Tag: texas cna state test

Texas CNA Skills (Part Two): the Initial Steps, a.k.a. “Opening Procedures,” That Must Be Performed Before Demonstrating Skills on the State Examination

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In most U.S. states, including Texas, a test-taker who wants to pass the state-approved CNA examination must demonstrate his or her ability to successfully complete several hands-on procedural tasks during the skills portion of the state test. This all takes place as an examiner carefully observes the steps associated with each skill performance from start to finish.

Out of 20+ possible testable skills on the CNA state test, five skills will be selected at random for the test-taker to perform in front of the examiner. In order to pass the skills portion of the CNA state test, four out of five of the randomly selected skills must be completed successfully and by the book. It is advisable to know how to perform all 20+ testable skills for maximal test preparation.

Each testable skill possesses an assigned value that shall correspond to each step associated with the complete, successful performance of the skill. For instance, a skill such as hand-washing that requires a number of steps from start to finish would be worth multiple points. If all steps of the hand-washing skill are performed properly and in the correct order by the test-taker, then all points will be awarded for the performance of that particular skill.

Keep in mind that the test-taker is allowed to miss a small number of steps that are considered not critical and still successfully pass the skills portion of the CNA state examination. The overriding point is that examiner wants to see that the test-taker knows how to execute the procedural skill from start to finish.

On the other hand, the nurse aide test-taker is absolutely not allowed to miss or forget to perform any critical steps of a procedural skill during the skills portion of the CNA state test. Generally, measures such as infection control, safety, privacy and provision of a signaling device or call light within reach are regarded as critical steps. In essence, these steps must always be performed. After all, they are considered critical steps.

Initial steps are known by various names, including pre-steps and opening procedures. Since the skills section of the CNA state exam is usually performed as one single scenario, these opening procedures need to be completed once, typically when the scenario starts. To reiterate, test-takers must carry out these opening procedures at the beginning of each test.

Opening procedures normally involve routinized steps such as knocking on the patient’s door, introducing oneself to the patient, identifying the correct patient, and ensuring privacy. According to Lewis-Clark State College (2013), the opening procedures should be carried out in the following order:

  1. The nursing assistant should get instructions from the nurse concerning the patient’s needs, functional limitations, and what the patient is able to do.
  2. The nursing assistant needs to knock before going inside the patient’s room. If applicable, await permission to enter the room if the patient is verbal in the scenario that has been assigned.
  3. The nursing assistant must refer to the patient by name. The nursing assistant must confirm the patient’s identity to ensure it is the right patient.
  4. The nursing assistant needs to identify himself or herself. The nursing assistant needs to identify his or her workplace title (e.g., “I am Joy. I am going to be your nurse aide for the day.”
  5. The nursing assistant should clearly explain the procedure in language the patient can understand. The nursing assistant should encourage the patient to complete as much as he or she possibly can.
  6. The nursing assistant should gather supplies and examine equipment prior to the start of the skill or procedure.
  7. The nursing assistant must properly wash his or her hands.
  8. The nursing assistant must ensure the patient’s privacy is upheld by keeping doors and/or privacy curtains in the closed position.
  9. The nursing assistant needs to keep the bed’s side rails in the ‘up’ position before elevating the bed to an appropriate height. The nursing assistant is to lower the side rails on the side of the bed where the care is being delivered.
  10. The nursing assistant should adhere to standard precautions by gloving up as needed.
  11. The nursing assistant should perform all skills while utilizing appropriate body mechanics. Maintain correct body alignment while working.

REFERENCES

4YourCNA. (2018). The Opening – a 4 YourCNA Lesson. Retrieved from https://www.youtube.com/watch?v=OOMXB_ahFyE

Lewis-Clark State College. (2013). Student Skills Packet. Retrieved from http://www.lcsc.edu/media/117278/2013-Student-Skills-Packet.pdf

Los Angeles Mission College. (2016). General Information, Exam Requirements, and Skills Steps Review Packet. Retrieved from https://www.lamission.edu/alliedhealth/docs/SkillsReview%20Rev02-16.pdf

Texas CNA Skills (Part One): Hand-Washing, a.k.a. Hand Hygiene Instructions and Video

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Hand-washing is arguably one of the easiest and most effectual methods of infection control in healthcare facilities. Correctly-performed hand hygiene prevents the spread of harmful diseases. In fact, the overarching goal of hand-washing is to remove microbes, dirt, debris and particles from the hands by way of sufficient manual friction along with soap and warm water to prevent the spread of disease-causing germs to vulnerable patients and residents.

In addition, hand-washing happens to be a testable skill on the Texas state examination and skills evaluation test to attain certification as a certified nursing assistant (CNA). During the course of the CNA state test, the test-taker is expected to perform a full hand-washing skill sequence in front of the examiner to ensure that it is being done properly. Thus, a thorough working knowledge of correct hand-washing techniques is imperative in order for a candidate to pass the skills portion of the state exam.

Without satisfactory knowledge of hand-washing techniques, a test taker could quite possibly fail the skills portion of the state test, resulting in a disappointing loss of time, money, effort and confidence. Who wants to continually retake the CNA state exam? Not you! In other words, it would be an excellent idea to know how to perform the skill of hand-washing in the precise manner that the state test examiner wants it completed.

CNAs and other healthcare workers will need to wash their hands multiple times per work shift during the course of performing direct care. The nurse aide must perform proper hand hygiene before entering patients’ rooms, prior to exiting patients’ rooms, before and after feeding residents, after handling unclean bedding and linens, prior to performing procedures on patients, and after coming into contact with skin tears and open wounds.

Again, the rationale for hand-washing is to reduce the likelihood of transmitting infectious germs. The World Health Organization (2009) asserts that five instances are appropriate for hand hygiene: 1) prior to contact with patients and residents; 2) prior to performing clean and/or aseptic tasks; 3) after body fluid exposure risks; 4) after contact with patients and residents; 5) after making contact with patients’ surroundings.

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To successfully complete the hand-washing skill for the Texas CNA state exam, Pearson Vue (2018) asserts that this procedure should be performed utilizing the following steps in the order that has been listed below:

  1. The nursing assistant must refer to the patient by his or her name. The nursing assistant must also introduce himself or herself to the patient by name.
  2. The nursing assistant must proceed to turn on the water faucet at the sink.
  3. The nursing assistant needs to completely wet his or her hands and wrists.
  4. The nursing assistant adds a sufficient amount of soap to his or her hands.
  5. The nursing assistant must ensure all surfaces of his or her hands, wrists and fingers are lathered up for a minimum of 20 seconds while using sufficient friction. While lathering up, make sure the hands remain lower than the elbows. While lathering up, also make sure elbows and fingertips are kept down.
  6. The nursing assistant needs to clean his or her fingernails by rubbing the fingertips against the palms of the opposite hand.
  7. The nursing assistant must rinse off all surfaces of his or her hands, wrists and fingers while being sure to keep the hands lower than the elbows and the fingertips down.
  8. The nursing assistant must use dry paper towels to dry off all surfaces of his or her hands, wrists and fingers while starting at the fingertips. The nursing assistant then must proceed to dispose of the used paper towels into the wastebasket receptacle.
  9. The nursing assistant must use dry paper towels to turn the water faucet off before properly throwing the used paper towels into the wastebasket receptacle.
  10. The nursing assistant must not touch the inside of the sink during any point in time while performing the hand-washing skill in front of the examiner.

REFERENCES

All About Medical Training. (2015). Hand Hygiene (Hand Washing) CNA Skill Video AAMT. Retrieved from https://www.youtube.com/watch?v=6ae0eODZyNQ&t=2s

Pearson Vue. (2018). Texas Nurse Aide Candidate Handbook. Retrieved from https://home.pearsonvue.com/getattachment/73a0c524-4cbe-401a-aa5c-fe1ebf4e2517/Texas

World Health Organization. (2009). Hand Hygiene: How, Why & When? Retrieved from http://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf

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