Skills Checklist: Personal Care & Restorative Skills
Key Takeaways
- Water temperature is checked for safety and comfort and the client is asked to verify it before any washing skill — a scored step in every bathing skill.
- In perineal and catheter care, always move front to back or away from the meatus, using a clean area of the washcloth for every stroke.
- Catheter care cleans at least four inches of catheter in one direction away from the meatus while holding it at the meatus without tugging.
- Passive range of motion is performed at least three times per joint, moved gently and slowly, and stopped immediately if the client verbalizes pain.
- Nearly every personal care skill ends with the same three steps: verify the signaling device is within reach, place the bed in the low position, and wash hands.
Skills Checklist: Personal Care & Restorative Skills
After Hand Hygiene and the one measurement skill, three of your five skills come from this group. There are too many to memorize as separate scripts, so learn the shared pattern first and then the individual Critical Element Steps.
The Pattern Every Personal Care Skill Follows
OPEN MIDDLE CLOSE
---- ------ -----
Explain the procedure Gloves BEFORE any Empty, rinse, dry basin
(clear, slow, direct, contact with body Basin to DIRTY supply area
face to face) fluids or mucous Linen to soiled hamper,
Provide privacy membranes not touching your uniform
(curtain, screen, door) Check WATER TEMPERATURE Remove gloves w/o
Cover / avoid and ASK the client contaminating self
overexposure to verify comfort WASH HANDS
Clean area of washcloth Verify SIGNALING DEVICE
for every stroke in reach
Move body gently and Bed in LOW position
naturally, no force
If you can reproduce that skeleton, you already have most of the scored steps in any bathing, hygiene, or elimination skill.
Bathing and Hygiene
Skill 11 — Gives Modified Bed Bath (Face and One Arm, Hand and Underarm)
★ Critical: Beginning with the eyes, wash the eyes with a wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect, then proceed to wash the face.
Other scored points: remove the gown directly into the soiled linen container while keeping the chest and lower body covered · check the water temperature and ask the client to verify comfort before washing · put on clean gloves before washing · expose one arm at a time and place a towel underneath · wash fingers including fingernails, hand, arm, and underarm keeping the rest of the body covered · rinse and dry · put a clean gown on the client · avoid contact between your clothing and used linens.
Skill 21 — Provides Perineal Care (Peri-Care) for Female
★ Critical: Wash the genital area moving front to back, using a clean area of the washcloth for each stroke. ★ Critical: Using a clean washcloth, rinse the genital area front to back, using a clean area of the washcloth for each stroke.
Other scored points: check water temperature and ask the client to verify · gloves before washing · place a pad or linen protector under the perineal area including the buttocks before washing · expose only between the hips and knees · dry front to back with a dry towel or washcloth · then turn to the side and wash, rinse, and dry the rectal area front to back with a clean area of cloth for each stroke · reposition the client.
💡 Front to back, every time, everywhere. The reason is anatomical: the urethral opening is close to the anus, and any stroke moving backward to forward drags bowel flora toward the urinary tract. Urinary tract infection is the most common infection in long-term care, and this is the single most effective thing a nurse aide does to prevent it.
Skill 18 — Provides Catheter Care for Female
★ Critical: While holding the catheter at the meatus without tugging, clean at least four (4) inches of catheter from the meatus, moving in only one direction, away from the meatus, using a clean area of the washcloth for each stroke. ★ Critical: Same, for rinsing with a clean washcloth.
Then dry at least four inches moving away from the meatus. Never pull on the catheter — tugging traumatizes the urethra and can dislodge the retention balloon.
Catheter safety rules for the floor: keep the drainage bag below the level of the bladder at all times and never on the floor; keep tubing free of kinks and never looped below the bag; secure the tubing to the leg per policy; never disconnect the closed system; empty the bag into the resident's own graduate; report cloudy, foul-smelling, or bloody urine, absent output, leaking, or complaints of burning or pain.
Skill 19 — Provides Foot Care on One Foot
Scored points: check water temperature and ask the client to verify · basin in a comfortable position on a protective barrier · gloves before washing · place the bare foot in the water · wash the foot including between the toes · rinse including between the toes · dry including between the toes · apply lotion to the top and bottom of the foot, excluding between the toes, removing excess with a towel · support the foot and ankle throughout.
⚠️ Lotion between the toes causes maceration and fungal infection. Dry between the toes; do not moisturize there. And remember that cutting toenails is excluded from nursing assistant duties in Rhode Island for every resident, and cutting any nails of a diabetic resident is separately excluded.
Skill 4 — Assists With Use of Bedpan
Scored points: lower the head of the bed before placing the bedpan · gloves before placing the bedpan · place it correctly under the buttocks · remove gloves and wash hands after positioning, then raise the head of the bed · verify toilet tissue is within reach · verify a hand wipe is within reach and instruct the client to use it · verify the signaling device is in reach and ask the client to signal when finished · gloves again before removing the bedpan · lower the head of the bed before removing · keep the client covered except while placing and removing · empty, rinse, and pour rinse into the toilet · place the bedpan in the dirty supply area · remove gloves and wash hands · signaling device in reach, bed in low position.
The glove sequence here is what catches candidates: on, off with handwashing, on again, off with handwashing — because between placing and removing you touch clean items like the bed controls and tissue.
Dressing and Feeding
Skill 9 — Dresses Client with Affected (Weak) Right Arm
★ Critical: Assist to put the right (affected/weak) arm through the right sleeve of the shirt before placing the garment on the left (unaffected) arm.
Other scored points: ask which shirt the client would like to wear and dress them in the shirt of choice · avoid overexposure by keeping the chest covered · remove the gown from the left (unaffected) side first, then the right (affected) side · dispose of the gown into the soiled linen container before dressing · move the body gently and naturally, avoiding force and over-extension · finish with clothing in place.
💡 The mnemonic: affected side dresses first, undresses last. Clothing has to travel over the joint that cannot extend, and doing it first means the garment is loose while it passes. Reverse it for removal.
Skill 10 — Feeds Client Who Cannot Feed Self
★ Critical: Before feeding, verify the client is in an upright sitting position (75–90 degrees).
Other scored points: look at the name card on the tray and ask the client to state their name · place the tray where the food can be easily seen · clean the client's hands before feeding · sit in a chair facing the client during the meal · tell the client what foods and beverages are on the tray · ask what they would like to eat first · offer one bite of each type of food using a spoon, telling them the content of each spoonful · offer a beverage at least once during the meal · ask if they are ready for the next bite or sip · clean the mouth and hands at the end · remove the tray · leave the client upright at 75–90 degrees with the signaling device in reach.
The steps encode the two things that matter: aspiration prevention (upright, small bites, unhurried pace, upright afterward) and autonomy (the client chooses the order, is told what is on the plate, and controls the pace).
Restorative Skills
Skill 2 — Applies One Knee-High Elastic Stocking
★ Critical: Finish the procedure with no twists or wrinkles, the heel of the stocking (if present) over the heel, and the toe opening (if present) either over or under the toe area. If using a mannequin, the candidate may state the stocking needs to be wrinkle-free.
Other scored points: the client is supine while the stocking is applied · turn the stocking inside-out at least to the heel · place the foot of the stocking over the toes, foot, and heel · pull the top over foot, heel, and leg · move the foot and leg gently and naturally, avoiding force and over-extension.
Skill 15 — Modified Passive ROM for One Knee and One Ankle
★ Critical: While supporting the leg at the knee and ankle, bend the knee and return the leg to its normal position (flexion/extension) at least 3 times unless pain is verbalized, moving the joint gently, slowly, and smoothly, discontinuing if the client verbalizes pain. ★ Critical: While supporting the foot and ankle close to the bed, push/pull the foot toward the head (dorsiflexion) and push/pull the foot down with toes pointing down (plantar flexion), at least 3 times unless pain is verbalized, with the same gentleness and pain rule.
Before starting: ensure the client is supine and instruct the client to tell you if pain is experienced during the exercise.
Skill 16 — Modified Passive ROM for One Shoulder
★ Critical: While supporting the arm at the elbow and wrist, raise the straightened arm from the side upward toward the head to ear level and return it to the side (flexion/extension), at least 3 times unless pain is verbalized. ★ Critical: While supporting the arm at the elbow and wrist, move the straightened arm away from the body to shoulder level and return (abduction/adduction), at least 3 times unless pain is verbalized.
⚠️ "At least three times" and "stop if pain is verbalized" are both part of the critical element. Doing two repetitions fails; pushing through a resident's report of pain fails. Support above and below the joint throughout, and never move a joint past the point of resistance.
Skill 5 — Cleans Upper or Lower Denture
Gloves before handling · line the sink with a towel and/or partially fill the sink with water before holding the denture over it · rinse in moderate-temperature running water before brushing · apply denture toothpaste · brush all surfaces · rinse all surfaces in moderate-temperature water · rinse the denture cup and lid · place the denture in the cup with moderate-temperature water or solution and put on the lid · rinse the toothbrush and place it in the designated container · maintain clean technique · remove the sink liner and/or drain the sink · remove gloves without contaminating yourself and wash hands.
The Endings You Cannot Skip
Almost every skill closes with some combination of:
- Empty, rinse, and dry the basin; place it in the designated dirty supply area.
- Dispose of used linen into the soiled linen container without touching your clothing.
- Remove and dispose of gloves without contaminating yourself.
- Wash hands.
- Verify the signaling device is within reach.
- Place the bed in the low position.
Candidates who run out of time almost always lose these final steps. Build them into practice as one reflexive block so they survive time pressure.
On the modified bed bath skill, how are the eyes washed?
During the passive range of motion skill for one shoulder, the client says, "That hurts," on the second repetition. What should the candidate do?
On the catheter care skill, how must the catheter be cleaned?
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