CNA Skills Checklist - pninursing.com

1 CNA Skills Checklist Page 1 of 2 CNA Skills Checklist First NameLast Name Social Security numberDate_____EmailPlease indicate your level of experience (0, 1, 2, or 3)0 = Theory, no practice1 = Limited2 = Confident 3 = Very ConfidentProvide AM care0 1 2 3 Provide PM care0 1 2 3 Assist patient with ambulation0 1 2 3 Provide back and skin care0 1 2 3 Give a bed bath0 1 2 3 Care for bedsores0 1 2 3 Care for Foley catheter0 1 2 3 Provide colostomy care0 1 2 3 Apply cold compresses0 1 2 3 Change non-sterile dressings0 1 2 3 Administer enema0 1 2 3 Assist with exercise/ROM0 1 2 3 Provide hair care0 1 2 3 Use correct hand

2 Washing technique0 1 2 3 Calculate and record intake and output0 1 2 3 Use correct isolation technique0 1 2 3 Complete menu with patient0 1 2 3 Provide oral hygiene0 1 2 3 Provide perineal care0 1 2 3 Provide post-mortem care0 1 2 3 Shave patient0 1 2 3 Transfer/transport patient0 1 2 3 Take vital signs: TPR & BP0 1 2 3 Apply restraints0 1 2 3 Universal precautions0 1 2 3 Feed patient0 1 2 3 Dispose of sharps0 1 2 3 Use of correct side rail position0 1 2 3 Specimen collection (urine, stool, sputum)

3 0 1 2 3 Follow fluid restrictions0 1 2 3 CNA Skills Checklist Page 2 of 2 Use of special mattresses0 1 2 3 Provide ostomy care0 1 2 3 Administer sitz bath0 1 2 3 Weigh patient/use of scale0 1 2 3 Apply TED hose0 1 2 3 Use of aqua-K pads0 1 2 3 Complete admission paper work0 1 2 3 Discharge a patient0 1 2 3 Stock supplies0 1 2 3 Clean equipment0 1 2 3 Answer phone0 1 2 3 Assist with care of the patient with alcoholism0 1 2 3 Assist with care of the patient with amputation0 1 2 3 Assist with care of the patient with arthritis0 1 2 3 Assist with care of the blind patient0 1 2 3 Assist with care of the patient with cancer0 1 2 3 Assist with care of the patient with cataracts0 1 2 3 Assist with care of the comatose patient0 1 2 3 Assist with care of the confused/disoriented patient0 1 2 3 Assist with care of the patient with convulsions0 1 2 3 Assist with care of the deaf patient0 1 2 3 Assist with care of the drug abuse patient0

4 1 2 3 Assist with care of the patient with diabetes0 1 2 3 Assist with care of the patient with fractures0 1 2 3 Assist with care of the patient with a gastrotomy0 1 2 3 Assist with care of the geriatric patient0 1 2 3 Assist with care of the patient with dementia0 1 2 3 Assist with care of the patient with heart condition0 1 2 3 Assist with care of the incontinent patient0 1 2 3 Assist with care of the infant0 1 2 3 Assist with care of the child0 1 2 3 Assist with care of the patient with multiple sclerosis0 1 2 3 Assist with care of the patient with a pacemaker0 1 2 3 Assist with care of the paraplegic patient0 1 2 3 Assist with care of the quadriplegic patient0 1 2 3 Assist with care of the patient with Parkinson s disease0 1 2 3 Assist with care of the retarded patient0 1 2 3 Assist with care of the senile patient0 1 2 3 Assist with care of the patient in shock0 1 2 3 Assist with care of the patient with stroke0 1 2 3 Assist with care of the terminally ill

5 Patient0 1 2 3