Side rails: Prometric does not grade side rail use. Credentia's "Positions On Side" skill includes raising the side rail on the side the client turns toward.
What to Bring and Wear
| Prometric | Credentia | |
|---|---|---|
| Identification | A government-issued ID with a current photo and signature, plus your Social Security card or a Social Security Administration letter; the name must match your registration | Two forms of official, signature-bearing ID, one with a photo; photocopies are not accepted |
| Other documents | Proof that you completed a state-approved training program; without it you will not be allowed to test | No other materials are allowed |
| Watch | A watch with a second hand | An analog watch with a sweeping second hand; no digital watch or smartwatch |
| Clothing | A uniform or scrubs and flat, nonskid, closed-toe shoes are recommended; you may be refused for inappropriate dress | As the client volunteer, wear flat slip-on nonskid shoes, a loose short-sleeved top, and loose pants that roll up; you will wear a gown over your clothes |
| Arrival | At least 30 minutes early; late arrivals forfeit the fee | 30 minutes early; late or unprepared candidates do not test and lose the fee |
Credentia adds a federal rule: a candidate on light duty or restricted activity for medical reasons may not take the skills evaluation and must bring medical documentation of a return to full duty. Neither vendor lets you bring your own equipment, notes, or phone into the testing room.
Prometric's Indirect Care Checkpoints
Indirect Care is one of Prometric's five scored skills. It is not a separate task: the evaluator watches for it during every skill except handwashing. The seven checkpoints are:
- Greet the resident, address the resident by name, and introduce yourself.
- Explain the care before you begin and as you go.
- Ask about the resident's preferences during care.
- Use Standard Precautions and infection control measures.
- Ask about the resident's comfort or needs before you finish.
- Promote the resident's rights.
- Promote the resident's safety.
Prometric publishes the specific behaviors the evaluator looks for:
- Infection control: do not touch the resident before your hands are clean; end every skill with clean hands; never put linen on the floor (except as a barrier during foot care or when measuring urine); never hold clean or dirty linen against your clothing; do not put a bedpan or soiled linen on the overbed table; do not shake or fluff linens; and remove gloves without contaminating yourself whenever you wear them, even if gloves were optional.
- Comfort: in bathing-type skills (catheter care, foot care, hand and nail care, the partial bed bath, perineal care, and denture care), ask whether the water temperature is comfortable. Other comfort or preference questions do not have to be skill-specific, such as asking whether the resident wants the curtain left open.
- Rights: knock or announce yourself before entering; never call the resident "honey" or any term other than a name; close the privacy curtain before care, except in ambulation, feeding, hand and nail care, pulse, respirations, and transfer, where the curtain is optional; minimize exposure; and leave the resident covered with the top sheet at the end of bed-level care.
- Safety: leave the call light in or near the resident's hand at the end of every skill (on the side the resident is turned toward after repositioning, or near the stronger hand after dressing); leave the bed in its low position; and keep the resident a safe distance from the edge of the bed.
Managing Time and Nerves
Prometric's timing study sorts skills from shorter (about 4 to 5 minutes, such as pulse, respirations, ROM, and ambulation) to longest (about 17 to 19 minutes, such as perineal care and the partial bed bath), and your total time is built from your specific skills. Most candidates finish early. Before you say "I am done," pause and check: hands clean, gloves off properly, call light in reach, bed low, resident covered, and measurement recorded.
On Prometric's Alabama clinical skills test, which two skills are scored on every candidate's test in addition to the three assigned skills?
Ambulation and transfer to a wheelchair
Measuring blood pressure and measuring weight
Bed bath and perineal care
Handwashing and Indirect Care
During a Prometric skills test, a candidate finishes repositioning the resident and realizes the call light is out of reach. The candidate has not yet said "I am done." What should the candidate do?
Say nothing and move on
Ask the evaluator whether the call light counts before deciding what to do
Explain the mistake to the evaluator after all of the skills are finished
Tell the evaluator and place the call light within reach
On Credentia's NNAAP skills evaluation, a candidate performs every step of a skill correctly except one bold Critical Element Step. What is the result for that skill?
The skill passes because almost every step was correct
The skill passes if the candidate finishes the other skills early
The skill fails, because missing a Critical Element Step fails the skill
The skill is repeated at the end of the test with no penalty
Sections you finish are checked off in the contents.