home health aide training - phi

HOMECARE AIDE WORKFORCE INITIATIVE (HAWI)

Skills Checklists for Section 3—

Home Health Aide Training

Skills Checklists for Section 3

Module 27. Performing Simple Measurements and Tests

Skills Checklist 1. Cleaning a Glass Thermometer

Skills Checklist 2. Measuring an Oral Temperature with a Glass Thermometer

Skills Checklist 3. Measuring an Oral Temperature with an Electronic Thermometer

Skills Checklist 4. Measuring an Axillary Temperature with a Glass Thermometer

Skills Checklist 5. Measuring an Axillary Temperature with an Electronic Thermometer

Skills Checklist 6. Measuring a Rectal Temperature with a Glass Thermometer

Skills Checklist 7. Measuring A Rectal Temperature with an Electronic Thermometer

Skills Checklist 8. Measuring Pulse and Respiration

Skills Checklist 9. Measuring Blood Pressure

Skills Checklist 10. Collecting Specimens

Skills Checklist 11. Measuring Intake

Module 28. Assisting with Prescribed Exercises

Skills Checklist 1. Assisting with Postural Drainage

Skills Checklist 2. Assisting with Passive Range-of-Motion Exercises




Module 29. Assisting with Prescribed Medical Equipment, Supplies, and Devices

Skills Checklist 1. Assisting with an ACE Bandage

Skills Checklist 2. Assisting with the Use of a Commercially Prepared Enema

Skills Checklist 3. Assisting with the Use of a Soap Solution Enema

Skills Checklist 4. Assisting with the Use of a Douche

Skills Checklist 5. Assisting with the Use of a Commercially Prepared Douche

Skills Checklist 6. Assisting with the Use of a Medication Nebulizer and Air Compressor

Skills Checklist 7. Assisting with the Use of a CPAP Machine

Skills Checklist 8. Assisting with the Use of an Oxygen Tank and Liquid Oxygen Reservoir

Skills Checklist 9. Assisting with the Use of an Oxygen Concentrator

Module 30. Assisting with Special Skin Care

Skills Checklist 1. Positioning a Client on His/Her Back

Skills Checklist 2. Positioning a Client on Her/His Side

Module 31. Assisting with Dressing Changes

Skills Checklist 1. Assisting with Changing a Clean Dressing




Module 32. Assisting with Ostomy Care

Skills Checklist 1. Assisting with Changing a Colostomy or Ileostomy Pouch

Skills Checklist 2. Assisting with Emptying an Open-Ended Ileostomy or Colostomy Pouch

Skills Checklist 3. Assisting with Cleaning a Reusable Pouch

Skills Checklist 4. Assisting with Colostomy Irrigation

Skills Checklist 5. Assisting with Emptying a Urinary Drainage Bag

Skills Checklist 6. Measuring Urinary Output

Skills Checklist 7. Assisting with the Use of a Condom Catheter

Skills Checklist 8. Assisting with Cleaning the Skin and Catheter Tubing

Skills Checklist 9. Assisting with Routine Tracheostomy Care



Skills Checklists

Skills Checklist 1. Cleaning a Glass Thermometer Cleaning a Glass Thermometer 1. Wash hands. 2. Gather equipment (thermometer; gauze, cotton balls, or tissue; soap;

alcohol). 3. Take equipment to a sink. 4. Turn on cool or cold tap water. 5. Hold thermometer firmly at end of stem (not bulb). Keep the bulb lower than

the stem. 6. With other hand, wet gauze, cotton ball, or tissue with soap and water. 7. Wipe down from stem to bulb, going from cleanest part to the part that has

been in contact with the client. Do not wipe up and down or go back over a part that has already been wiped. Use a twisting motion that applies friction.

8. Throw away gauze, cotton ball, or tissue. 9. Rinse thermometer with clean, wet gauze, cotton ball, or tissue, using same

downward, twisting motion as in step #7. 10. Throw away gauze, cotton ball, or tissue. 11. Soak clean gauze, cotton ball, or tissue with alcohol. 12. Wipe thermometer from stem to bulb with alcohol-soaked gauze, cotton ball,

or tissue. 13. Throw away gauze, cotton ball, or tissue. 14. Rinse thermometer with cool water to remove alcohol taste. 15. Wipe thermometer with clean, dry gauze, cotton ball or tissue or let

thermometer air dry. 16. Store thermometer in its case in clean, safe, cool place. 17. Wash hands.



Skills Checklists

Skills Checklist 2. Measuring an Oral Temperature with a Glass Thermometer Measuring an Oral Temperature with a Glass Thermometer

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment (thermometer, watch or clock, tissues). 4. Hold thermometer at stem end (not bulb). 5. Check thermometer for breaks or chips. 6. If necessary, shake the thermometer until the reading is below 94°F.

a. Stand away from any furniture or counters that might be hit accidentally. b. Shake hand at wrist using a snapping motion. c. Do this a few times, then check temperature reading. d. If temperature is above 94°F, continue shaking until temperature is below

this point. 7. Place bulb end into client’s mouth, under the tongue and a little to one side. 8. Tell client to close lips, to breathe through nose, and not to talk or bite down. 9. Leave thermometer in place for at least 3 minutes. 10. Observe for any problems during procedure, such as biting down, difficulty

keeping mouth closed, or difficulty breathing. 11. Remove thermometer and wipe once from stem to bulb with clean tissue. 12. Read thermometer.

a. Hold thermometer at stem end (not bulb) so scale is at eye level. b. Move thermometer back and forth between fingers until you see column

of mercury. c. Find end of column of mercury. d. Find line on scale closest to end of the mercury column.

13. Record temperature accurately, noting it was taken by mouth. 14. Shake thermometer until mercury column is below 94°F or 33°C. 15. Report anything unusual—such as temperature above 100°F or below 95°F. 16. Clean thermometer correctly. 17. Store thermometer in clean, safe, cool place. 18. Wash hands.



Skills Checklists

Skills Checklist 3. Measuring an Oral Temperature with an Electronic Thermometer Measuring an Oral Temperature with an Electronic Thermometer 1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment (thermometer, plastic covering). 4. Hold thermometer at end opposite pointed end. 5. Turn on thermometer, making sure it is working. 6. Place plastic covering on pointed end. 7. Place pointed end in client’s mouth, under the tongue and a little to one side. 8. Tell client to close lips, to breathe through nose, and not to talk or bite down. 9. Leave thermometer in place until light or sound signals it is ready. 10. Observe for any problems during procedure, such as biting down, difficulty

keeping mouth closed, or difficulty breathing. 11. Remove thermometer and read temperature in display window. 12. Throw away plastic covering. 13. Record temperature accurately, noting it was taken by mouth. 14. Turn off thermometer. 15. Report anything unusual observed, such as temperature above 100°F or

below 95°F. 16. Store thermometer in clean, safe, cool place. 17. Wash hands.



Skills Checklists

Skills Checklist 4. Measuring an Axillary Temperature with a Glass Thermometer

Measuring an Axillary Temperature with a Glass Thermometer

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment (blunt-end thermometer, watch or clock, tissues). 4. Hold thermometer at end of stem (not bulb). Keep the bulb lower than the

stem. 5. Check thermometer for breaks or chips. 6. If necessary, shake thermometer until mercury column is below 94°F. 7. Place bulb of dry thermometer high up and into center of dry armpit. 8. Ask client to hold opposite shoulder to keep arm close to body. If client is

not able to do this, hold arm close to body. 9. Leave thermometer in place for 10 minutes. 10. Observe for any problems client has during procedure, such as restlessness or

inability to keep thermometer in place. 11. Remove thermometer and wipe once from stem to bulb with clean tissue. 12. Read thermometer accurately, as noted in other checklist. 13. Record temperature accurately, noting it was taken by armpit. 14. Shake thermometer until mercury column is below 94°F. 15. Report anything unusual observed, such as temperature reading above 99°F

or below 95°F. 16. Clean thermometer. 17. Store thermometer in its case in clean, safe, cool place. 18. Wash hands.



Skills Checklists

Skills Checklist 5. Measuring an Axillary Temperature with an Electronic Thermometer

Measuring an Axillary Temperature with an Electronic Thermometer

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment (thermometer, plastic covering). 4. Hold thermometer at end opposite pointed end. 5. Turn on the thermometer and make sure it’s working. 6. Place plastic covering on pointed end. 7. Place pointed end high up and into center of dry armpit against skin. 8. Ask client to hold opposite shoulder to keep arm close to the body. If client is

not able to do this, hold arm close to the body. 9. Leave thermometer in place until light or sound signals it is ready. 10. Observe for any problems client has during procedure, such as restlessness,

inability to keep thermometer in place. 11. Remove thermometer and read temperature in display window. 12. Throw away plastic covering. 13. Record temperature accurately, noting it was taken by armpit. 14. Turn off thermometer. 15. Report anything unusual observed, such as temperature reading above 99°F

or below 95°F. 16. Store thermometer in its case in clean, safe, cool place. 17. Wash hands.



Skills Checklists

Skills Checklist 6. Measuring a Rectal Temperature with a Glass Thermometer Measuring a Rectal Temperature with a Glass Thermometer

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. Put on gloves. 3. Gather equipment (blunt-end thermometer; watch or clock; lubricant;

tissues). 4. Place small amount of lubricant on tissue. 5. Hold thermometer at stem end (not bulb). 6. Check thermometer for breaks or chips. 7. If necessary, shake thermometer until mercury column is below 94ºF. 8. Lubricate bulb end of thermometer. 9. Position client to lie on side with upper leg bent and forward. 10. Uncover buttocks area only. 11. Separate buttocks with hand and locate anal opening. 12. With other hand, gently insert bulb one inch through anus into rectum (for

adults). 13. Hold thermometer in place for three minutes. 14. Observe for any problems client has during procedure, such as discomfort or

desire to move bowels. 15. Gently remove thermometer from rectum. 16. Wipe anal area with tissue to remove excess lubricant. 17. Throw tissue away. 18. Cover client. 19. Wipe thermometer from stem to bulb with clean, dry tissue and discard tissue

in wastebasket. 20. Read thermometer accurately. 21. Record temperature accurately, noting it was taken by rectum. 22. Report anything unusual observed, such as temperature reading above 101ºF

or below 96ºF. 23. Clean thermometer correctly. 24. Wash hands. 25. Put away lubricant and store thermometer in clean, safe, cool place.



Skills Checklists

Skills Checklist 7. Measuring A Rectal Temperature with an Electronic Thermometer Measuring a Rectal Temperature with an Electronic Thermometer

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. Put on gloves. 3. Gather equipment (thermometer, plastic covering, lubricant, tissues). 4. Place small amount of lubricant on tissue. 5. Hold thermometer at end opposite pointed end. 6. Place plastic covering on pointed end. 7. Lubricate plastic covering. 8. Position client to lie on side with upper leg bent and forward. 9. Uncover buttocks area only. 10. Separate buttocks with hand and locate anal opening. 11. With other hand, gently insert pointed end one inch through anus into rectum

(for adults). 12. Hold thermometer in place until light or sound signals it is ready. 13. Observe for any problems client has during procedure, such as discomfort,

desire to move bowels. 14. Gently remove thermometer from rectum. 15. Wipe anal area with tissue to remove excess lubricant. 16. Throw tissue away. 17. Cover client. 18. Throw away plastic covering. 19. Read temperature in display window. 20. Record temperature, noting it was taken by rectum. 21. Turn off the thermometer. 22. Report anything unusual observed, such as temperature reading above 101ºF

or below 96ºF. 23. Wash hands. 24. Put away lubricant and other supplies. 25. Store thermometer in clean, safe, cool place.



Skills Checklists

Skills Checklist 8. Measuring Pulse and Respiration Measuring the Pulse

1. Explain to client what you are going to do. 2. Gather equipment (watch or clock with second hand). 3. Find radial pulse using correct fingers (not thumb). 4. Count number of pulse beats for 15 seconds. Multiply by four to get pulse

per minute.1 5. Write down the pulse rate. Measuring Respiration

6. Continue to hold client’s wrist (as if measuring pulse) and count respirations for one minute.2

7. Observe for any problems client has during procedure, such as difficulty breathing or discomfort.

8. Write down the respiration rate. 9. Report anything unusual observed, such as changes in pulse or respirations

from last time they were taken, readings above or below what is normal for client, etc.

1 Measurement should be accurate within plus or minus 5 beats/minute. 2 Measurement should be accurate within plus or minus 2 respirations per minute.



Skills Checklists

Skills Checklist 9. Measuring Blood Pressure Page 1 of 2

Measuring Blood Pressure 1. Explain to client what you plan to do. Ensure privacy. 2. Gather equipment (blood pressure cuff, stethoscope). 3. Position client:

If sitting: arm to be used is slightly bent with palm up, resting on a table or arm of a chair. Arm should be level with heart.

If lying down: on back with arm to the side and palm up. 4. Position self so that you can comfortably handle equipment and can read

gauge (at eye level if it is a mercury gauge). 5. Apply cuff on bare upper arm with bottom of cuff about one inch above bend

of elbow. Make sure tubes are not tangled or twisted. Apply cuff evenly and snugly.

6. Find pulse with middle three fingers. 7. Place earpieces of stethoscope into the ears so they fit downward and

forward. 8. Place end of stethoscope over spot where you feel pulse. Place end lightly on

skin. There should be no space between skin and stethoscope. 9. Tighten valve screw clockwise with right hand if right-handed or with left

hand if left-handed. 10. Inflate cuff to about 160 mm Hg, or 30 mm Hg above the client’s usual BP.

(Do not inflate above 200 mm Hg.) 11. Loosen valve screw slightly by turning counter-clockwise. Deflate cuff

slowly and steadily at about 2-3 mm Hg per second. Note point on gauge when you hear two tapping sounds through stethoscope.

12. Continue to deflate cuff slowly to point when you can no longer hear the sound. Continue to deflate cuff slowly all the way to zero.

13. Observe for any problems client has during procedure, such as discomfort, difficulty breathing, anxiety, etc.

14. Record blood pressure accurately. 15. Repeat procedure if not sure about blood pressure reading. Deflate cuff

completely and wait 2 to 3 minutes before inflating it again.



Skills Checklists

Skills Checklist 9. Measuring Blood Pressure Page 2 of 2

16. Remove cuff. 17. Report anything unusual observed, such as inability to get blood pressure

reading, excessively high or low blood pressure, etc. 18. Store equipment in a safe place.



Skills Checklists

Skills Checklist 10. Collecting Specimens Collecting Specimens

1. Assemble the equipment and supplies you need. 2. Wash hands. 3. Ensure privacy. 4. Explain procedure to client. 5. Collect specimen. 6. Observe for any problems that the client has during procedure, such as pain

or discomfort. 7. Assist the client in cleaning self after the specimen is collected. 8. Transfer specimen to the appropriate specimen container. Do not touch the

inside of the container with your fingers—this will contaminate the specimen.

9. Cover specimen container with a lid that fits tightly. If the outside of the container has become soiled, wash it off and dry it with a paper towel.

10. Discard soiled materials appropriately. 11. Wash and dry equipment. 12. Store equipment in the appropriate place. 13. Wash hands again. 14. Label the specimen container with the client’s name, the type of specimen,

the date and the time of collection. 15. Place the labeled specimen in a clean paper or plastic bag and store

appropriately. 16. Record what specimen was collected and where the specimen was stored or

sent. 17. Report anything unusual, such as the inability to collect a specimen. There are also specific steps you should follow depending on the type of specimen you are collecting. These specific steps are described in sections 20, 21, and 22 in the Learner’s Book .



Skills Checklists

Skills Checklist 11. Measuring Intake Measuring Intake

1. Explain to the client why it is necessary to keep track of intake. Ask the client when they last had something to drink and how much they had.

2. Wash your hands. 3. Gather equipment for measuring the bowls, cups, and glasses that are used

when the client drinks or eats something. 4. Measure the client’s usual cups, glasses, and bowls.

a. Fill first serving container with water. b. Pour water into measuring cup. c. Write down this amount on paper. d. Discard water. e. Repeat steps a–d for each serving container. f. Keep this list for use each time client’s intake is measured.

5. Always serve liquids in the containers (bowls, glasses, or cups) that you measured in Step 4.

6. Write down the types and amounts of liquids served to the client. 7. When the client is finished, remove the serving containers. (DO NOT throw

out the liquid that is left) 8. For each container, measure how much liquid is left. Write it down. 9. For each container, subtract the leftover amount from the amount that was

served to client. (Remember, you measured how much that container would hold in Step 4.) Write down this amount. That is how much the client took in from that container (“intake”).

10. Add all of the “intake” numbers together. Write down the total—this is the client’s total “intake.”

11. Clean the measuring and serving equipment. 12. Store the measuring and serving equipment. 13. Wash your hands. 14. Record the total amount of fluid intake for a particular time. 15. Observe, record, and report any changes in condition or behavior.



Skills Checklists

Skills Checklist 1. Assisting with Postural Drainage 1. Explain procedure to client. 2. Wash hands. 3. Assemble the equipment. 4. Put on gloves, if needed. 5. Assist the client into the position written on the Care Plan. 6. DO NOT leave the client alone in this position. 7. Measure and record the client’s pulse and respiration rate. 8. IN SPECIAL CIRCUMSTANCES ONLY—Clap or vibrate the client’s chest

for the length of time written in the care plan. 9. Observe the client for any problems during and after the procedure. Stop the

procedure if the client complains of fatigue, or if the client feels faint, is breathing rapidly or complains of chest pain.

10. Encourage the client to cough up mucous. 11. Dispose of used tissue in appropriate waste container. 12. Wash hands. 13. Record and report the position used for postural drainage and the length of

time for the procedure, the color and odor of mucous and any difficulty the client had during the procedure.



Skills Checklists

Skills Checklist 2. Assisting with Passive Range-of-Motion Exercises Page 1 of 2

Prepare yourself and the client 1. Check the care plan (or ask the supervising nurse) to see which exercises you

should assist the client in doing. You should also check how long and how many times the client should do each exercise.

2. Wash your hands. 3. Greet the client and check to see if he or she is ready for prescribed exercises.

Explain what you both are going to do. 4. Provide privacy (as appropriate)—for example, curtain off the space, or cover all of

the client’s body except for the part that is getting exercised. 5. Check safety issues—for example, lock wheels on a wheelchair or bed, adjust side

rails on a bed. General guidelines for passive range-of-motion exercises 6. Make sure the client is in the correct position for each exercise. 7. Hold the part of the body to be exercised gently but firmly with the flat part of the

hand and fingers. 8. Support the joint by holding above and below the joint. 9. Move the part of the body smoothly and comfortably to the point of resistance. 10. Repeat as often as is stated in the care plan. 11. Place the part of the body back in its natural position at the end of the exercise. 12. Ask if the client had any difficulty or pain during exercise. 13. Record the exercise that was performed, the number of times it was performed, and

any problems with the exercise. 14. Report any problems in doing the exercise.



Skills Checklists

Skills Checklist 2. Assisting with Passive Range-of-Motion Exercises

Page 2 of 2 Perform Passive Range-of-Motion Exercises for Specific Parts of the Body 15. Shoulder Exercises:

a. Place one hand at elbow and one hand at wrist and then raise the client’s straightened arm toward the ceiling and then back down.

b. Place one hand above elbow and one hand at the wrist and then move the straightened arm out to the side and then return the straightened arm to the client’s side.

16. Elbow Exercises: Place one hand under bent elbow and one hand at wrist while arm is alongside the body. Then turn the forearm so the palm faces up. Then rotate the forearm so the palm faces down.

17. Wrist Exercises: a. Place one hand above wrist and one at palm and then bend the wrist toward the

thumb and then away from the thumb. b. Place one hand under flexed elbow and one hand at palm and then bend the

wrist toward the palm and away from the palm. 18. Finger Exercises: Place one hand at wrist and one hand at palm or fingers and

move the fingers to make a fist, and then straighten all the fingers together. 19. Hip Exercises:

a. With leg flat on the bed and knee kept pointing to the ceiling, place one hand at ankle and one hand above the knee and then assist the knee in bending toward the chest to the point of resistance. Then support the knee and lower the knee to the bed, keeping the foot off the bed.

b. With legs flat on the bed, place one hand at ankle and one hand under the knee and assist the straightened leg out to the side of the body to the point of resistance.

20. Ankle Exercises: Place one hand under ankle and one hand on foot and then push the foot up towards the body and then pull the foot down and away from the body.

21. Toe Exercises: Place one hand on foot for support and one hand at the toe area and then bend the toes toward the body and then away from the body.



Skills Checklists

Skills Checklist 1. Assisting with an ACE Bandage

Assisting with an ACE Bandage

1. Explain the procedure to the client. 2. Wash hands. 3. Gather the equipment and supplies you need (ACE bandage; clip, tape, or

safety pin). 4. Make sure the area to be wrapped is clean and dry. 5. Position the client to apply the ACE bandage. 6. Apply the ACE bandage. Make sure that:

a. The bandage is in the place that the care plan indicates. b. The bandage is snug enough to stay in place but not so tight that it will

decrease circulation. c. The bandage is secured with a clip, tape, or safety pin. (Do NOT tie the

bandage.) 7. Observe and feel the part of the extremity that is below the bandage:

a. Note the temperature and any changes in color b. Note any sores c. Note if the skin is swelling, or shiny and tight d. Note any dryness of the skin

8. Wash hands. 9. Observe, record, and report.



Skills Checklists

Skills Checklist 2. Assisting with the Use of a Commercially Prepared Enema

Assisting with the Use of a Commercially Prepared Enema

1. Explain the procedure to the client. 2. Wash hands. 3. Gather the equipment and supplies you need (enema, bedpan or commode if

necessary, toilet paper, waterproof bed protector pad, soap, wash basin if necessary).

4. Put on gloves. 5. Assist client into position directed on the care plan. 6. Place waterproof pad under client’s buttocks. 7. Place blanket on client so only the rectal area is exposed. 8. Remove air from the tip of the enema applicator. 9. Enema is administered slowly. (DONE BY AIDE UNDER SPECIAL

CIRCUMSTANCES ONLY.) 10. Put the used enema applicator back into the box, tip first. 11. If the client has used an oil retention enema, remind client to hold the enema

for the time ordered. 12. Help the client onto bedpan or assist client into bathroom or onto commode.

Remind the client not to flush the toilet. Check on results of enema. 13. Observe the enema results for color, amount, odor, and consistency. 14. Assist client to clean self, if necessary, including wash hands. 15. Remove the waterproof bed protector. 16. Empty and clean the bedpan or commode pail. 17. Dispose of used enema applicator. 18. Remove gloves and throw them away. 19. Wash hands. 20. Help client into a comfortable position. 21. Observe, record, and report the use and results of the enema, including the

amount of stool, whether or not the stool was hard, streaked with red or was very dark, and if client had difficulty administering enema or was unable to tolerate the enema because of cramping.

22. Observe, record, and report any changes in condition or behavior.



Skills Checklists


Page 1 of 2 Assisting with the Use of a Soap Solution Enema

1. Explain procedure to the client. 2. Wash hands. 3. Gather the equipment and supplies you need (enema bag and tubing, clamp,

measuring container, bedpan, lubricant, toilet paper, commode if necessary). 4. Put on gloves. 5. Prepare the enema:

a. Close the clamp on the enema tubing. b. Adjust water flow from the faucet. c Fill the measuring container with water to the quart mark or as ordered. d. Check the temperature of the water on wrist. e. Prepare the enema solution as directed by the care plan. f. Pour the solution into the enema bag. g. Seal the top of the enema bag. h. Hang the bag at the height directed by the care plan.

6. Position the client, as directed by the care plan. 7. Place the waterproof pad under the client’s buttocks. 8. Place blanket on client so only the rectal area is exposed. 9. Position bedpan so it is behind client. 10. Position the enema tubing over the bedpan and open clamp to allow the

solution to flow through the tubing to remove air. 11. Reclamp the tubing. 12. Lubricate the tip of the enema tubing with the lubricant. 13. The enema is administered. (THE AIDE NEVER DOES THIS STEP.) 14. After the enema has been administered and the tubing has been removed,

wrap the tip of the tubing with paper towels and place inside the enema bag. 15. Help the client onto a bedpan or assist client to the bathroom or bedside

commode. Remind the client not to flush the toilet. 16. Assist client in cleaning self, if necessary.



Skills Checklists


Page 2 of 2 17. Help client wash his/her hands. 18. Remove the waterproof bed protector. 19. Discard disposable items. 20. Observe the enema results for amount, color, odor, and consistency. 21. Empty and clean the bedpan or commode pail. 22. Rinse the enema bag and tubing with clear water. Wash the tip of the tubing

with hot, soapy water. Allow to dry; and then store. 23. Remove gloves and throw them away. 24. Wash hands. 25. Observe, record, and report the use and results of the enema, including the

amount of stool, whether or not the stool was hard, streaked with red or was very dark, and if client had difficulty administering enema or was unable to tolerate the enema because of cramping.




Skills Checklists


Page 1 of 2 Assisting with the Use of a Douche

1. Explain procedure to the client. 2. Wash hands. 3. Gather the equipment and supplies you need (douche bag, tubing, clamp,

bedpan, waterproof pad, toilet paper, washcloth, soap, washbasin, thermometer).

4. Put on gloves. 5. Offer the bedpan or suggest the client use the bathroom to urinate. 6. Empty bedpan, if necessary. 7. Wash hands. 8. Prepare the solution. 9. Warm the douching solution to the temperature directed by the care plan. 10. Clamp the tubing and pour solution into the douche bag or container. 11. Position douche bag tubing over the bedpan and open clamp to allow

solution to flow through tubing to remove air. 12. Reclamp tubing. 13. Help client to lie on back. 14. Place waterproof pad under client. 15. Help client to clean the vaginal area. 16. Remove gloves and throw them away. 17. Wash hands. 18. Put on a new pair of gloves. 19. Position client to use the douche (on a bedpan, if necessary). 20. Hold the douche bag or container above the vagina at the height indicated in

the care plan. 21. The douche is administered. (DONE BY AIDE ONLY UNDER SPECIAL

CIRCUMSTANCES.) 22. Observe client for fatigue or pain while douching. 23. Clamp the tubing when the douche bag or container is empty. 24. Place the tubing in the douche bag.



Skills Checklists


Page 2 of 2

25. Help the client to sit up to allow the rest of the solution to drain out. 26. Help the client to lie down again. 27. Remove the bedpan, if necessary, and help the client to dry self with toilet

tissue. 28. Observe returned solution for amount, color, odor, and any material in it,

such as mucus or particles. 29. Empty the bedpan, if necessary, in the toilet. 30. Remove the waterproof pad. 31. Change linen, if necessary. 32. Assist client into a comfortable position. 33. Empty and clean the bedpan, if necessary. 34. Wash hands. 35. Record the amount and type of solution, how client responded (discomfort,

fatigue), the color and odor of the return solution. 36. Report to supervisor if the return solution appeared bloody or smelled foul;

client appeared tired by the procedure; client complained of pain; or client had difficulty in administering the douche.




Skills Checklists


Page 1 of 2 Assisting with the Use of a Commercially Prepared Douche

1. Explain procedure to client. 2. Wash hands. 3. Gather the equipment and supplies you need (douche, bedpan, waterproof

pad, toilet paper, washcloth, soap, washbasin, thermometer). 4. Put on gloves. 5. Offer the bedpan or suggest the client use the bathroom to urinate. 6. Empty bedpan, if necessary. 7. Wash hands. 8. Warm the douching solution to the temperature directed by the care plan. 9. Remove air from tip of the applicator. 10. Help client to lie on back. 11. Place waterproof pad under client. 12. Help client to clean the vaginal area. 13. Remove gloves and throw them away. 14. Wash hands. 15. Put on a new pair of gloves. 16. Position the client to use the douche (on bedpan, if necessary). 17. Douche is administered. (DONE BY AIDE ONLY UNDER SPECIAL

CIRCUMSTANCES). 18. Observe the client for fatigue or pain while douching. 19. Put the used douche back into the box, tip first, and discard. 20. Help the client to sit up to allow the rest of the solution to drain out. 21. Help the client to lie down again. 22. Remove the bedpan, if necessary, and help the client to dry self with toilet

tissue. 23. Observe returned solution for amount, color, odor, and any material in it,

such as mucus or particles.



Skills Checklists


Page 2 of 2 24. Empty the bedpan, if necessary, in the toilet. 25. Remove the waterproof pad. 26. Change linen, if necessary. 27. Assist client into a comfortable position. 28. Empty and clean the bedpan, if necessary. 29. Wash hands. 30. Record the amount and type of solution, how client responded (discomfort,

fatigue), the color and odor of the return solution. 31. Report to supervisor if the return solution appeared bloody or smelled foul;

client appeared tired by the procedure; client complained of pain; or client had difficulty in administering the douche.




Skills Checklists


Page 1 of 2

Assisting with the Use of a Medication Nebulizer and Air Compressor 1. Explain to client what you plan to do. 2. Wash hands. 3. Gather the equipment and supplies you will need (nebulizer, saline, clock or

watch with a second hand; medication, if allowed under special circumstances).

4. Put on gloves. 5. Attach the tubing to the compressor. 6. Add saline to the nebulizer. 7. Ensure that the medication is placed in the nebulizer. (THIS STEP IS DONE

BY THE AIDE UNDER SPECIAL CIRCUMSTANCES ONLY.) 8. Put the top back on the nebulizer, and attach the mouthpiece. 9. Attach the tubing to the nebulizer and mouthpiece. 10. Assist client to a sitting or semi-reclining position if necessary. 11. Take and record the client’s pulse and respiratory rate. 12. Turn on the compressor and check for visible mist from the nebulizer. 13. Remind the client to breathe in slowly through the mouth so that the

medication is carried deep into the lungs. The client should hold his or her breath for a short time, and then breathe out.

14. Turn off the machine if the client coughs. Provide tissue to the client. Turn on the compressor when the client is ready.

15. Take the client’s pulse and respirations during the use of the medication nebulizer, and observe for a big increase in pulse rate.



Skills Checklists


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16. Observe for signs that the client is not getting enough oxygen:

a. Rapid pulse and respiration b. Difficulty breathing c. Cold, clammy skin d. Blue or darkened lips, fingernails, or eyelids e. Being unresponsive (not responding when you call his or her name)

IF YOU OBSERVE ANY OF THESE SIGNS, STOP THE PROCEDURE IMMEDIATELY AND CALL YOUR SUPERVISOR.

17. Time the treatment. 18. Turn off the compressor. 19. Take the client’s pulse and respirations and record them. 20. Wash the nebulizer and mouthpiece according to the directions in the care

plan. 21. Remove gloves and throw them away. 22. Wash hands. 23. Replace the medication nebulizer and mouthpiece as needed. 24. Record the use of the medication nebulizer and any of the signs of too little

oxygen. 25. Report to the supervisor any sign of the client not getting enough oxygen, if

the client has an increase in pulse rate, of if the client does not use the nebulizer as directed on the care plan.



Skills Checklists

Skills Checklist 7. Assisting with the Use of a CPAP Machine Assisting with the Use of a CPAP Machine1. Explain the procedure to the client. 2. Wash hands. 3. Gather all of the parts of the CPAP machine. 4. Put on gloves. 5. Attach the tubing to the flow generator. 6. Assemble the valve according to the directions of the supplier and attach the

mask. 7. Attach valve and mask to the tubing. 8. Assist the client in adjusting mask and head straps. 9. Position the client comfortably in bed. 10. Remove gloves and throw them away. 11. Observe the client for snoring or sleep interruptions, or the need to sit up and

breathe. 12. Assist the client in removing the mask after sleep. 13. Take the tubing, mask, and valve apart to clean according to the directions of

the supplier. 14. Allow the pieces to air dry. 15. Wash hands. 16. Observe the client for problems, such as runny nose, dry throat, headache, or

ear pain. Observe for daytime sleepiness. 17. Record the use of the CPAP machine and your observations of the client, as

well as any problems with the CPAP machine. 18. Report any problems with the CPAP machine or any problems with the

client, such as: o Runny nose o Dry throat o Headache o Ear pain o Daytime sleepiness o Loud snoring o Complaints of not sleeping well, or of needing to sit up to breathe.



Skills Checklists


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Assisting with the Use of the Oxygen Tank and Liquid Oxygen Reservoir

1. Explain to client what you plan to do. 2. Wash hands. 3. Gather equipment and supplies you will need (oxygen tank or liquid oxygen

reservoir, mask or nasal cannula, humidifying bottle if used, distilled water, clock or watch with second hand)

4. Put on gloves, if necessary. 5. Check oxygen tank or reservoir gauge to see if there is enough oxygen. Call

supervisor if not 6. Wash humidifying bottle. 7. Check the humidifying bottle to make sure it has an adequate amount of

distilled water in it, and the bottle is screwed on tightly. 8. Take and record the client’s pulse and respiration rate. 9. Turn on the oxygen tank. 10. Ensure that flow meter is set to appropriate level as noted in the care plan.

(REGULATION OF FLOW METER DONE BY AIDE ONLY UNDER SPECIAL CIRCUMSTANCES.)

11. Check that water in humidifying bottle is bubbling. 12. Check that air is flowing from the mask or nasal cannula. 13. Assist the client in putting on and adjusting the mask or nasal cannula. 14. Cannula: prongs go into the nose. 15. Mask: should sit close to face, but not pinch it. 16. Take and record the client’s pulse and respirations. 17. Turn oxygen tank off. 18. Turn the flow meter off. 19. Assist the client in removing the oxygen mask or nasal cannula. 20. Wash hands.



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21. Observe for difficulty breathing; rapid pulse and respiration; cold, clammy

skin; blue or darkened lips, fingernails, or eyelids; client unable to sit still; client not responding when you call his/her name; client has headaches or complains of no energy.

22. Record the use of the oxygen tank or liquid oxygen reservoir and observations of the client.

23. Report to the supervisor IMMEDIATELY if the client has difficulty breathing; has rapid pulse and respiration; has cold, clammy skin; has blue or darkened lips, fingernails, or eyelids; is unable to sit still; does not respond when you call his/her name; has headaches or complains of no energy.



Skills Checklists


Page 1 of 2 Assisting with the Use of an Oxygen Concentrator

1. Explain to client what you plan to do. 2. Wash hands. 3. Gather equipment and supplies you will need (oxygen concentrator,

humidifying bottle if used, distilled water, nasal cannula, clock or watch with second hand)

4. Clean air filter. 5. Wash humidifying bottle, if used. 6. Check the humidifying bottle to make sure it has an adequate amount of

distilled water in it, and that the bottle is screwed on tightly, if used. 7. Attach the air tube to the oxygen concentrator or humidifying bottle. 8. Take and record the client’s pulse and respiratory rate. 9. Turn on the switch to the oxygen concentrator. 10. Check that air is bubbling through the humidifying bottle. 11. Check that air is flowing through the nasal cannula. 12. Ensure that flow meter is set to appropriate level as noted in the care plan.

(REGULATION OF FLOW METER DONE BY THE AIDE UNDER SPECIAL CIRCUMSTANCES ONLY.)

13. Assist the client in putting on the nasal cannula. 14. Take and record the client’s pulse and respiratory rate. 15. Turn off the oxygen concentrator. 16. Assist the client in removing the nasal cannula. 17. Wash hands. 18. Observe for difficulty breathing; rapid pulse and respiration; cold, clammy

skin; blue or darkened lips, fingernails, or eyelids; client unable to sit still; client not responding when you call his/her name; client has headaches or complains of no energy.



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19. Record the use of the oxygen concentrator and observations of the client, and

any problems with the oxygen concentrator. 20. Report to the supervisor IMMEDIATELY if the client has difficulty

breathing; has rapid pulse and respiration; has cold, clammy skin; has blue or darkened lips, fingernails, or eyelids; is unable to sit still; does not respond when you call his/her name; has headaches or complains of no energy.



Skills Checklists

Skills Checklist 1. Positioning a Client on His/Her Back

1. Talk with client about need to reposition (from lying on her or his side). Explain what the steps will be. Talk with client throughout the procedure.

2. Wash hands. 3. Gather equipment (large and small pillows, sheepskin). 4. Move client either to center of bed or a safe distance from the side. 5. Turn client onto back with head and body in line with each other. 6. Place pillow under client’s head and neck. 7. Place pillow under lower legs from knees to ankles with heels hanging free. 8. Position client’s arms, slightly bent, at side or folded on top of abdomen. 9. Cover client and make sure bedding is loosened over the feet. 10. Make client comfortable and safe.

11. Wash hands. 12. Record and report unusual observations or problems.



Skills Checklists

Skills Checklist 2. Positioning a Client on Her/His Side

1. Talk with client about need to reposition (from lying on her or his back). Explain what the steps will be. Talk with client throughout the procedure.

2. Wash hands. 3. Gather equipment (large and small pillows, sheepskin). 4. Move client either to center of bed or a safe distance from the side. 5. Turn client onto side with head and body in line with each other. 6. Place pillow under client’s head and neck. 7. Place pillow (lengthwise) at client’s back, anchoring in place. 8. Flex hips and knees slightly. 9. Position bottom legs comfortably. 10. Position entire upper leg and foot on top of thin pillow or sheepskin, slightly

in front of bottom leg. 11. Pull bottom shoulder slightly forward so weight of body is not resting on

bottom arm. 12. Fold bottom arm across chest or place arm flat on bed with elbows bent and

palm of hand facing up. 13. Rest top arm on pillow in front of client.

14. Cover client—make sure bedding is loosened over feet. 15. Make client comfortable and safe.

16. Wash hands. 17. Record and report any unusual observations or problems.

Module 31. Assisting with Dressing Changes


Skills Checklists

Skills Checklist 1. Assisting with Changing a Clean Dressing Assisting with Changing a Clean Dressing1. Explain procedure to client. 2. Wash hands. 3. Assemble equipment:

New dressing Tape Bag for waste

4. Provide the client with privacy. 5. Assist client to a comfortable position. 6. Provide good lighting. 7. Remove clothing covering the dressing (if needed). 8. Place waste bag near client for disposal of dressing/waste products. 9. Put on gloves. 10. Remove wrappings from new dressing. 11. Cut tape. 12. Remove and discard old dressing and used gloves. 13. Wash hands. 14. Put on new gloves. 15. Clean skin around the wound according to directions on the care plan. 16. Apply new dressing to wound. 17. Tape new dressing in place. 18. Remove and discard waste bag. 19. Remove gloves and wash hands. 20. Store unused/unopened supplies. 21. Observe, record, and report any changes in condition (such as a change in

how the wound looks) or changes in behavior.



Skills Checklists


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Assisting with Changing a Colostomy or Ileostomy Pouch 1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment:

A clean pouch and faceplate Skin barrier Deodorizer Adhesive or cement Solvent or adhesive remover Gauze squares Tape, belt, and closure Washcloth or paper towels Mild soap, water Gloves, trash container

4. Prepare clean pouch system according to the client’s routine or the directions of the care plan. This may include: Cutting opening in skin barrier and/or pouch using a pattern Applying adhesive, cement, or double-faced disc or reusable system Adding deodorizer to the pouch Securing the bottom of an open-ended pouch

5. Put on gloves. 6. Empty open-ended pouch if necessary. 7. Remove old pouch, faceplate, and/or skin barrier according to client’s

routine or directions in the care plan. 8. Remove any adhesive on skin with adhesive remover if indicated by the

client’s routine or directions on the care plan. Do not rub or scrub. 9. Clean stoma and skin around stoma gently with soft cloth or paper towel,

mild soap, and warm water. Do not rub or scrub. 10. Pat area dry.



Skills Checklists


Page 2 of 2 11. Observe condition of stoma and skin. Look for redness, raw skin, bleeding,

discharge, or client’s complaints of pain or soreness. 12. Cover stoma with gauze square. 13. Apply skin sealant, if used, according to the client’s routine or directions in

the care plan. 14. Prepare and apply skin barrier if separate from the pouch, according to the

client’s routine or directions on care plan. 15. Sealant may be applied directly to the skin or to the pouch first. Do not apply

sealant under the skin barrier. 16. Remove paper backing from self-sticking disc/wafer or use adhesive or

cement to prepare skin and pouch for a seal. 17. Remove gauze square covering stoma. 18. Center faceplate opening over stoma and press and seal to skin. Make sure

air is removed from pouch. 19. Tape edges of faceplate to skin if indicated by client’s routine or directions

on care plan. 20. Attach belt if indicated by client’s routine or directions on care plan. 21. Discard soiled supplies and disposable equipment. 22. Clean and store reusable supplies and equipment. 23. Remove gloves and wash your hands. 24. Record that pouch was changed. 25. Report any problems, such as:

A change in the appearance of the stoma Bleeding from the stoma Irritation or bleeding of skin Change in odor or appearance of stool Client in discomfort or pain Leaking equipment or equipment that doesn’t fit well



Skills Checklists

Skills Checklist 2. Assisting with Emptying an Open-Ended Ileostomy or Colostomy Pouch Assisting with Emptying an Open-Ended Colostomy or Ileostomy Pouch

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment:

Squeeze bottle or bulb syringe

Pitcher of water

Deodorizer, if required

Gloves

Tissue or paper towels

Container for receiving contents of pouch 4. Position client so that the pouch can be emptied. 5. Put on gloves. 6. Open the bottom of the pouch so that the contents can drain into the

container. 7. Flush emptied pouch with water from squeeze bottle or pitcher. 8. Allow water to drain from pouch. 9. Use tissue or paper towel to dry outside of pouch. 10. Squeeze pouch to get rid of any air. 11. Close and fasten end of pouch securely. 12. Clean and store reusable equipment. 13. Remove gloves and wash your hands. 14. Observe, record, and report any problems, such as leaking from the pouch,

bloody drainage, or client discomfort.



Skills Checklists

Skills Checklist 3. Assisting with Cleaning a Reusable Pouch

Assisting with Cleaning a Reusable Pouch

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment:

Adhesive remover

Detergent or special pouch cleaner

Brush

Container

Soaking solution

Paper towels

Talcum powder or cornstarch 4. Put on gloves. 5. Remove buildup of adhesive from faceplate by rubbing with finger or using

adhesive remover. 6. Rinse pouch with cold water to remove any stool. 7. Wash inside and outside of pouch using detergent or special pouch cleaner. 8. Brushes inside of pouch with appliance brush. 9. Rinse pouch thoroughly. 10. Soak pouch in container filled with soaking solution for length of time

indicated on care plan. 11. Remove pouch from solution and rinse thoroughly. 12. Hang pouch up to dry. Separate sides so that they are not sticking together or

stuff with wadded paper towel. 13. Allow pouch to air thoroughly. 14. Powder the inside of the pouch with talcum powder or cornstarch after it is

dry. 15. Store pouch. 16. Remove gloves and wash hands. 17. Observe, record, and report any problems, such as cracked or split equipment.



Skills Checklists

Skills Checklist 4. Assisting with Colostomy Irrigation Page 1 of 2

Assisting with Colostomy Irrigation

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Assemble equipment:

Irrigation container

Irrigating solution

Thermometer

Toilet paper or paper towels

Belt

Irrigation sleeve

Cone tip catheter tip

Lubricant

Clamp for tube

Closure or clip for irrigation sleeve

Clean pouch

Gauze 4. Put on gloves. 5. Fill irrigation container with the amount, type and temperature of irrigating

solution that is specified in the care plan. 6. Unclamp water flow regulating valve, and allow irrigating solution to run

through tube to get rid of air, then reclamp the valve. 7. Assist client into position for irrigation. 8. Hang or hold filled irrigation water container so that the bottom is level with

the client’s shoulder, or as specified in the care plan. 9. Remove colostomy pouch or dressing and wipe off excess mucus or stool. 10. Center the faceplate or irrigation sleeve over colostomy stoma, and attach the

belt to both sides of the faceplate. (The belt should be snug, but not tight.) 11. Place irrigation sleeve between the client’s legs with bottom touching water

level in the toilet bowl. 12. Lubricate cone tip catheter tip. 13. Insert cone tip or catheter tip into colostomy stoma.



Skills Checklists

Skills Checklist 4. Assisting with Colostomy Irrigation Page 2 of 2

14. Hold tube in place. Do not apply pressure or move. 15. Regulate the flow of irrigation solution using the water flow–regulating

valve so that it meets the client’s needs. Client should feel full, but not cramped.

16. Allow solution to flow into colostomy. Clamp tubing before last bit of water leaves the tube.

17. Observe the client for discomfort, cramps, or pain. If the client cramps, shut off the flow of water while the client takes deep breaths until pain or cramps stop. Discontinue irrigation at the client’s request.

18. Keep cone tip or catheter in colostomy stoma momentarily. 19. Remove cone tip or catheter from colostomy stoma. 20. Close top of irrigation sleeve. 21. Allow time for irrigation fluid and stool to be passed through stoma into

irrigation sleeve and out into the toilet. 22. Close lower end of the sleeve by folding up sleeve bottom and using a

closure or clip. 23. Assist client to move around to enable remaining stool to pass. 24. Remove irrigation sleeve and belt after irrigation procedure is complete. 25. Clean stoma and skin around stoma. 26. Apply a clean pouch or gauze dressing. 27. Clean reusable supplies. 28. Throw away disposable supplies. 29. Remove gloves and wash hands. 30. Observe, record, and report that irrigation was done, and any problems, such

as the client having discomfort, cramping, or pain, inability to insert cone tip or catheter, client refused to have irrigation, not enough fluid return, and changes in client’s condition or behavior.



Skills Checklists

Skills Checklist 5. Assisting with Emptying a Urinary Drainage Bag Assisting with the Emptying of a Urinary Drainage Bag 1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Assemble equipment:

Measuring pitcher

Container

Soap

Brush 4. Put on gloves. 5. Put measuring pitcher below the drainage bag. 6. Observe the condition of tubing: clear or has particles in it. 7. Take the drainage tube on the bag out of its holder. 8. Unclamp and open the drainage tube on the bag, being careful not to touch

the end of the tube. 9. Drain urine from the bag into a measuring pitcher. 10. Clean the end of the drainage tube as directed by the care plan. 11. Clamp the drainage tube and put it back into its holder, being careful not to

touch the end with hand or anything else. 12. Measure the amount of urine, if directed by the care plan. 13. Observe the color of the urine, odor of the urine, whether mucus or blood

was present in the urine, and condition of the drainage bag. 14. Empty urine into the toilet. 15. Rinse pitcher with cool water. Clean with soap and brush. 16. Store clean pitcher. 17. Remove gloves and wash hands. 18. Record the amount of urine, if directed by the care plan, and observations. 19. Report cloudy, strong-smelling, or bloody urine. Report if there is only a

small amount or no urine in the drainage bag when it is scheduled to be drained.



Skills Checklists

Skills Checklist 6. Measuring Urinary Output Measuring Urinary Output 1. Explain to the client why it is necessary for you to measure their urinary

output. Ask the client to use a bedpan, urinal, or commode when they need to urinate. Ask the client to tell you when they need to pass urine. (This will not be necessary with a client who has a urinary drainage bag.)

2. Wash your hands. 3. Gather equipment. 4. Put on gloves. 5. Pour or drain urine from the bedpan, urinal, commode, or urinary drainage

bag into a measuring pitcher that is on a flat surface. 6. Record the amount that is in the pitcher or the urinary drainage bag. 7. Discard the urine unless a specimen is needed. 8. Clean the reusable equipment. 9. Store the reusable equipment. 10. Wash your hands. 11. Observe, record, and report any changes in condition or behavior, such as

strong-smelling urine, cloudy urine, blood in the urine, very small amount of urine, or if the client has pain or difficulty when urinating.



Skills Checklists

Skills Checklist 7. Assisting with the Use of a Condom Catheter

Assisting with The Use of a Condom Catheter

1. Explain to client what you plan to do. 2. Wash hands. 3. Assemble the equipment and supplies you need:

Condom catheter

Tubing

Soap

Towel 4. Put on gloves. 5. Maintain client’s privacy. 6. Expose genital area only. 7. Wash and dry penis carefully. 8. Observe skin of penis for sores. 9. Report presence of any sores or raw areas on or around the penis.*

* If there are sores, proceed only with permission of the supervising nurse.

10. Attach condom to tubing, if necessary. 11. Roll condom catheter onto penis as directed on the care plan or by the

supervising nurse. 12. Check that tubing is one to two inches below the tip of the penis. 13. Check that the tip of the condom is not twisted. 14. Remove gloves and wash hands. 15. Record the application of condom catheter and/or presence of sores or raw

areas.



Skills Checklists

Skills Checklist 8. Assisting with Cleaning the Skin and Catheter Tubing Assisting with Cleaning the Skin and Catheter Tubing

1. Explain to client what you plan to do. 2. Wash hands. 3. Assemble the equipment and supplies you need:

Wash basin

Disposable bed protector

Soap

Washcloths

Towel(s) 4. Put on gloves. 5. Maintain client’s privacy. 6. Place client on back so that the catheter and urinary opening are exposed. 7. Put towel or disposable bed protector under client. 8. Wash the genital area gently with soap and water from front to back. Do not

pull on the catheter, but hold with one hand while wiping the area with the other. Gently push back foreskin on uncircumcised male before cleaning.

9. Observe area around the catheter for sores, crusting, leakage, or bleeding. 10. Dry area with towel. 11. Clean the catheter tubing as directed by the care plan, starting with the tubing

closest to the client. 12. Position the client so that the catheter and tubing do not pull and are free

from all kinks. 13. Tape tubing to the client as directed on the care plan. 14. Dispose of any dirty water into the toilet. 15. Discard disposable equipment. 16. Remove the bed protector or towel. 17. Clean and store reusable equipment. 18. Remove gloves and wash hands. 19. Record time catheter care was done. 20. Observe, record, and report any changes in client’s condition or behavior.



Skills Checklists

Skills Checklist 9. Assisting with Routine Tracheostomy Care Page 1 of 2

Assisting with Routine Tracheostomy Care

1. Explain to client what you plan to do. Ensure privacy. 2. Wash hands. 3. Gather equipment :

Solution (as specified in care plan)

Container

Applicators or special gauze

“Y” clean-cut dressing, if used

Special tape for neck ties

Rinse solution 4. Put on gloves. 5. Pour the amount and type of solution into the container that is specified in

the care plan. 6. Remove inner tube, if there is one, and soak in container of solution. 7. Remove soiled or moist dressing, and throw it away. 8. Dip applicator or gauze in solution, and clean around outer tube. Throw

away applicator or gauze. 9. Clean the skin under the neckplate with applicator or gauze. Discard

applicator or gauze. 10. Observe skin for any signs of irritation. Observe for changes in the amount

or type of discharge from the opening. 11. Dry area gently and thoroughly with gauze. 12. Apply folded “Y” clean-cut dressing around neck opening under neckplate,

if ordered in the care plan. 13. Replace soiled or moist neck straps:

Cut two special tape ties to specified lengths.

Loop clean ties through openings on both sides of the neckplate.

Tie tape in double or triple knot on either side of the neck, and trim off any extra tape.

Cut soiled tapes, and remove them from the neckplate. 14. Clean inside of inner tube with brush, pipe cleaner, or gauze.



Skills Checklists

Skills Checklist 9. Assisting with Routine Tracheostomy Care

Page 2 of 2 15. Check inside of tube to make sure it is clean. 16. Rinse inner tube with solution specified in the care plan. Dry thoroughly. 17. Put inner tube in outer tube. Make sure it is locked in place. 18. Discard soiled materials and solutions. 19. Clean reusable equipment, and store properly. 20. Remove gloves and wash hands.

21. Record and report any unusual problems with tracheostomy, such as unusual odor, difficulty in replacing inner tube, client discomfort, or any changes in client’s condition or behavior.

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