CNA Review: Know Indirect Care or You'll Regret it

Having an instructor watch your every move, take notes on your performance, and
ultimately decide whether you have passed the CNA certification test or not can
be a nerve-wracking experience. Since the clinical skills section is a timed exa
m, even more pressure is felt by examinees. Such pressure causes additional stre
ss which may cause students to make mistakes while demonstrating skills. Oversig
hts, no matter how minor they may seem, can greatly impact the result of your te
st, which is why an adequate CNA review is absolutely essential to your success.
If you do not perform Indirect Care practices during your exam, you will surely
fail because they directly affect the safety of patients and their rights. Indi
rect Care is also extremely important because: (1) It is a graded performance, (
2) It has separate score ratings, and (3) It greatly affects the testees' overal
l performance during the clinical skills exam.

Pay attention to your behavior in terms of how you communicate with the resident
, valuing the residents’ rights, providing safety and comfort to the resident, and
following proper infection control (standard precautions). It is one of the mos
t important of the 5 skills needed during the skills test. Remember: The Nurse A
ide Evaluator will observe and also evaluate your performance based on your cond
uct. Remember to take a deep breath and don’t panic.

Below are the methods of demonstrating Indirect Care. They will help you pass th
e skills test.

1. Communication. Communicate with the resident respectfully and in a dignified

manner:

* Greet the resident appropriately (ex. "Good morning, Mrs. Smith.”)

* Introduce yourself to the resident
* Explain to the resident why you are there and what procedure you will perfo
rm
* Explain each step of the procedure to the resident before performing it (ex
: "Now I’m going to turn you over on your side.”)

2. Resident’s Rights.

* Knock on the door before entering the resident’s room

* Provide the resident with privacy by pulling the curtain down before perfor
ming care
* Always be aware of your language and actions while rendering care to the re
sident
* Ask the resident about their preferences, such as nail length, hairstyle, o
r choice of food
* Avoid addressing residents by nicknames such as "Honey”, "Dear”, "Sweetie”, etc.

3. Safety and Comfort.

* Always check the resident’s bed to see if he or she is in a safe sleeping pos
ition
* Adjust the resident’s sleeping position to a safer one, if necessary
* Lower the bed while rendering care
* Apply a gait belt when rendering a transfer
* Make sure the side rails are raised before leaving the resident
* Always place the call light within the resident’s reach (Highly important!)
* Always lock the bed wheels before helping the resident into or out of a cha
ir

4. Infection Control.

* Always wash your hands before and after performing care. (Highly Important!
)
* Use gloves if required, especially during perineal care, catheter care, dra
inage bag care, denture and mouth care (brushing of teeth), assisting with the u
se of the bedpan, measurement, and the reporting of the urine output
* Dispose of gloves in a hazardous waste container
* Follow disposal method for soiled items correctly
* Avoid direct contact with the floor during bed making
* Make sure the resident’s personal items are not soiled or contaminated
* Offer toileting during bedpan usage
* Use soap and water on the resident during perineal care
* Use clean equipment when performing care

Don’t forget to:

 1. Knock on the door before entering the resident’s room
2. Pull down the curtain (if you are performing perineal care or giving reside
nt a bath)
3. Always put the call light within the resident’s reach
4. Wash your hands before and after performing care.

It is important to commit the Indirect Care procedures to memory. You wouldn t w

ant you to be among the examinees that fail their clinical skills exam because t
hey were not well-prepared or forgot Indirect Care altogether. Remember all the
rules and standard precautions you have learned from your CNA training classes.
Evaluators will allow for corrections; in case you forgot something, you are fre
e to correct it, and immediately proceed to the other skills. As long as you rem
ain calm and focused on the skills sets, then you should be able to pass the CNA
clinical exam with relative ease.