Make Sure You Know About Indirect Care For Your CNA Skills Exam – Or You’ll Be Sorry!

What everybody needs to know about CNA Test Takers’ Failures

Those CNA test takers received a failing mark on their Clinical Skills Exam because, oftentimes, they forgot to demonstrate Indirect Care. What is Indirect Care? It places emphasis on the test taker’s behaviors that are part of every skill tested on the Clinical Skills Test. The skills exam is a timed test that lasts from 30 to 35 minutes. In an actual examination setting, time constraints add to the pressure felt by examinees. It can be a nerve-wracking experience because someone will be watching you the entire time, and taking note of your every move. Remember to take a deep breath and don’t panic. Why? Most of the evaluators are not too meticulous about the way you do things; so just stay calm and focused. Evaluators are more concerned with your hygiene and behavior. Always be mindful of the fact that Indirect Care is extremely important because:

(1) It is a rated performance,

(2) It has separate score ratings, and

(3) It greatly affects the test taker’s overall performance during the skills exam.

Pay attention to your behavior in terms of communicating 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 most important among the five skills needed during the skills exam. Remember: The Nurse Aide Evaluator will observe and also evaluate your performance based on your behavior!!!

Here are the methods of performing Indirect Care: (Remember this – it will help you pass the Skills Exam)

1. Communication. Communicate with the resident in a respectful and dignified manner:

• Greeting the resident appropriately (ex. “Good morning, Mrs. Smith.”)
• Introduce yourself to the resident
• Explain to the resident why you are there and what care you will perform
• Explain each step of the process to the resident before performing care (ex: “Now I’m going to turn you over on your side.”)

2. Resident’s Rights

• Knock before entering the resident’s room
• Provide the resident with privacy by pulling the curtain down before performing care
• Always pay attention to your language and actions while providing the care to the resident
• Ask the resident about their preferences, such as nail length, hairstyle, or choice of food
• Avoid addressing residents by nicknames such as “Honey”, “Dear”, “Sweetie”, etc.

3. Safety and Comfort.

• Always check resident’s bed to see if he or she is in a safe sleeping position
• Adjust the resident’s sleeping position to a safer one, if necessary
• Lower the bed while performing care
• Apply a gait belt when performing 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 chair

4. Infection Control.

• Always wash hands before and after performing care. (Highly Important!)
• Use gloves if required, especially during perineal care, catheter care, drainage bag care, denture and mouth care (brushing of teeth), assisting with the use of the bedpan, measurement and 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

Note: 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 resident a bath)
3. Always put the call light within the resident’s reach
4. Wash your hand before and after performing care.

It’s important to keep in mind the Indirect Care procedures. Many examinees FAILED their Clinical Skills Exam because they were not well-prepared and oftentimes forget to remember the Indirect Care approach to meet the resident’s needs. You don’t have to be a fast learner, but you need to remember all the rules and standard precautions you have learned from your training classes. Evaluators allow for corrections; in case you forgot something, you are free to correct it, and immediately proceed to the other skills. As long as you remain calm and make sure you think through the skills sets, then passing the CNA clinical exam should be a breeze.