Practical Skills
This domain tests correct technique and safe practice in the common procedures a health care assistant performs. Examiners award marks for sequence, asepsis and documentation.
Measuring blood pressure
Let the patient rest five minutes, seated with back supported and arm at heart level. Place the cuff 2 cm above the cubital fossa, palpate the radial pulse and inflate about 30 mmHg above the point where it disappears, then auscultate over the brachial artery and deflate slowly. Record systolic over diastolic with the arm used.
Hand hygiene and PPE
Six-step hand hygiene, then donning in the order gown, mask or respirator, goggles, gloves, and doffing gloves, goggles, gown, mask last, with hand hygiene at each stage.
Injections
Intramuscular 90°, subcutaneous 45°, intradermal 15°. Sites: deltoid (limited to about 1 mL), ventrogluteal (safest for adults and larger volumes) and vastus lateralis (infants). Aspirate is not required for routine IM injections; never recap a needle.
Dressings and specimens
Use sterile technique, clean from the wound outwards, and dispose of soiled material into the correct colour-coded bin. Label specimens at the bedside with patient name, ID, date, time and test.
Documentation
Record objectively, with date, time, findings and signature. Correct an error with a single line, write 'error', initial and date it - never erase or overwrite.
Worked example
You must give 2 mL of an antibiotic intramuscularly to an adult. Reasoning: 2 mL exceeds the safe deltoid volume, so choose the ventrogluteal site - thick muscle, away from major nerves and vessels. Position the patient on the side or back, landmark the site, cleanse, inject at 90°, and dispose of the needle in the white sharps container without recapping.
Traps that cost marks
Recapping needles; erasing a charting error; touching the needle or hub; choosing the deltoid for large volumes.