Generic Practical Task Outline

1) Check-in with nurse (receive task if comfortable)

a. ambulating- is patient fall-risk?
b. feeding- ask if patient on ventilator, trach tube or high risk
aspiration
2) Gather supplies (cleaned wheelchair, gait belt, bedpan, etc.)
3) Knock and ask if I can come in
4) Close curtain
5) Introduce yourself, Hi, I am.
6) Gel and Glove (if needed, mask or gown)
a. gel
b. gown (both ties are tied)
c. mask
d. gloves
7) Identify patient (2 identifiers)
8) Ask how patient would like to be addressed.
9) State purpose
10) State duration (usually 10-15 minutes)
11) Assess room
a. signage (left/right arm, aspiration precautions))
b. bed locked
c. IV/catheters
12) Prepare for task
a. raise bed to proper height
b. guard rails in position (3 up)
13)
Begin task
a. Explain throughout task
b. Make conversation with patient, How are you?
14)
Finish task
15) Ask, Is there anything else I can do for you?
16) Lower bed to ground
17) Proper bed position
a. keep high position if after feeding or leaving bedpan
b. ensure 3 rails are up
18) Thank the patient
19) Exit procedure
a. remove gloves
b. untie gown, dispose
c. gel
d. mask to trash
e. gel again
f. check clothing for any bodily fluids
20) Check-in with nurse
a. % of food eaten
b. discharged patient

Outside My Scope
1. Taking a patient to the bathroom
2. Handling any sort of medication (O2, blood, even
water)
3. Doing CPR or Heimlich maneuver (call nurse!) or using
bag valve mask
4. Ambulating a fall-risk patient
5. Seeing a patients charts
6. Directing/informing friends and family about patient
condition (HIPAA)
7. Entering a strict isolation room
8. Entering an airborne precaution room
9. Discarding any PHI, even to appropriate bin or
shredding
10. Adjusting catheters/pressing buttons on monitor

Incident
ex: bedsores, patient falls or patient injury, patient
complaint accidentally entered a strict iso, entered isolation
room w/o PPE, etc.
1. tell charge nurse
2. call program manager @ 888-248-2914
Injury
ex: when I fall and get hurt, traumatic event, etc.
1. tell charge nurse
2. get treated
3. call program manager
Accidentally in isolation room w/o PPE.
1. wash hands
2. examine clothes
3. notify charge nurse
4. call program manager
Accidental blood exposure
1. wash hands
2. flush/irrigate eyes
3. notify charge nurse
4. document (employee health)
5. call program manager

Ambulating a Patient
(immediately after preparing for task)
1) Assess patient condition to walk
a. When was the last time you went on a walk?
b. Have you walked on this floor before?
c. IV/catheters? (check with nurse, must have nurse
assistance)
d. Non-skid shoes or specialized socks
i. yellow socks- double check with nurse that
patient isnt fall-risk
2) Is patient immunocompromised? Patient wears mask.
Isolation room? Patient wears gown. (and also a mask if
droplet room)
3) Raise bed into fowlers position (40-60 degrees)
4) Perform Swivel Technique
a. one rail up on my side
b. ask patient to scoot over to edge of bed
c. ask patient to cross legs and bend knees
d. one hand behind knees, one hand on patients
shoulder closest to me
e. use proper body mechanics
i. knees bent
ii. dont lift, but spin patient
f. ask patient to use hands to help swivel
5) Use gait belt around patient hips, it will give me a handhold
to better assist you
a. dont forget to tuck belt tail into back
6) Lower bed so patients feet on ground
7) Place dominant foot in-between patients feet, bend knees
8) Grab gait belt from behind
9) Ask patient to help push off from bed
10) Count to 3, slowly stand up
11) Ask if patient is dizzy
12) Use shoulder-shoulder method to assist patient
a. left hand on gait belt, right arm supporting patients
wrist
13) Wear same PPE out in hallway
14) If patient faint/dizzy, guide patient to nearest seat and call
for assistance
15) If patient falls
a. wrap arms under their arms
b. guide patient slowly to floor
c. protect patient head and neck
d. try to position patient back to floor
e. CALL FOR HELP

f. stay with patient until appropriately helped

g. immediately tell charge nurse
h. call program manager at 888-248-2914
16) Return patient to bed and adjust bed as directed by nurse
Repositioning a Patient (Up)
1) Bed should be flat
2) Side rails down
3) Remove pillows, but place on at the headboard to protect
patient
4) Proper Body Mechanics
a. point feet towards head of the bed
b. bend knees
5) Grab blue pad with underhand grip
6) Ask patient to push up with their legs
7) Count to 3, slide patient upwards
Repositioning a Patient (Side)
1) Perform Log Roll
a. flat bed, 1 rail up on my side and 2 on the other
b. remove pillows
c. patient cross arms and legs
d. ask patient to reach over to grab far handrail
e. count to 3, roll patient
f. CHECK FOR BEDSORES
2) Wedge a pillow underneath the chux behind patients back
3) Roll patient back over
4) Place pillow between legs and also behind neck
Making an Occupied Bed
1) Perform Log Roll (6 steps)
2) Roll chux toward patient
3) Roll fitted sheet toward patient, under chux
4) Wipe bed with purple Sani-wipe.
a. can also wipe pillow (throw pillowcase to bin)
5) Wait 2 minutes
6) Change gloves and gel
7) Place new fitted sheet on bed, roll other half and tuck.
ensure tightly fitted.
8) Place new chux on top of clean sheet, roll other half and
tuck. no wrinkles.
9) Warn patient of bump when rolling back
10) Perform Log Roll the other way (6 steps)
11) Remove soiled linen to bin
12) Soiled chux to trash
13) Wipe bed with purple Sani-wipe

14) Wait 2 minutes

15) Change gloves and gel
16) Pull out clean linens and chux (smooth and taut)
17) Roll patient back
18) Make sure pillow cleaned and has new case
19) Place pillow behind neck
Changing a Patient Bedpan and Gown
1) Ask patient if they can lift their hips to help us out
2) If not, perform Log Roll (6 steps)
3) Place the bedpan properly
a. regular- the larger side upwards (deeper side down)
b. fracture- smaller, covered side upwards (deeper side
down, hook side down)
4) Roll patient back, warning of some discomfort
5) Raise head of the bed until comfortable
6) Lower bed to ground
7) Leave call button near patient and exit room
a. remove gloves and gel
b. close door behind you
8) Re-enter room
a. gel, gloves
b. assess room: bed brakes, signs, IV catheters, rails
9) Raise bed up again
10) Perform Log Roll while holding onto bedpan!
11) Place bedpan on floor (do not dispose, have nurse examine)
12) Ask patient if they can wipe themselves
13) Wipe with at least 2 of the proper wipes, front to back.
14) Roll soiled chux towards patient
15) Change gloves, gel
16) Place clean chux, roll other half and tuck under soiled chux
17) Roll patient onto back, warning of the bump
18) Perform Log Roll the other way
19) Remove soiled chux
20) Change gloves, gel
21) Roll out clean chux
22) Roll patient onto back
23) Place clean towel on the length of patient body (privacy)
24) Unclip side buttons and neck ties on soiled gown
25) Ask patient to hold onto towel
26) Carefully take soiled gown from under the towel, dispose in
bin
27) Quickly place clean gown on top of patient
28) Quickly remove towel from under gown, from the bottom,
and dispose in bin
29) Clip side buttons (and maybe tie the neck ties?)

Bed to Wheelchair
1) Preliminary: checked-in with nurse (1st), got wheelchair,
cleaned wheelchair, wait 2 minutes, checked again with
nurse(2nd), then entered room
2) Place wheelchair at the foot of the bed, flush to the bed
3) Ensure foot rests are put to the side
4) LOCK THE WHEELCHAIR BRAKES
5) Raise head of the bed to high position
6) Perform Swivel Technique
a. one rail up on my side
b. ask patient to scoot over to edge of bed
c. ask patient to cross legs and bend knees
d. one hand behind knees, one hand on patients
shoulder closest to me
e. use proper body mechanics
i. knees bent
ii. dont lift, but spin patient
f. ask patient to use hands to help swivel
7) Lower bed so patients feet on ground
8) Place dominant foot in-between patients feet, bend knees
9) Place hands on patients hips
10) Ask patient to help push off from bed
11) Count to 3, slowly stand up
12) Ask if patient is dizzy
13) Ask patient to place hands on my shoulders
14) Waltz or turn patient so their back to wheelchair (it better
be locked!)
15) Shuffle back to wheelchair
16) Ask patient when back of knees hit wheelchair
17) Lower patient slowly, ask them to assist by grabbing
armrests
18) Once patient seated, place their feet in the footrests (may
need to unlock wheelchair)
19) Ask patient if they have all belongings
20) Go check room, closet, etc.
a. DO NOT LEAVE PATIENT IN UNLOCKED WHEELCHAIR.
21) Exit room (remove gloves, gel out)
22) Check out with nurse or unit secretary that patient is
discharged (3rd)

23) Wheel patient to discharge location in lobby? (back into the

elevator so patient doesnt face the wall)
24) Stay with patient until transportation arrives
25) Thank the patient, but do not help patient into car
26) Clean wheelchair and return to the department
27) Check in with the nurse that patient was discharged

Bed to Gurney
1) Flat bed is a must
2) Perform Log Roll (6 steps)
3) Tuck the rolled up drawsheet underneath chux and patient
body
4) Roll patient back, warning of the bump
5) Perform Log Roll the other direction
6) Roll out the drawsheet, smooth chux on top
7) Roll patient onto back
8) Remove both rails from my side of the bed
9) Position gurney right up against the bed
10) LOCK THE GURNEY
11) Elevate gurney until it is just under height of the bed
12) Put up the guard rail on your side
13) Again, ensure that both the bed and gurney are locked
14) Roll up the drawsheet against patients body (chux inside)
15) Ask patient to cross arms and legs
16) Ask patient to tuck chin (lift head) and also lift feet
17) Slide patient to edge of bed, with underhand grip technique
a. Proper Body Mechanics: bend knees, use legs, slide,
dont lift
18) Again, ask patient to tuck chin and lift feet
19) Slide patient onto gurney
20) Unlock bed to allow other helper to get on opposite side of
gurney
21) LOCK GURNEY IMMEDIATELY
22) Raise up the other guardrail
23) Perform Log Roll to remove drawsheet, but leaving the chux
underneath patient
a. Remember to check for bedsores AGAIN
24) Ensure: both guardrails up, chux under patient, gurney
locked
25) Offer pillow
26) Offer to raise head of the gurney
Feeding a Patient

1) Preliminary: checked with nurse that patient is NOT at high

risk for aspiration (patient on ventilator or trach tube)
2) Adjust head of bed to high-Fowlers position (90 degrees)
3) Verify patient name and MR# on food tray matches patient
ID
4) Put on gloves, and Sani-wipe the tray table before placing
food on it
5) Wait 2 minutes
6) Discard gloves, gel
7) Place meal on the tray
8) Assist patient in wiping face and hands
9) Cut up food into small pieces
10) Ask patient what they would like to start with
11) Feed slowly to ensure safety
12) Talk to the patient
13) Remove tray and clean tray table
14) LEAVE THE BED IN HIGH-FOLWERS POSITION
15) Ask patient if they want assistance in cleaning up
16) Exit room (just gel)
17) REPORT TO NURSE THE % of food and liquid that patient ate
Taking Vitals
1) Clean the vital machine
2) Wait two minutes
3) Raise head of bed to Fowlers position (45-60 degrees)
4) Turn on monitor
5) Start with taking blood pressure
a. CHECK SIGNAGE. normally use left side, but DOUBLE
CHECK
b. press start
i. adult: 100-140 sys/ 60-90 dia (normal is
120/80).
6) Place oxygen sensor on opposite side as BP cuff (red light on
top of fingernail)
7) Take temperature (using new covering, and then disposing
of it)
a. normally take orally. but can do temporally and then
axillary
i. oral: 98.6F, 37C
ii. temporal: 100.4F, 37.8C
iii. axillary: 97.6F, 36.4C
8) Record temperature
9) Take pulse/hr using watch
a. use radial for adults, brachial for infants
i. adult: 60-100 beats/min
ii. children: 80-100

iii. toddlers: 100-120

iv. infants: 120-160
10) Count respirations
a. chest rise and fall
i. adult: 12-20 breaths/min
ii. children: 15-30
iii. newborn: 30-60

11) Ask pain level from 0-10

a. if 8 or above, report to nurse
12) Record all vitals
13) Remove cuff and clean
14)
Give piece of paper with vitals to nurse. (DO NOT
CHART VITALS.)