Pennsylvania CNA common mistakes
Pennsylvania CNA · Understand the traps and how to avoid them.
Performing hand hygiene late or skipping it after removing gloves and before moving to the next resident-care task.
Candidates rush under time pressure and mistakenly treat gloves as a substitute for hand hygiene.
What to do instead
Verbalize and perform hand hygiene immediately before resident contact, before clean/aseptic tasks, after body-fluid exposure, after glove removal, and after contact with resident surroundings; use the exam checklist order every time.
Starting a procedure without identifying the resident by wristband and without explaining what will be done.
Candidates focus on completing the skill and overlook resident rights and communication steps.
What to do instead
Knock, introduce yourself, check the ID band against the name and date of birth, explain the procedure in plain language, and obtain permission before beginning.
Transferring a resident without locking bed or wheelchair wheels, lowering the bed, or using a gait belt; lifting the resident under the arms.
Habit and rushing lead candidates to skip safety steps they know in theory.
What to do instead
Lock wheels, lower the bed to a safe height, use a gait belt, keep the resident close, bend at the knees, and get help or a mechanical lift when indicated by the care plan.
Leaving the door or curtain open, exposing the resident unnecessarily, or failing to drape during bathing, dressing, or toileting.
Task-focused candidates concentrate on completing care and forget dignity and privacy.
What to do instead
Close the door or curtain, explain each step, expose only the body part being cleaned, keep the resident covered with a bath blanket, and ask before touching.
Applying a restraint, or continuing one, without checking the order, circulation, or release schedule.
Candidates misunderstand restraint safety and may use a restraint to prevent falls or manage behavior without recognizing the required safeguards.
What to do instead
Never apply a restraint without a current order; check circulation and skin, release and reposition at required intervals, offer toileting and fluids, and report any need for continued restraint to the nurse.
Doing all self-care for a resident instead of encouraging independence, range of motion, or use of hearing aids, glasses, and dentures.
Candidates try to save time or assume the resident cannot participate.
What to do instead
Follow the care plan: encourage the resident to perform as much self-care as possible, provide setup and verbal cues, perform ROM as ordered, and ensure assistive devices are clean, in place, and working.
Taking inaccurate vital signs, such as counting respirations for only 15 seconds, using the wrong blood pressure cuff size, or failing to recheck an abnormal value.
Time pressure and improper technique cause shortcuts in measurement.
What to do instead
Count respirations for a full 30 seconds and multiply by two, or for 60 seconds if abnormal; use the correct cuff size and position; recheck abnormal values and report them promptly to the nurse.
Charting before care is completed, documenting for another aide, writing opinions instead of facts, or missing intake and output entries.
Candidates misunderstand documentation accuracy and try to catch up at the end of the shift.
What to do instead
Document immediately after care, record only objective facts and actual care provided, never pre-chart or chart for someone else, and record all intake and output accurately on the correct resident record.
Observing a change in condition, such as new confusion, pain, skin breakdown, or refusal to eat, and waiting until the end of the shift to tell the nurse.
Candidates may not recognize the significance of the change or may fear being blamed.
What to do instead
Report changes promptly to the nurse using specific observations, including time, what was seen, vital signs if obtained, and what the resident said; document the report and follow facility policy.
Feeding a resident too quickly, with the resident lying flat, or continuing to feed when coughing or swallowing difficulty occurs.
Candidates rush meals and do not recognize signs of aspiration or dysphagia.
What to do instead
Position the resident upright, offer small bites and allow time to chew and swallow, check for pocketing, stop feeding and report coughing, choking, or a wet voice, and follow the speech-language pathology recommendations.