Clinical Skills Performance
Skills are graded as a whole performance
Evaluators look for a safe, complete sequence rather than speed: hand hygiene, identification, explanation, privacy, correct technique, clean-to-dirty order, resident comfort and dignity, and a clean finish. Missing hand hygiene or privacy is often scored as an automatic failure, so treat them as non-negotiable bookends on every skill.
High-frequency skills
Handwashing uses soap, warm running water, and friction for at least 20 seconds, including between the fingers, the thumbs, and under the nails. For blood pressure, use the correct cuff size, arm supported at heart level, feet flat, and no talking during the reading. Count respirations without announcing it, for example after taking the pulse while still holding the wrist. For transfers, place the gait belt around the waist over clothing, lock the bed or wheelchair, stand on the weak side, and pivot toward the strong side. For range of motion, support the joint and move only to the point of resistance. For catheter care, wear gloves, clean with downward strokes, secure the tubing, and keep the bag below bladder level. For feeding, sit the resident upright, offer small bites, alternate fluids, and watch for pocketing.
Documentation and reporting
Chart what you did, what you observed, and what you reported, using objective descriptions and the resident's own words when quoting. Chart after care, never before. If you make an error, tell the nurse at once and document the facts. Report by exception: any change, refusal, fall, or abnormal vital sign goes to the nurse, not just into the chart.
Traps and a rule of thumb
Traps include announcing that you are counting respirations, taking a blood pressure over a sleeve, leaving the bed elevated, and documenting a comfort level you never checked. Rule of thumb: identity, explain, privacy, clean hands - then close it out with bed low, call light, report, and chart.