CNA

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Patient Rights

Communicates and obtains information while respecting the rights and privacy and confidentiality of information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). *

Involves the patient and family and respects their role in determining the nature of care to be provided, including Advance Directives. *

Complies with nursing staff responsibility included in the hospital policy related to Organ Donation. *

Meets patient and families needs regarding communication, including interpreter services. *

Provides accurate information to patient and families in a timely manner. *

Vital Signs And Weights

Obtaining and Recording *

Blood Pressure (Including Orthostatic) *

Pulse (Radial) *

Temperature (Oral) *

Temperature (Rectal) *

Temperature (Axillary) *

Temperature (Tympanic) *

Respirations *

Weight (Pounds and Kilograms) *

Recognizing Cardiac Arrest *

Activating Code Team *

Bringing Emergency Equipment to Room *

Providing Appropriate Code Support *

Use of Electronic VS equipment

Automatic BP Machine (Dynamap) *

Electronic Thermometer *

Applying Oximeter *

Scale Use

Standing *

Chair *

Bed *

Gi/Gu

Report Abnormal Findings *

Bowel Function *

Bladder Function *

Administering Enemas

Tap Water *

Fleets *

Return Flow *

Vital Signs And Weights

Placing and Removing Bed Pan *

Clamping Catheter *

Emptying Foley Bag *

Placing Condom Catheter *

Emptying and Replacing Ostomy Bag (Established Ostomy) *

Nutrition

Estimating Intake *

Setting Up for Meals *

Feeding Patients *

Aspiration Precautions *

Nourishments *

Counting Calories *

Fluid Restriction *

NPO *

Specimens

Collecting Stool *

Collecting Sputum *

Labeling Specimens and Preparing for Transport *

Collecting Urine

Clean Catch *

24 Hour *

Hygiene/Skin

Risk Factors for Skin Breakdown *

Observing Pressure Points for Redness or Breakdown *

Bathing/Daisy/Hygiene

Bathing (Shower/Tub/Arjo) *

Oral Care, Including Patients who are NPO, Comatose, Patients with *

Pen Care *

Foot Care for Patients with Impaired Circulation or Sensation *

Incontinence Care *

Shaving and Precautions *

Reducing Pressure and Friction *

Us of Pressure And Friction Reduction Devices

Special Beds/Mattresses *

Heels and Elbow Protection *

Foot Cradles *

Use of Shower Chair *

Use of Bath/Shower Boat *

Infection Control

Reverse Isolation *

Body Substance Isolation *

TB Precautions *

MRSA Precautions *

Hand Washing *

Infectious/Hazardous Waste Disposal *

Supply/Equipment Disposal *

Use of Disposable Thermometer *

Use of CPR Mask/Bag *

Proper use of Specific Barrier, Methods

Gloves *

Gown *

Mask/Goggles *

Safety and Activity

Determining Patient ID *

Identifying Safety Hazards *

Determining Need for Additional Help *

Assessing Safety and ADL Needs *

Maintaining Clean, Orderly Work Area *

Disposing of Sharps *

Handling Hazardous Materials *

Proper Body Mechanics *

ROM Exercises *

Transferring to Bed, WC, Commode, etc. *

Turning and Positioning *

Patient Safety Module *

Reporting Broken Equipment *

Responding to Safety Hazards *

Use of Hoyer Lift (Dextra / Maxi) *

Bed Operation *

Use of Wheel Locks *

Use of Alarms: Bed, Patient, Unit *

Use of Call Light *

Documenting Use of Restraints *

Use of Transfer Belt *

Use of Gait Belt for Ambulation *

Use of Seizure Pads *

Application of restraints

Belt Including Seat Belt *

Wrist/Ankle *

Vest *

New Admissions and Transfers

Inventory and Disposition of Belongings, Use of Checklist *

Room Orientation, Call Bell *

Post-Op Patients

Transferring into Bed *

Call Bell *

Assist with Turns *

ROM Exercises *

Maintaining 02 Therapy

Replacing Mask or Nasal Cannula if Needed *

Notifying Nurse of Problems *

Basic Comfort Measures *

Preparation For and Transfer to SNF

Early Bath *

Preparing Belongings *

Preparing for and Explaining Routines to Patient *

Post Mortem Care *

Use of Incentive Spirometer *

Removing Replacing

Antiembolic Stockings *

Sequential Stockings *

communication

Using Appropriate Abbreviations *

Identifying Unusual Patient Incidents that Require Reporting *

Reinforcing RN Teaching With Patient *

Selecting and Using Forms Appropriately *

Using Alternate Communication Tools/Devices *

Communicating To RN

Changes in Patient Condition *

Patient Needs, Complaints and Concerns *

Unusual Incidents *

Recording And Reporting

Vital Signs *

Bathing/Hygiene *

Turning and Repositioning *

Ambulation and Activity *

Diet Intake, Calorie Count *

Bowel Movements *

1 & 0

Shift Volumes and Totals *

Marking and/or Measuring Amount of Urine, Gastric Fluid, NG Drainage, Emesis, Diarrhea *

Age Specific Competencies

Infant (Birth - 1 year) *

Preschooler (ages 2-5 years) *

Childhood (ages 6-12 years) *

Adolescents (ages 13-21 years) *

Young Adults (ages 22-39 years) *

Older Adults (ages 65-79 years) *

Adults (ages 40-64 years) *

Elderly (ages 80+ years) *

Unit Activity

Identifying Unusual Incidents on the Unit that Require Reporting *

Locating and Using Appropriate Reference Materials: Hospital, Patient Care and *

Charging for Patient Care Items *

Completing Risk Management Reports as Needed *

Obtaining Needed Supplies and Equipment *

Reporting and Following up on Faulty Equipment and Supplies *

Using Telephone System *

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