Skills Inspection Checklist Template (Page 10 of 12) in pdf

PROVIDE PERINEAL CARE (While testing ONLY FEMALE peri-care is done on the manikin) - Page 220

___ 1 Knock, Greet the Client by Name, Gather Supplies, Ensure Privacy, Explain Procedure, Wash your Hands, Adjust Equipment

___ 2 Layout a clean towel on over-bed table. Fill wash basin with warm water (105 – 115 degrees). Check temp with bath thermometer.

___ 3 Check the water temperature for safety and comfort then ask the client to verify comfort of water. Place basin on the clean towel

___ 4 Raise bed between mid-thigh and waist level (opt: not necessary for testing but it is safer for your back).

___ 5 Lower the head of the bed as low as the client can tolerate

___ 6 Put on clean gloves. Keep the client covered with bath blanket or top sheet to provide privacy.

___ 7 Remove soiled clothing (if necessary) and ask the client to bend their knees and spread their legs as much as possible

___ 8 Ask client to raise their buttocks to place pad/linen protector under perineal area before washing

___ 9 Expose only perineal area by lifting the corner of the bath blanket or top sheet over the abdomen helping avoid overexposure of client

___ 10 Wet the washcloth and make a mitt. (or fold in 4) Apply soap to wet washcloth.

___ 11 Wash the pubic hair on lower abdomen area first

___ 12 FOR TESTING PURPOSES: Verbalize separating the labia. Otherwise physically separate the labia with one hand

___ 13A FEMALE: Wash one side of the labia using one gentle motion moving from front to back, then using a clean area of the

cloth, wash the other side of the labia, then using a different part of the washcloth gently wash down the middle of the peri area.

___ 13B - MALE: Hold the penis in one hand. If the male is uncircumcised, retract the foreskin. Moving from the urethral opening outward,

was the penis using a circular motion, starting with the tip and moving down to the base.

___ 14 Use a clean washcloth to rinse soap from genital area using the same steps as you did when washing

___ 15 With a clean towel dry the genital area using the same steps as you did when washing and rinsing.

___ 16 After washing & rinsing the genital area, ask client to roll to the side (assist if needed), wash and rinse the rectal area moving

from front to back using a clean area of the washcloth for each stroke. Pat the area dry with towel from front to back.

___ 17 Remove the linen protector and reposition client so they are comfortable using proper body mechanics

___ 18 Empty, rinse, and dry basin then place basin in designated dirty supply area

___ 19 Ensure client is covered with the top sheet. Properly dispose of used linens into soiled linen avoiding contact with your clothing

___ 20 After disposing of used linen, and placing used equipment in designated dirty supply area, remove and dispose of gloves

(without contaminating yourself ) into waste container then wash your hands

___ 21 Ensure signaling device is within reach, bed is in low position, side rails are down and client is comfortable

GIVE MODIFIED BED BATH (FACE AND ONE ARM, HAND AND UNDERARM) Page 222

___ 1 Knock, Greet the Client by Name, Gather Supplies, Ensure Privacy, Explain Procedure, Wash your Hands

___ 2 Gather supplies (bath blanket for full bed bath, 2 sm towels or 1 lg, 2 wash clothes, gloves, wash basin, soap, lotion if needed)

___ 3 Provide privacy with a curtain, screen or door and wash your hands

___ 4 Fill a wash basin with water, have the client check water temperature for safety and comfort and ask client to verify comfort of water

___ 5 Adjust the bed the bed level and lower the head of the bed as low as the client can tolerate and put on clean gloves

___ 6 Cover client with a bath blanket and remove top sheet by fan folding it to the foot of bed for full bed bath or place towel across clients

chest to protect bedding

___ 7 Remove client’s gown (or soiled clothing) while keeping the client covered. Dispose of gown in hamper

___ 8 Wash clients eyes with wet washcloth (NO SOAP), using a different area of the washcloth for each stroke,

wash from the inner aspect to the outer aspect then proceeds to wash face

___ 9 Dry client’s face with towel

___ 10 Expose one arm and place towel underneath and over the arm

___ 11 Apply soap to the wet washcloth

___ 12 Wash arm, hand, and underarm, keeping the rest of body covered

___ 13 Rinse and dry arm, hand, and underarm

___ 14 Move client’s body gently and naturally, avoiding force and over-extension of limbs and joints

___ 15 Put a clean gown on the client (and a clean top sheet if giving a complete bed bath)

___ 16 Empty, rinse and dry basin, place basin in designated dirty supply area

___ 17 Dispose of linen into soiled linen container avoiding contact with your clothing

___ 18 Place basin in designated dirty supply area, remove & properly dispose of gloves without contaminating self

___ 19 Ensure client is in a comfortable position, place signaling device within reach, place bed in the low position and wash your hands

Skills Inspection Checklist Template Page 10

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