Virginia CNA common mistakes
Virginia CNA · Understand the traps and how to avoid them.
Skips hand hygiene before resident contact, after removing gloves, or uses alcohol rub when hands are visibly soiled.
Candidates rush under skill-test time pressure and mistakenly believe gloves replace handwashing.
What to do instead
Perform and verbalize hand hygiene at the key moments: before touching the resident, before a clean procedure, after body-fluid exposure risk, and after contact. Wash with soap and water whenever hands are visibly soiled; save sanitizer for non-soiled hands.
Takes blood pressure over clothing, with the wrong cuff size, or deflates the cuff rapidly.
Nerves and unfamiliar equipment lead candidates to skip setup steps and rush the release valve.
What to do instead
Use a bare upper arm, select a cuff that fits the arm circumference, let the resident rest 5 minutes, inflate 20–30 mm Hg above the estimated systolic, and deflate at 2–3 mm Hg per second.
Counts respirations for only 15 seconds or announces to the resident that breathing is being counted.
Candidates underestimate how long a full count takes and forget that awareness changes breathing rate.
What to do instead
Keep fingers on the wrist as if continuing the pulse, count for a full 60 seconds or two 30-second counts, and do not tell the resident you are counting respirations.
Begins a procedure without knocking, identifying self and role, explaining the skill, or asking permission.
Candidates focus on completing the physical checklist and treat communication as optional.
What to do instead
Use a consistent script before every skill: knock, state name and title, explain what you will do, ask if it is okay, and proceed only after the resident agrees.
Leaves the door or curtain open, fails to drape the resident, or exposes more of the body than the area being cleaned.
Attention is on the procedure steps rather than the resident’s dignity and privacy.
What to do instead
Close the door or curtain first, cover the resident with a bath blanket, and uncover only the part being washed. Verbalize privacy as a step in the skill.
Leaves the bed raised, wheels unlocked, side rails in the wrong position, or the call light out of reach after care.
Candidates forget the final safety check when they believe the main task is finished.
What to do instead
Before stepping away, lower the bed, lock the wheels, place side rails as ordered, and put the call light within reach. Make this the last action of every bed-related skill.
Bends at the waist and twists while moving a resident, does not raise the bed, or transfers without a gait belt.
Habit and awkward practice conditions lead to using the back instead of the legs.
What to do instead
Raise the bed to waist height, stand facing the resident, spread feet shoulder-width, bend the knees, use a gait belt, and pivot with the feet instead of twisting the spine.
Performs perineal care back-to-front or uses the same washcloth for the anal area and urinary meatus.
Embarrassment and rushing cause candidates to skip the direction rule and cloth changes.
What to do instead
Wash from the urinary meatus toward the rectum, use a new area of cloth for each stroke, clean catheter tubing from the meatus outward, and wear gloves throughout.
Fails to report a change or error promptly, or charts subjective guesses instead of objective observations.
Candidates fear blame or do not understand the aide’s reporting role and documentation limits.
What to do instead
Report immediately to the nurse, then document the time, exact observation, vital sign, and action taken. Chart only what was seen, heard, or measured; never chart before care or write opinions.
Feeds a resident flat in bed, does not check diet or allergy information, or continues feeding when the resident coughs or pockets food.
Mealtime pressure and unfamiliarity with swallowing precautions cause candidates to skip pre-feeding checks.
What to do instead
Verify the diet card and allergies, position the resident upright at about 90 degrees, offer small bites, alternate with fluids, check for pocketing, and stop and call for help if choking occurs.