Illinois CNA common mistakes
Illinois CNA · Understand the traps and how to avoid them.
Removing gloves and then leaving the room or moving to the next resident without performing hand hygiene, or using alcohol sanitizer when hands are visibly soiled or after caring for a resident with C. difficile.
Candidates treat gloves as a substitute for handwashing and rush between tasks; they also default to sanitizer because it is faster and mounted on the wall.
What to do instead
Use a fixed verbal checklist at every glove removal: gloves off, then soap and water or sanitizer before touching anything else. Memorize the exceptions that require soap and water: visible soil, after toileting or perineal care, and after C. difficile care.
Performing perineal care by wiping from back to front, or keeping the same gloves on after cleaning the anal area and then washing the front.
Candidates mirror the direction used for washing the back or follow the resident's body position without thinking about fecal contamination; glove changes feel wasteful or slow.
What to do instead
State the rule out loud before starting: front to back, one stroke per wipe, new washcloth each stroke, and change gloves after the anal area before returning to the front. Practice on a manikin until the sequence is automatic.
Pushing a joint past the point of resistance or bouncing at the end of a range-of-motion movement to get more motion.
Candidates think more force produces more benefit, or they confuse the resident's pain response with stiffness that must be worked through.
What to do instead
Move only to the point of gentle resistance, hold briefly, and stop at any report of pain. Say the rule before each exercise: 'Slow, smooth, stop at resistance.' Report pain or a new limitation rather than forcing the joint.
Ambulating a resident by holding the arm or by placing the gait belt over bare skin or so loosely it slides up to the ribs.
Candidates are nervous about the belt, were shown it only briefly, or think holding the arm is more supportive and less intrusive.
What to do instead
Apply the belt snug over clothing at the waist, check two fingers fit underneath, and grip it from behind or at the side with one hand. Rehearse the sequence: belt on, lock brakes, stand, then walk.
Correcting a resident with dementia who insists a deceased spouse is coming to visit, or arguing that it is time for a shower when the resident says it is not.
Candidates apply ordinary logic and honesty, believing the person must be reoriented to reality; they also fear that agreeing is lying.
What to do instead
Use validation and redirection instead of correction: acknowledge the feeling ('You miss him'), then redirect to a safe activity or need. For refusals, offer choices and try again later rather than arguing. Practice three redirect phrases.
Discussing a resident's diagnosis, behavior, or bowel habits at the nurses' station or in the hallway within hearing of visitors, or entering a room without knocking and waiting for permission.
Candidates treat the unit as a private workplace and copy staff who talk casually; they knock while opening the door because they are in a hurry.
What to do instead
Use the rule 'no name, no information, no location' in public areas, and move conversations behind a closed door. Knock, state your name and purpose, and wait for an answer before entering.
Responding to a resident's worry with 'Don't worry, it'll be fine,' or giving personal advice about family problems.
Candidates want to comfort and do not know what else to say; silence feels unhelpful.
What to do instead
Replace reassurance with acknowledgment and an open question: 'That sounds frightening. Tell me more about it.' Then report significant concerns to the nurse. Practice two reflective statements before clinical.
Taking a blood pressure with the cuff over a sleeve, the arm unsupported, or immediately after the resident walked in; counting a pulse for 15 seconds and multiplying.
Candidates are pressed for time and were taught shortcuts by peers; they do not connect positioning and rest to accuracy.
What to do instead
Follow the full sequence every time: rest five minutes, bare arm supported at heart level, correct cuff size, then inflate. Count the pulse for a full 60 seconds, or 30 seconds and double only if the rhythm is regular and the facility permits it. Recheck anything abnormal.
Charting a task before performing it, or writing 'resident refused' without reporting the refusal, change in condition, or new skin finding to the nurse.
Candidates chart at the end of a rushed shift from memory, or they assume the nurse already knows and do not want to bother anyone.
What to do instead
Chart after care, not before; use the rule 'if it is new, it goes to the nurse first.' Report any change in condition, refusal, fall, or skin breakdown verbally and document the time and to whom it was reported.
Leaving the bed in a raised position after care, leaving the call light on the floor or out of reach, or lowering side rails on a resident who needs them.
Candidates focus on finishing the task and forget the exit check; call lights get clipped to a sheet that then moves.
What to do instead
Use a fixed exit checklist before leaving any room: bed low, brakes locked, call light in the resident's hand, side rails per care plan, personal items within reach. Say the checklist aloud until it becomes routine.