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CNA - Hospice Care

CNA - Hospice Care

This checklist was electronically signed on September 12, 2026

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

VITAL SIGNS (TAKE AND RECORD)

Temperature
Pulse
Respirations
Blood Pressure
Height and Weight

COMMUNICATIONS

Verbal and Non-verbal with Cognitively Impaired Patients
Maintaining Patient Confidentiality

ENVIRONMENT

Linen Change
Light Housekeeping
Meal/Snack Preparation

AMBULATING

Cane
Crutches
Walker
Standby Assistant

TRANSFER TECHNIQUE

Gait Belt
Weight Bearing
Hoyer/Easystand
Two-Person Transfer
Pivot
Wheelchair

POSITIONING/TURNING

Supine
Side Lying
Use of Draw Sheet
Range of Motion Exercises
In Chair

PERSONAL CARE

Bath
Back Rub
Applying Lotion
Decubitus Care
Shampoo
Nail Care
Oral Hygiene
Denture Care
Shaving
Dressing: Assist/Complete
Female Perineal Care
Male Perineal Care
Post-mortem Care

NUTRITION/HYDRATION

Encourage Fluids per Patient’s Orders
Types of Diet
Assist in Feeding
Feeding Techniques
Measure and Record Intake and Output

INFECTION CONTROL

Hand Washing
Universal Precautions

ELIMINATION

Bed Pan/Urinal and Fracture Pan
Bedside Commode
Measure and Record Output
Foley Catheter Care
External Catheter Care/Placement
Enemas
Urine Specimen Collection
Stool Specimen Collection
Sputum Specimen Collection

SAFETY DEVICES

Vest Restraint
Soft Ankle Restraints
Wrist Restraints

OXYGEN THERAPY

Check for Accuracy of the Flow Rate
Cannula/Mask Placement

OBSERVATIONS/REPORTING/DOCUMENTATION

Change in Body Functions
Change in Behavior
Change in Routines
Change in Mentation

ELECTRONIC DOCUMENTATION

Allscripts
Care360
Cerner
CPSI
eCLinicalWorks
Eclipsys
EPIC
MACLAB
McKesson/Paragon
Meditech
PACS
Quadramed
Soarian

AGE SPECIFIC COMPETENCIES

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18- 39 years)
Middle adults (39- 64 years)
Older adults (64-79 years)
Elderly adults (80+ years)