Indirect care refers to skills related to communication with the nursing facility resident, rights of the resident, the resident's safety and comfort, and precautions against infection control. Indirect care includes items such as greeting the resident by using the resident's name and introducing yourself, explaining the procedure being formed prior to starting and throughout the procedure, using standard precautions and infection control measures throughout the procedure, and promoting the resident's comfort, rights, and safety while performing clinical skills.
Hands should be washed prior to and after physical contact with the resident. CNAs are expected to know this and candidates will not be prompted to perform this skill. Applicants should know how to appropriately wash their hands--cleansing the front and back of the hands and wrists, between fingers, around cuticles and under nails.
Procedures related to direct aid of a patient are changing a resident's position to a supported-side lying position, dressing a resident with a weak arm, feeding a resident who is in bed, aiding a patient in ambulation with a gait belt and transferring a resident from the bed into a wheelchair. CNAs and candidates should know how to perform each of these procedures correctly without harming the resident.
CNAs and candidates should know how to measure and record the contents of urinary drainage bags, the resident's blood pressure, pulse, respiration and weight. All measurements have to be within specific ranges compared to readings taken by a nurse.
The ability to perform passive range of motion exercises to both the upper and lower extremities is a clinical skill. Candidates perform range of motion exercises applicable to the extremity specified. The candidate should make sure to perform three repetitions of each range of motion exercise and that she maintains control of the limb to provide a smooth, slow, non-forceful movement.
Grooming skills include foot, hair, and nail care to the resident. Additionally, CNAs provide mouth care to residents who have teeth or dentures, provide partial bed baths and provide perineal care to female residents who are incontinent.
CNAs can also be tested on skills to assist residents to use a bedpan, change an occupied bed, and provide care to residents with an indwelling urinary catheter.