Standard set
MD SKILLS LISTING FOR THE 2023 NNAAP®
Standards
Showing 314 of 314 standards.
1
HAND HYGIENE (HAND WASHING)
2
APPLIES ONE KNEE-HIGH ELASTIC STOCKING
3
ASSISTS TO AMBULATE USING TRANSFER BELT
4
ASSISTS WITH USE OF BEDPAN
5
CLEANS UPPER OR LOWER DENTURE
6
COUNTS AND RECORDS RADIAL PULSE
7
COUNTS AND RECORDS RESPIRATIONS
8
SKILL 8 — DONNING AND REMOVING PPE (GOWN AND GLOVES)
9
SKILL 9 — DRESSES CLIENT WITH AFFECTED (WEAK) RIGHT ARM
10
SKILL 10 — FEEDS CLIENT WHO CANNOT FEED SELF
11
SKILL 11 — GIVES MODIFIED BED BATH (FACE AND ONE ARM, HAND AND UNDERARM)
12
SKILL 12* — MEASURES AND RECORDS ELECTRONIC BLOOD PRESSURE
13
SKILL 13 — MEASURES AND RECORDS URINARY OUTPUT
14
SKILL 14 — MEASURES AND RECORDS WEIGHT OF AMBULATORY CLIENT
15
SKILL 15 — PERFORMS MODIFIED PASSIVE RANGE OF MOTION (PROM) FOR ONE KNEE AND ONE ANKLE
16
SKILL 16 — PERFORMS MODIFIED PASSIVE RANGE OF MOTION (PROM) FOR ONE SHOULDER
17
SKILL 17 — POSITIONS ON SIDE
18
SKILL 18 — PROVIDES CATHETER CARE FOR FEMALE
19
SKILL 19 — PROVIDES FOOT CARE ON ONE FOOT
20
SKILL 20 — PROVIDES MOUTH CARE
21
SKILL 21 — PROVIDES PERINEAL CARE (PERI-CARE) FOR FEMALE
22
SKILL 22 — TRANSFERS FROM BED TO WHEELCHAIR USING TRANSFER BELT
23
SKILL 23* — MEASURES AND RECORDS MANUAL BLOOD PRESSURE
1.1
Address client by name and introduces self to client by name
1.2
Turns on water at sink
1.3
Wets hands and wrists thoroughly
1.4
Applies soap to hands
1.5
Lathers all surfaces of wrists, hands, and fingers producing friction, for at least 20 (twenty) seconds, keeping hands lower than the elbows and the fingertips down
1.6
Cleans fingernails by rubbing fingertips against palms of the opposite hand
1.7
Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down
1.8
Uses clean, dry paper towel/towels to dry all surfaces of fingers, hands, and wrists starting at fingertips then disposes of paper towel/ towels into waste container
1.9
Uses clean, dry paper towel/towels to turn off faucet then disposes of paper towel/ towels into waste container or uses knee/ foot control to turn off faucet
1.10
Does not touch inside of sink at any time
2.1
and directly, maintaining face-to-face contact whenever possible
2.2
Privacy is provided with a curtain, screen, or door
2.3
Client is in supine position (lying down in bed) while stocking is applied
2.4
Turns stocking inside-out, at least to the heel
2.5
Places foot of stocking over toes, foot, and heel
2.6
Pulls top of stocking over foot, heel, and leg
2.7
Moves foot and leg gently and naturally, avoiding force and over-extension of limb and joints
2.8
Finishes procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in toe area (if present) is either over or under toe area; if using a mannequin, candidate may state stocking needs to be wrinkle-free
2.9
Signaling device is within reach and bed is in low position
2.10
After completing skill, wash hands
3.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
3.2
Privacy is provided with a curtain, screen, or door
3.3
Before assisting to stand, client is wearing non-skid shoes/footwear
3.4
Before assisting to stand, bed is at a safe level
3.5
Before assisting to stand, checks and/or locks bed wheels
3.6
Before assisting to stand, client is assisted to sitting position with feet flat on the floor
3.7
Before assisting to stand, applies transfer belt securely at the waist over clothing/gown
3.8
Before assisting to stand, provides instructions to enable client to assist in standing including prearranged signal to alert client to begin standing
3.9
Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing
3.10
On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidate’s hands are in upward position), and maintaining stability of client’s legs by standing knee to knee, or toe to toe with client
3.11
Walks slightly behind and to one side of client for a distance of ten (10) feet, while holding onto the belt
3.12
Assists client to bed and removes transfer belt
3.13
Signaling device is within reach and bed is in low position
3.14
After completing skill, wash hands
4.1
Explains procedure speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
4.2
Privacy is provided with a curtain, screen, or door
4.3
Before placing bedpan, lowers head of bed
4.4
Puts on clean gloves before placing bedpan under client
4.5
Places bedpan correctly under client’s buttocks
4.6
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
4.7
After positioning client on bedpan and removing gloves, raises head of bed
4.8
Toilet tissue is within reach
4.9
Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished
4.10
Signaling device within reach and client is asked to signal when finished
4.11
Puts on clean gloves before removing bedpan
4.12
Head of bed is lowered before bedpan is removed
4.13
Ensures client is covered except when placing and removing bedpan
4.14
Empties and rinses bedpan and pours rinse into toilet
4.15
Places bedpan in designated dirty supply area
4.16
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
4.17
Signaling device is within reach and bed is in low position
5.1
Puts on clean gloves before handling denture
5.2
Bottom of sink is lined and/or sink is partially filled with water before denture is held over sink
5.3
Rinses denture in moderate temperature running water before brushing them
5.4
Applies denture toothpaste to toothbrush
5.5
Brushes all surfaces of denture
5.6
Rinses all surfaces of denture under moderate temperature running water
5.7
Rinses denture cup and lid
5.8
Places denture in denture cup with moderate temperature water/solution and places lid on cup
5.9
Rinses toothbrush and places in designated toothbrush basin/container
5.10
Maintains clean technique with placement of toothbrush and denture
5.11
Sink liner is removed and disposed of appropriately and/or sink is drained
5.12
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
6.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
6.2
Places fingertips on thumb side of client’s wrist to locate radial pulse
6.3
Count beats for one full minute
6.4
Signaling device is within reach
6.5
Before recording, washes hands
6.6
Records pulse rate within plus or minus 4 beats of evaluator’s reading
7.1
Explains procedure (for testing purposes), speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
7.2
Counts respirations for one full minute
7.3
Signaling device is within reach
7.4
Before recording, washes hands
7.5
Records respiration rate within plus or minus 2 breaths of evaluator’s reading
8.1
Picks up gown and unfolds
8.2
Facing the back opening of the gown places arms through each sleeve
8.3
Fastens the neck opening
8.4
Secures gown at waist making sure that back of clothing is covered by gown (as much as possible)
8.5
Puts on gloves
8.6
Cuffs of gloves overlap cuffs of gown
8.7
Before removing gown, with one gloved hand, grasps the other glove at the palm, remove glove
8.8
Slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed
8.9
Disposes of gloves into designated waste container without contaminating self
8.10
After removing gloves, unfastens gown at waist and neck
8.11
After removing gloves, removes gown without touching outside of gown
8.12
While removing gown, holds gown away from body without touching the floor, turns gown inward and keeps it inside out
8.13
Disposes of gown in designated container without contaminating self
8.14
After completing skill, washes hands
9.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
9.2
Privacy is provided with a curtain, screen, or door
9.3
Asks which shirt he/she would like to wear and dresses him/her in shirt of choice
9.4
Avoids overexposure of client by ensuring client’s chest is covered
9.5
Removes gown from the left (unaffected) side first, then removes gown from the right (affected/weak) side
9.6
Before dressing client, disposes of gown into soiled linen container
9.7
Assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on left (unaffected) arm
9.8
While putting on shirt, moves body gently and naturally, avoiding force and over- extension of limbs and joints
9.9
Finishes with clothing in place
9.10
Signaling device is within reach and bed is in low position
9.11
After completing skill, washes hands
10.1
Explains procedure to client, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
10.2
Before feeding, looks at name card on tray and asks client to state name
10.3
Before feeding client, client is in an upright sitting position (75-90 degrees)
10.4
Places tray where the food can be easily seen by client
10.5
Candidate cleans client’s hands before beginning feeding
10.6
Candidate sits in a chair facing client during feeding
10.7
Tells client what foods and beverage are on tray
10.8
Asks client what he/she would like to eat first
10.9
Using spoon, offers client one bite of each type of food on tray, telling client the content of each spoonful
10.10
Offers beverage at least once during meal
10.11
Candidate asks client if they are ready for next bite of food or sip of beverage
10.12
At end of meal, candidate cleans client’s mouth and hands
10.13
Removes food tray
10.14
Leaves client in upright sitting position
10.15
(75-90 degrees) with signaling device within client’s reach
10.16
After completing skill, washes hands
11.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
11.2
Privacy is provided with a curtain, screen, or door
11.3
Removes gown and places directly in soiled linen container while ensuring client’s chest and lower body is covered
11.4
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
11.5
Puts on clean gloves before washing client.
11.6
Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face
11.7
Dries face with dry cloth towel/washcloth
11.8
Exposes one arm and places cloth towel underneath arm
11.9
Applies soap to wet washcloth
11.10
Washes fingers (including fingernails), hand, arm, and underarm keeping rest of body covered
11.11
Rinses and dries fingers, hand, arm, and underarm
11.12
Moves body gently and naturally, avoiding force and over-extension of limbs and joints
11.13
Puts clean gown on client
11.14
Empties, rinses, and dries basin
11.15
Places basin in designated dirty supply area
11.16
Disposes of linen into soiled linen container
11.17
Avoids contact between candidate clothing and used linens
11.18
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
11.19
Signaling device is within reach and bed is in low position
12.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
12.2
Privacy is provided with a curtain, screen, or door
12.3
Has client assume a comfortable lying or sitting position
12.4
Client’s arm is positioned at level of heart with palm up and upper arm is exposed
12.5
Selects appropriate cuff size
12.6
Feels for brachial artery on inner aspect of arm, at bend of elbow
12.7
Places blood pressure cuff snugly on client’s upper arm and sensor/arrow is over the brachial artery site
12.8
Turns on the machine and ensures device is functioning. If the machine has different settings for infants, children, and adults, selects the appropriate setting
12.9
Pushes start button. If cuff inflates to more than 200 mm Hg then stops machine and uses cuff on client’s other arm
12.10
Waits until the blood pressure reading appears on the screen and for the cuff to deflate, then removes the cuff
12.11
Signaling device is within reach
12.12
Before recording, washes hands
12.13
After obtaining reading using BP cuff, records both systolic and diastolic pressures exactly as displayed on the digital screen
13.1
Puts on clean gloves before handling bedpan
13.2
Pours the contents of the bedpan into measuring container without spilling or splashing urine outside of container
13.3
Rinses bedpan and pours rinse into toilet
13.4
Measures the amount of urine at eye level with container on flat surface (if between measurement lines, round up to nearest 25 ml/cc)
13.5
After measuring urine, empties contents of measuring container into toilet
13.6
Rinses measuring container and pours rinse into toilet
13.7
Before recording output, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
13.8
Records contents of container within plus or minus 25 ml/cc of evaluator’s reading
14.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
14.2
Client has non-skid shoes/footwear on before walking to scale
14.3
Before client steps on scale, candidate sets scale to zero
14.4
Asks client to step on center of scale and obtains client’s weight
14.5
Asks client to step off scale
14.6
Before recording, washes hands
14.7
Records weight based on indicator on scale. Weight is within plus or minus 2 lbs of evaluator’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evaluator’s reading)
15.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
15.2
Privacy is provided with a curtain, screen, or door
15.3
Ensures that client is supine in bed and instructs client to inform candidate if pain is experienced during exercise
15.4
While supporting the leg at knee and ankle, bends the knee and then returns leg to client’s normal position (flexion/ extension) (AT LEAST 3 TIMES unless pain is verbalized). Moves joints gently, slowly and smoothly through the range of motion, discontinuing exercise if client verbalizes pain.
15.5
While supporting the foot and ankle close to the bed, pushes/pulls foot toward head (dorsiflexion), and pushes/pulls foot down, toes point down (plantar flexion) (AT LEAST 3 TIMES unless
15.6
pain is verbalized). Moves joints gently, slowly and smoothly through the range of motion, discontinuing exercise if client verbalizes pain.
15.7
Signaling device is within reach and bed is in low position
15.8
After completing skill, washes hands
16.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
16.2
Privacy is provided with a curtain, screen, or door
16.3
Instructs client to inform candidate if pain experienced during exercise
16.4
While supporting arm at the elbow and at the wrist, raises client’s straightened arm from side position upward toward head to ear level and returns arm down to side of body (flexion/extension) (AT LEAST 3 TIMES unless pain is verbalized). Moves joint gently, slowly and smoothly through the range of motion, discontinuing exercise if client verbalizes pain.
16.5
While supporting arm at the elbow and at the wrist, moves client’s straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES unless pain is verbalized). Moves
16.6
joint gently, slowly and smoothly through the range of motion, discontinuing exercise if client verbalizes pain.
16.7
Signaling device is within reach and bed is in low position
16.8
After completing skill, washes hands
17.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
17.2
Privacy is provided with a curtain, screen, or door
17.3
Before turning, lowers head of bed
17.4
Raises side rail on side to which body will be turned
17.5
Candidate assists client to slowly roll onto side toward raised side rail
17.6
Places or adjusts pillow under head for support
17.7
Candidate repositions arm and shoulder so that client is not lying on arm
17.8
Supports top arm with supportive device
17.9
Places supportive device behind client’s back
17.10
Places supportive device between legs with top knee flexed; knee and ankle supported
17.11
Signaling device is within reach and bed is in low position
17.12
After completing skill, washes hands
18.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
18.2
Privacy is provided with a curtain, screen, or door
18.3
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
18.4
Puts on clean gloves before washing
18.5
Places linen protector under perineal area including buttocks before washing
18.6
Exposes area surrounding catheter (only exposing client between hip and knee)
18.7
Applies soap to wet washcloth
18.8
While holding catheter at meatus without tugging, cleans at least four inches of catheter from meatus, moving in only one direction, away from meatus, using a
18.9
clean area of the washcloth for each stroke
18.10
While holding catheter at meatus without tugging, using a clean washcloth, rinses at least four inches of catheter from meatus, moving only in one direction, away
18.11
from meatus, using a clean area of the washcloth for each stroke
18.12
While holding catheter at meatus without tugging, dries at least four inches of catheter moving away from meatus using a dry cloth towel/washcloth
18.13
Empties, rinses, and dries basin
18.14
Places basin in designated dirty supply area
18.15
Disposes of used linen into soiled linen container and disposes of linen protector appropriately
18.16
Avoids contact between candidate clothing and used linen
18.17
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
18.18
Signaling device is within reach and bed is in low position
19.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
19.2
Privacy is provided with a curtain, screen, or door
19.3
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
19.4
Basin is in a comfortable position for client and on protective barrier
19.5
Puts on clean gloves before washing foot
19.6
Client’s bare foot is placed into the water
19.7
Applies soap to wet washcloth
19.8
Lifts foot from water and washes foot (including between the toes)
19.9
Foot is rinsed (including between the toes)
19.10
Dries foot (including between the toes) with dry cloth towel/washcloth
19.11
Applies lotion to top and bottom of foot (excluding between the toes) removing excess with a towel/washcloth
19.12
Supports foot and ankle during procedure
19.13
Empties, rinses, and dries basin
19.14
Places basin in designated dirty supply area
19.15
Disposes of used linen into soiled linen container
19.16
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
19.17
Signaling device is within reach
20.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
20.2
Privacy is provided with a curtain, screen, or door
20.3
Before providing mouth care, client is in upright sitting position (75-90 degrees)
20.4
Puts on clean gloves before cleaning mouth
20.5
Places cloth towel across chest before providing mouth care
20.6
Secures cup of water and moistens toothbrush
20.7
Before cleaning mouth, applies toothpaste to moistened toothbrush
20.8
Cleans mouth (including tongue and all surfaces of teeth), using gentle motions
20.9
Maintains clean technique with placement of toothbrush
20.10
Candidate holds emesis basin to chin while client rinses mouth
20.11
Candidate wipes mouth and removes clothing protector
20.12
Disposes of used linen into soiled linen container
20.13
Rinses toothbrush and empties, rinses, and dries basin
20.14
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
20.15
Signaling device is within reach and bed is in low position
21.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
21.2
Privacy is provided with a curtain, screen, or door
21.3
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
21.4
Puts on clean gloves before washing perineal area
21.5
Places pad/ linen protector under perineal area including buttocks before washing
21.6
Exposes perineal area (only exposing between hips and knees)
21.7
Applies soap to wet washcloth
21.8
Washes genital area, moving from front to back, while using a clean area of the washcloth for each stroke
21.9
Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke
21.10
Dries genital area moving from front to back with dry cloth towel/washcloth
21.11
After washing genital area, turns to side, then washes rectal area moving from front to back using a clean area of washcloth for each stroke.
21.12
Using clean washcloth, rinses soap from rectal area, moving from front to back, while using a clean area of the washcloth for each stroke
21.13
Dries rectal area moving from front to back with dry cloth towel/washcloth
21.14
Repositions client
21.15
Empties, rinses, and dries basin
21.16
Places basin in designated dirty supply area
21.17
Disposes of used linen into soiled linen container and disposes of linen protector appropriately
21.18
Avoids contact between candidate clothing and used linen
21.19
Removes and disposes of gloves (without contaminating self ) into waste container and washes hands
21.20
Signaling device is within reach and bed is in low position
22.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
22.2
Privacy is provided with a curtain, screen, or door
22.3
Before assisting to stand, wheelchair is positioned alongside of bed, at head of bed facing foot or foot of bed facing head
22.4
Before assisting to stand, footrests are folded up or removed
22.5
Before assisting to stand, locks wheels on wheelchair
22.6
Before assisting to stand, bed is at a safe level
22.7
Before assisting to stand, checks and/or locks bed wheels
22.8
Before assisting to stand, client is assisted to a sitting position with feet flat on the floor
22.9
Before assisting to stand, client is wearing shoes
22.10
Before assisting to stand, applies transfer belt securely at the waist over clothing/gown
22.11
Before assisting to stand, provides instructions to enable client to assist in transfer including prearranged signal to alert when to begin standing
22.12
Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing
22.13
On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidates hands are in upward position) and maintaining stability of client’s legs by standing knee to knee, or toe to toe with the client
22.14
Assists client to turn to stand in front of wheelchair with back of client’s legs against wheelchair
22.15
Lowers client into wheelchair
22.16
Positions client with hips touching back of wheelchair and transfer belt is removed
22.17
Positions feet on footrests
22.18
Signaling device is within reach
22.19
After completing skill, washes hands
23.1
Explains procedure, speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible
23.2
Before using stethoscope, wipes bell/ diaphragm and earpieces of stethoscope with alcohol
23.3
Client’s arm is positioned with palm up and upper arm is exposed
23.4
Feels for brachial artery on inner aspect of arm, at bend of elbow
23.5
Places blood pressure cuff snugly on client’s upper arm, with sensor/arrow over brachial artery site
23.6
Earpieces of stethoscope are in ears and bell/ diaphragm is over brachial artery site
23.7
Candidate inflates cuff between 160mm Hg to 180 mm Hg. If beat heard immediately upon cuff deflation, completely deflate cuff. Re-inflate cuff to no more than 200 mm Hg
23.8
Deflates cuff slowly and notes the first sound (systolic reading), and last sound (diastolic reading) (If rounding needed, measurements are rounded UP to the nearest 2 mm of mercury)
23.9
Removes cuff
23.10
Signaling device is within reach
23.11
Before recording, washes hands
23.12
After obtaining reading using BP cuff and stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading