7.1 How the Skills Test Works & Indirect Care
Key Takeaways
- KCTCS evaluators randomly select 5 skills from a master list of about 34; you must perform 4 of 5 correctly within 30 minutes to pass the Kentucky SRNA skills demonstration.
- Hand hygiene and a fixed set of indirect-care 'courtesy and safety' steps — knock, introduce, provide privacy, explain, keep the call light in reach, wash hands, and leave the bed low and locked — are scored on EVERY skill, not just handwashing.
- Critical-action steps (hand hygiene, resident safety, correct sequence) must be performed 100% correctly; missing one critical step fails that entire skill even if every other step was perfect.
- Failing the skills test does not require repeating the written exam — you may retake skills only ($75) within the 3-attempts-in-6-months window before a new training program is required.
- A wrong step can be corrected on the spot: tell the evaluator 'I need to redo that,' return to the last correct point, and continue — self-correction is allowed and does not fail you.
How the Kentucky Skills Demonstration Test Works
The Kentucky skills demonstration test is the hands-on half of the State Registered Nurse Aide (SRNA) competency exam. Unlike most states, Kentucky administers it through the Kentucky Community and Technical College System (KCTCS) rather than a national vendor such as Prometric or Credentia. On test day a KCTCS evaluator — a registered nurse — randomly selects 5 skills from a master checklist of about 34 skills and asks you to perform them, one at a time, on a live volunteer 'resident' (or a mannequin for private procedures) within a single 30-minute window. You pass by performing 4 of the 5 correctly. Fail three skills and you fail the entire skills portion.
A failed skills test does not force you to repeat the written exam. You may re-register for skills only (the $75 skills-only fee) and retest, subject to Kentucky's 3 attempts within 6 months rule. After three failures on either portion you must complete another KCTCS-approved training program before testing again.
Handwashing is (almost) always one of the five
Across Kentucky testing sites, hand hygiene / handwashing is almost always assigned as one of your five skills — it is the single most heavily weighted infection-control competency. Even when handwashing is not the standalone assigned skill, you must still wash your hands as an indirect-care step inside every other skill. Treat handwashing as guaranteed and rehearse it until it is automatic.
Indirect care: the 'courtesy and safety' steps scored on EVERY skill
Every skill sheet contains two layers of scoring. Direct-care steps are the technical actions unique to the skill (for example, cleaning front-to-back during perineal care). Indirect-care steps — often labeled courtesy and safety — are the same on every skill and are scored every single time. Miss them and you lose points on a skill you otherwise performed flawlessly. The indirect-care steps evaluators watch for are:
| # | Indirect-care / courtesy & safety step | Why it matters |
|---|---|---|
| 1 | Knock and wait before entering; address the resident by name | Dignity + right to privacy (OBRA) |
| 2 | Introduce yourself and identify the resident | Correct-resident safety |
| 3 | Wash hands at the start (and again at the end) | Infection control — critical action |
| 4 | Explain what you are going to do before you do it | Informed consent, right to know |
| 5 | Provide privacy — close the door / pull the curtain | OBRA privacy right |
| 6 | Keep the call light / signal within reach before leaving | Safety — a frequent silent fail |
| 7 | Return the bed to its lowest locked position; raise side rails only if the care plan directs | Fall prevention |
| 8 | Wash hands again and thank the resident when finished | Infection control + courtesy |
Memorize this sequence as a wrapper you place around every skill: knock, introduce, wash, explain, privacy, perform the skill, call light in reach, bed low and locked, wash again. Candidates who script this wrapper rarely fail on indirect care.
Critical-action steps and critical fail points
Within each skill, certain steps are critical actions that must be performed correctly 100% of the time. Missing a critical action fails the entire skill regardless of how well you did everything else, because Kentucky scores critical steps on a pass/fail basis while non-critical steps are scored for overall accuracy (roughly 70% of listed steps needed to pass a skill). The most common critical fail points are:
- Skipping or shortening hand hygiene (less than ~20 seconds of friction, or forgetting the final wash).
- Leaving the call light out of reach or leaving the bed in a raised/unlocked position.
- Wrong direction or sequence — cleaning back-to-front in perineal care, dressing the strong arm first, forcing a joint past resistance in range-of-motion.
- Compromising resident safety — letting an arm dangle off the bed, not locking wheelchair brakes, or losing control of a gait belt.
- Not measuring accurately — a vital sign outside the allowed tolerance (pulse within 5 beats, respirations within 5 breaths, blood pressure within 4 mmHg of the evaluator's reading).
Timing and what evaluators look for
You have 30 minutes for all five skills, so budget roughly five to six minutes each and do not rush handwashing to 'save time.' Evaluators score what they see — narrate your indirect-care steps out loud ('I'm placing the call light within reach') so the evaluator can mark them even if the motion is small. They watch for hand hygiene, resident safety, dignity/privacy, correct sequence, and accurate measurement, and they record numbers you report so your reading can be compared to theirs.
Live resident vs. mannequin, and reporting your numbers
Most skills use a live volunteer playing the resident, which is why courtesy steps (knocking, explaining, privacy) actually matter — the evaluator wants to see you treat a real person with dignity. Private procedures such as perineal or catheter care are typically demonstrated on a mannequin or manikin, but you still narrate and drape as if the resident were awake. Whenever a skill produces a number (a pulse, a blood pressure, a urine volume), say it out loud and 'record' it where the evaluator directs; an accurate skill performed without reporting the value can still lose the measurement point. When in doubt, over-communicate — evaluators score what they observe, not what they assume you did.
How to recover from a mistake
Self-correction is explicitly allowed. If you perform a step wrong, stop, tell the evaluator 'I need to redo that step,' return to the last correct point, and perform it correctly. A corrected step counts as correct. What you cannot recover is a critical safety breach that has already occurred (for example, the resident has already fallen or you contaminated a sterile field), so protect safety first. If you forget the final handwash, doing it as soon as you remember — before touching anything else — still earns the point. Staying calm and finishing the wrapper is far better than freezing.
During the skills demonstration test, a candidate performs a perfect blood-pressure measurement but forgets to place the call light within the resident's reach before stepping back. What is the most likely result?
A candidate fails 3 of the 5 assigned skills on the Kentucky SRNA skills demonstration. Which statement is correct?
Midway through a transfer skill, a candidate realizes they positioned the wheelchair on the resident's weaker side instead of the stronger side. The candidate has not yet moved the resident. What is the best action?