Student Name___________________________________ Class_______________________
Nursing Assistant Skills Checklist: Classroom and 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.
Competency Date
Date
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
Pivot transfer a Wt. Bearing, Non-
Ambulatory Resident from Bed to W/C
Vital Signs TR, Pulse Oximetry, Electronic
BP
Competency Date
Date
Assist in Admitting Resident
Assist in Discharging Resident
Assist in Transferring Resident
Assist with Diagnostic Test/Obtains
Specimen
