Student Name___________________________________ Class_______________________
Arizona Nursing Assistant Skills Checklist: Clinical
*Students may not perform skills on residents/patients until they have demonstrated competency
and been signed off by a RN in the skills laboratory.
Date
Initials
Ambulation with Gait Belt
Applying Antiembolic Stockings
Bed Bath-Whole Face, One Arm, and Underarm
Dressing Bedridden Resident
Feeding the Dependent Resident
Isolation Gown and Gloves
Mouth Care-Brushing teeth
Mouth Care of Comatose Resident
Perineal Care-Male with a Soiled Brief
Positioning Resident on Side
Range of Motion Hip and Knee
Pivot Transfer a Wt. Bearing, Non-Ambulatory
Resident from W/C to Bed using Gait Belt
Pivot transfer a Wt. Bearing, Non-Ambulatory
Resident from Bed to W/C using Gait Belt
Vital Signs TR, Pulse Oximetry, Electronic BP
Date
Initials
Assist in Admitting Resident
Assist in Discharging Resident
Assist in Transferring Resident
