Certified Nursing Assistant Skills Checklist

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1-2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Electronic Documentation
Documentation of ADLs, I&O
Universal Precautions
Measuring and Documenting Intake and Output
Standing Scale Patient Weight
Bed Scale Patient Weight
Charting
Bed Making Occupied
Bed Making Unoccupied
Code Cart
Point of Care Blood Glucose Monitoring
Bed Rails (Putting Up, Down, How to Use)
Bed Alarm
Vital Signs
Hand Hygiene
Coughing and Deep Breathing
Dietary Needs
Urine Specimen Collection-Routine
Urine Specimen Collection-Clean Catch
Urine Specimen Collection-12 and 24 Hour
Stool Specimen Collection
Reporting Change in Patient Condition
Dismissal of Patient
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge/familiarity with HCAHPS scores

Activities Of Daily Living

Assisting With Ambulation
Assisting With Toileting
Bathing of Patient (Shower, Bed Bath)
Perineal Care
Back Care
Positioning of Patient
Range of Motion Exercises
Foley Care and Measuring of Output
Oral Hygiene
Denture Care
Skin Care

Wound/skin-care Of Patient With:

Dressing Changes
Pressure Relief Mattresses
Decubitus Ulcers
Leg Ulcers

Additional Skills-care Of Patient With

Hemovacs
Jackson-Pratt Drains
Penrose Drains
Surgical Wound Irrigations & Dressings

Infectious Disease - Care Of The Patient With

HIV
MRSA
CRE
VRE
C. Difficile
Hepatitis
Influenza
Isolation Precautions
Shingles
Scabies