CNA Skills Checklist

Skills Checklist

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1

= No theory and/or experience
2

= Limited Experience
3

= Experienced/minimal support needed to perform
4

= Proficient

Age of Patients Cared For
Newborn/Neonate (Birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (1 month to 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 year to 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 years to 5 years)*
- 1
- 2
- 3
- 4
School Age (5 years to 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 years to 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 years to 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (79 years and up)*
- 1
- 2
- 3
- 4
Skills
Assist with admission of patient*
- 1
- 2
- 3
- 4
Assist with ambulation*
- 1
- 2
- 3
- 4
Assist with bedpan / urinal / commode*
- 1
- 2
- 3
- 4
Backrubs/back care*
- 1
- 2
- 3
- 4
Basic Medical Asepsis*
- 1
- 2
- 3
- 4
Bathing: complete/partial/Sitz*
- 1
- 2
- 3
- 4
Bed cradles*
- 1
- 2
- 3
- 4
Bed making: occupied/unoccupied/surgical*
- 1
- 2
- 3
- 4
Bed rails: when/how to use them*
- 1
- 2
- 3
- 4
Cast care*
- 1
- 2
- 3
- 4
Charting/checklists/graphic charts*
- 1
- 2
- 3
- 4
Compresses: warm/cold*
- 1
- 2
- 3
- 4
Coughing/ Deep Breathing*
- 1
- 2
- 3
- 4
CPR*
- 1
- 2
- 3
- 4
Crutch walking: Assist patient*
- 1
- 2
- 3
- 4
Dangling Patient*
- 1
- 2
- 3
- 4
Dietary Restrictions*
- 1
- 2
- 3
- 4
Discharge of Patient*
- 1
- 2
- 3
- 4
Documentation: vital signs and I&O*
- 1
- 2
- 3
- 4
Documentation of patient belongings*
- 1
- 2
- 3
- 4
Douches*
- 1
- 2
- 3
- 4
Elastic stockings (TED hose)*
- 1
- 2
- 3
- 4
Elimination check and record*
- 1
- 2
- 3
- 4
Enemas, rectal tubes, Harris flush*
- 1
- 2
- 3
- 4
Feed patient*
- 1
- 2
- 3
- 4
Foley catheter care and emptying*
- 1
- 2
- 3
- 4
Footboard*
- 1
- 2
- 3
- 4
Hand Hygiene*
- 1
- 2
- 3
- 4
Height: measure and record*
- 1
- 2
- 3
- 4
Intake and output measure and record*
- 1
- 2
- 3
- 4
Infection Control: Standard Universal Precautions*
- 1
- 2
- 3
- 4
Infection Control: Reverse Isolation*
- 1
- 2
- 3
- 4
Infection Control: TB/Airborne Precautions*
- 1
- 2
- 3
- 4
Infection Control: MRSA/VRE Precautions*
- 1
- 2
- 3
- 4
Nourishment for patients*
- 1
- 2
- 3
- 4
Observing Patients*
- 1
- 2
- 3
- 4
Oral Hygiene*
- 1
- 2
- 3
- 4
Patient safety standards / Precautions*
- 1
- 2
- 3
- 4
Perineal Care*
- 1
- 2
- 3
- 4
Positioning Patients*
- 1
- 2
- 3
- 4
Prosthetic Devices (dentures, contact lenses, etc.)*
- 1
- 2
- 3
- 4
Range of motions exercises*
- 1
- 2
- 3
- 4
Reporting Changes of Patient Condition*
- 1
- 2
- 3
- 4
Reporting/Recording of Patient's pain level*
- 1
- 2
- 3
- 4
Restraints*
- 1
- 2
- 3
- 4
Skincare*
- 1
- 2
- 3
- 4
Specimen Collection: Routine Urine*
- 1
- 2
- 3
- 4
Specimen Collection: Clean Catch*
- 1
- 2
- 3
- 4
Specimen Collection: 12 & 24 hour urine specimen*
- 1
- 2
- 3
- 4
Specimen Collection: Stool*
- 1
- 2
- 3
- 4
Specimen Collection: Culture*
- 1
- 2
- 3
- 4
Specimen Collection: Sputum*
- 1
- 2
- 3
- 4
Specimen Collection: From Foley catheter*
- 1
- 2
- 3
- 4
Vital Signs - Manual*
- 1
- 2
- 3
- 4
Dynamap*
- 1
- 2
- 3
- 4
Computerized Charting*
- 1
- 2
- 3
- 4
Suicide/Homicide precautions*
- 1
- 2
- 3
- 4
First Aid/CPR*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
*
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Your Recruiter*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

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Skills Checklist

Age of Patients Cared For

Skills