Get Started

Certified Nursing Assistant Checklist

Specialty areas

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Experience in these care areas: *
Acute Care Hospital
Long Term Care
Rehabilitation Center
Home Health/Private Duty
Hospice
Clinical tasks

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Assist in clinical tasks as delegated by licensed nurse: *
Vital signs (Temp, HR, B/P, Respirations)
Manual B/P (using cuff and stethoscope)
Oxygen saturation
Ambulation with 1-2 assist
Ambulation with walker
Turn and reposition q 2 hrs
Fingerstick glucose checks
Indwelling urinary catheter care (Foley)
Empty urinary catheter drainage bag
General review of skin condition
Reporting unusual or concerning information to the nurse
Empty surgical drains (e.g. Jackson Pratt/JP drain)
Calculate and record intake and output values
Application of oxygen via nasal cannula
Proper disposal of soiled linen
Incontinence care (urinary and bowel)
Proper transfer technique (bed to chair, bed to wheelchair, etc.)
Provide privacy during routine care (use of curtain, close door, etc.)
Use of military time in documentation
Perform daily weights
Collect specimens (urine, stool, sputum)
Administer enema (under supervision of nurse)
Application and removal of anti-embolic stockings (e.g. TED hose)
Basic Life Support (chest compressions, rescue breathing, etc.)
Therapeutic communication techniques for combative patients/residents
Ostomy care (under supervision of nurse)
Activities of Daily Living

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Assist patient/resident with the following ADLs: *
Bed bath
Shower
Bath tub
Perineal care (male and female)
Voiding (urinal, bedpan, bedside commode, toilet)
Grooming (brush/comb hair, shaving, etc.)
Oral care (brush teeth, dentures, etc.)
Application of hearing aids and glasses
Set up of meal tray (opening items, etc.)
Assisting with eating/drinking at meal times
Linen changes (occupied and unoccupied beds)
Passive range of motion exercises
Foot care (as directed by nurse)
Hand and nail care (as directed by nurse)
Massage (as directed by nurse)
Encourage use of adaptive equipment (cane, walker, trapeze bar, etc.)
Use of non-skid footwear
Equipment

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Use of the following equipment to assist in ADLs and other tasks: *
Vest restraint (e.g. Posey)
CPM machine
Glucometer (please specify brands)
Mechanical lift (e.g. Hoyer)
Gait belt
Call light/bell
Electronic B/P machine
Oxygen saturation monitor
Wrist/ankle restraints
Nasal cannula
Portable O2 tank
Wheelchair
Reclining chair
Various beds (including changing height, using for weight measurement, etc.)
Protective devices (skin protectors for heels, elbows, coccyx, etc.)
Precautions

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Implement and follow these precautions: *
Aspiration
Bleeding
High risk for falls
Elopement
Suicide
General & Other

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Implements and correctly follows: *
Proper body mechanics
Technique to preserve respect and dignity for patient/resident
Introduction of self prior to providing care
Preparing thickened liquids
Various special diets (e.g. diabetic, reduced sodium, pureed, clear liquids, etc.)
Post-mortem care
Infection Control

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Implementation and management of: *
Hand hygiene
Precautions and associated PPE (transmission, contact, airborne, droplet)
Negative-pressure room
Prevention and protocols for HAIs (CAUTI, CLABSI, VAP)
Prevention and protocols for MRSA, C.Diff, Sepsis, etc.
Age Specific

Rank each of the following sections on a scale of 1 to 4: 1) No experience 2) Limited experience 3) Experienced 4) Very Experienced Care of the following age groups: *
Infant (birth to 1 year)
Toddler (ages 1-3 years)
Preschooler (ages 4-5 years)
Childhood (ages 6-12 years)
Adolescent (ages 13-21 years)
Young adults (ages 22-39 years)
Adults (ages 40-64 years)
Older adults (ages 65-79 years)
Elderly (ages 80+ years)