CNA Skills Competency Checklist

Certified Nursing Assistant Skills Checklist

Name

Date

Self	Rating Key:
0	No Experience
1	Minimal Experience/works with supervision
2	Independent/works without supervision in most cases
3	Senior/ works at a supervisory or teaching level

Has knowledge of and can provide care and assist patients with the following tasks:

AMBULATION

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

1. Crutches

2. Walker

3. Cane

4. Gait Belt

PERSONAL CARE

1. BATH

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Bed

b.Tub

c. Shower

2. Skin Care

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Back rub

b. Decubitous Prevention/care

3. Dress

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Assist as needed

b. Use of assistive devices

4. Hair Care

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

Hair Care

5. Nail Care (Fingers & Toes)

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Clean/file/trim with clippers

6. Oral Hygiene:

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Mouth Care

b. Brush Teeth

c. Denture Care

7. Shaving:Safety Razor/Electric Razor

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

Shaving: Safety razor/electric razor

8. NUTRITION / HYDRATION

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Feeding techiniques

b. Assist with eating

c. Use of feeding assistive device

d. Measure & record intake

e. Encourage fluids

9. BASIC INFECTION CONTROL PROCEDURES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Hand washing

b. Universal precautions

c. Use of warm & cool applications

10. ASSISTING OR CARE OF PATIENT WITH BOWEL AND BLADDER ELIMINATION

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Bedpan/Urinal

b. Bedside commode

c. Care of incontinent patient

d. Stoma care

e. Bowel / bladder training

11. URINARY CATHETER CARE

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Perineal Hygiene

b. Foley catheter

c. Supra pubic catheter

12. TRANSFER TECHNIQUES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Use of transfer gait

b. Weight bearing

c. Non-weight bearing

d. Mechanical lift

e. Wheel chair

13. TURNING / POSITIONING PATIENT

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Supine

b. Side-lying

c. In chair

d. In bed

e. Use of lift sheet

14. COMMUNICATION

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Verbal

15. RANGE OF MOTION EXERCISES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Active

b. Passive

c. Combination

16. TAKE & RECORD VITAL SIGNS

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

1. Temperature

a. Oral

b. Rectal

c. Ear canal

2. Pulse

a. Apical

b. Radial

C. Pedal

3. Respirations

4. Blood pressure

5. Height

6. Weight

a. Standing

b. Bed scale

c. Chair scale

17. SAFETY DEVICES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Vest restraints

b. Soft wrist/ankle restraints

c. Padded side rail

d. Side rails

18. MENTAL HEALTH & SOCIAL SERVICES NEEDS

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Demonstrates principles of behavior management

b. Provides emotional support to patients

c. Encourages patients to make personal choices

d. Encourages family support

e. Respect patients rights & dignity, including privacy & confidentiality

f. Encourages self care as ability allows

g. Knowledge of adult, child and elder abuse reporting statutes

h. Knowledge of domestic violence and violent injury reporting statues

19. SAFETY / EMERGENCIES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Recognizes & reports safety hazards

b. Recognizes & reports emergencies and responds appropriately

c. Handles oxygen safety

d. Observes, reports & documents changes in body functions, behaviors

20. CARE OF PROSTHETIC DEVICES

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Limbs

b. Eye glasses

c. Hearing aids

21. SPECIMEN COLLECTION

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

a. Urine

b. Stool

c. Sputum

22. UNDERSTANDS & CAN PERFORM

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

1. BINDERS & BANDAGES

a. Ace Bandages

b. Support stockings

2. CARE OF THE DISEASED

23. ASSIST THE CARE OF PATIENT WITH

0-No Experience
1-Minimal Experience
2-Independent
3-Senior

1. Diabetes

2. Cancer

3. Heart disease

4. Oxygen Therapy

5. Respiratory disease

6. Terminal

7. Infectious diseases

To the best of my knowledge, information provided on this CNA skills checklist is true and accurate. My signature indicates that I have read this document in entirety and unerstands its contents.

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