Home Health Aide Student Portal

Click on the skills to review procedures discussed in this chapter.

Opening Procedure

Wash hands

Knock on the door

Introduce yourself

Explain the procedure clearly, using eye contact and ensuring understanding

Provide privacy (if needed)

Ensure bed is at proper height for procedure, bed is locked, and side rail is down for good body mechanics

Use gloves on any procedure that might provide exposure to blood or body fluids

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Donning Personal Protective Equipment

When: PPE is used when there is the potential for contact with blood or bodily fluids. Which type of PPE is used is determined by any specialty precautions the client may be on. Don PPE before client contact, preferably before entering the room.

Why: To protect the healthcare worker from exposure to infectious agents and to reduce the spread of illness.

What: Supplies needed for this skill include:

  • Mask
  • Gown
  • Gloves
  • Goggles

How:

  1. Complete your opening procedures.
  2. Open the gown from the back and insert both arms into the sleeves of the gown.
  3. Bring the gown up over your shoulders and overlap the gown in the back to cover your uniform completely.
  4. Tie the neck ties and the waist ties of the gown.
  5. Place the mask over your nose and mouth, ensuring that the moisture barrier is to the outside. Tie the upper set of strings behind your head, above your ears, and tie the lower set of strings behind your head, under your ears.
  6. Pinch the flexible nose piece to form around the bridge of your nose. Ensure that the mask has a snug fit without gaps along the cheeks or under the chin.
  7. Position the eyewear over your eyes and adjust to fit comfortably.
  8. Don gloves. Gown cuffs should be securely tucked under the gloves.

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Removing Personal Protective Equipment

When: PPE is removed after client contact is complete and the healthcare worker is no longer at risk of exposure. Contaminated PPE is removed at the doorway of the client’s room just before exiting.

Why: PPE is removed carefully to reduce the risk of contamination and limit the spread of infection.

What: Supplies needed for this skill include:

  • Mask
  • Gown
  • Gloves
  • Goggles

How:

  1. Remove gloves and discard into the wastebasket.
  2. Hand wash or hand sanitize, as appropriate.
  3. Grasp the earpieces or the headband of the goggles, and lift them away from your face.
    • If reusable, place the goggles in the designated receptacle for decontamination; if not, discard them into the wastebasket.
  4. Untie the neck and the waist ties of the gown.
  5. Slip your hands underneath the gown at the neck and shoulder. Peel away the gown from your shoulders to the upper arm area.
  6. Slip two fingers of your dominant hand under the gown cuff on the opposite sleeve. Grasping the inside sleeve of the gown with your dominant hand, pull the sleeve over your nondominant hand.
  7. With your nondominant hand covered by the gown sleeve, grasp the opposite sleeve and pull it down to cover your dominant hand.
  8. Roll the gown inside itself, only touching the inside of the gown until it is rolled into a ball inside out. Ensure that you do not touch the outside of the gown.
    • If the gown is disposable, place it in a wastebasket. If it is reusable, place it in the linen bag.
  9. Untie the bottom set of strings and then the top set of strings of the mask. Holding only the top ties, discard the mask into the wastebasket.
  10. Complete your finishing-up steps.

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Donning and Removing Gloves

Supplies needed for this skill include:

  • One pair of clean gloves (vinyl, nitrile, or latex*)

Donning Gloves

  1. Wash hands.
  2. Insert one hand into each clean glove.

Removing Gloves

  1. With your dominant hand, grab the glove at the palm/wrist area of your nondominant hand.
  2. Pull and peel the glove away from the hand. The glove should now be inside out with the contaminated side contained.
  3. Hold the removed glove in your gloved dominant hand.
  4. Slide one or two fingers of your ungloved hand under the wrist area of the remaining glove.
  5. Peel this glove off from the inside, creating a bag of both gloves.
  6. Discard the bagged gloves into the wastebasket. Hand wash or hand sanitize, as appropriate.

*Please note that many healthcare facilities will not supply latex gloves due to the risk of sensitivity and allergies associated with this product.

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Donning and Removing a Gown

Supplies needed for this skill include:

  • Isolation gown

Donning a Gown

  1. Open the gown from the back. Insert both arms into the sleeves of the gown.
  2. Bring gown up over your shoulders and overlap the gown in the back to cover your uniform completely.
  3. Tie the neck ties of the gown; tie the waist ties of the gown.

Removing a Gown

  1. With ungloved hands, untie the neck ties of the gown; untie the waist ties of the gown.
  2. Slip your hands underneath the gown at the neck and shoulder. Peel the gown away from your shoulders to the upper arm area.
  3. Slip two fingers of your dominant hand under the gown cuff on the opposite sleeve.
  4. Grasping the inside sleeve of the gown with your dominant hand, pull the sleeve over your nondominant hand.
  5. With your nondominant hand covered by the gown sleeve, grasp the opposite sleeve and it pull down to cover your dominant hand.
  6. Roll the gown inside itself, only touching the inside of the gown until it is rolled into a ball inside out. Ensure that you do not touch the outside of the gown.
  7. If the gown is disposable, place it in a wastebasket. If reusable, place it in the linen bag.
  8. Hand wash or hand sanitize, as appropriate.

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Donning and Removing a Mask

Supplies needed for this skill include:

  • Mask

Donning a Mask

  1. Place the mask over your nose and mouth.
  2. Tie the upper set of strings behind your head, above your ears; tie the lower set of strings behind your head, under your ears. If the mask has elastic bands rather than ties, place the top elastic band behind your head above your ears and the lower elastic band at the base of your head under your ears.
  3. Pinch the flexible nosepiece to form around the bridge of your nose. Ensure the mask has a snug fit without gaps along the cheeks or under the chin.

Removing a Mask

  1. Untie or unfasten the bottom ties or elastic; untie or unfasten the top ties or elastic. Continue to hold.
  2. Only holding the top ties, discard the mask into the wastebasket.
  3. Hand wash or hand sanitize, as appropriate.

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Donning and Removing Protective Eyewear

Supplies needed for this skill include:

  • Protective eyewear

Donning Protective Eyewear

  1. Position the goggles over your eyes and secure them to your head using either the earpieces or the head band.
  2. Adjust to fit comfortably. The eyewear should be snug but not tight.

Removing Protective Eyewear

  1. Using ungloved hands, grasp the earpieces or the head band of the goggles and lift them away from your face. If reusable, place the goggles in the designated receptacle for decontamination; if not, discard them into the wastebasket.
  2. Hand wash or hand sanitize, as appropriate.

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Hand Washing

When: Hand hygiene is performed before and after each client contact; after removing gloves; before and after eating, smoking, or drinking; after using the restroom; and anytime the hands become contaminated with blood or bodily fluids.

Note: Hands must be washed (hand sanitizing may not be substituted for hand washing) when hands are visibly soiled, after using the restroom, and when working with clients who are contaminated or suspected of being contaminated with norovirus or Clostridium difficile.

Why: Hand hygiene is the best way to stop the spread of infection, including nosocomial infections.

What: Supplies needed for this skill include:

  • Antimicrobial soap
  • Paper towels
  • Orange stick or nail brush, as necessary

How:

  1. Remove any rings you may be wearing. Push your watch up your wrist approximately 2 inches.
  2. Turn on the faucet with a paper towel. Check the temperature of the water with the opposite hand. The water should be warm, not hot. Discard the paper towel in a wastebasket.
  3. Wet both hands with fingertips pointing downward.
  4. Apply a quarter-size amount of antimicrobial soap to the palm of one hand.
  5. Vigorously lather outside the stream of water for at least 20 seconds.
    • Lather up to 1 inch above your wrists, all surfaces of your hands including the palms, tops of your hands, in between fingers, and under nails.
    • You may use an orange stick or nail brush to clean under the nails.
  6. Rinse the soap off of your hands starting at the wrist with your fingertips pointing downward.
  7. Dry hands thoroughly with a clean paper towel. Use more towels as necessary. Discard the paper towel into the wastebasket.
  8. With a clean paper towel, turn off the faucet. Discard the paper towel into the wastebasket.
  9. Apply a small amount of hand cream to prevent dermatitis and cracking.

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Hand Sanitizing

When: Hand hygiene is performed before and after each client contact; after removing gloves; before and after eating, smoking, or drinking; after using the restroom; and anytime the hands become contaminated with blood or bodily fluids.

Note: Hands must be washed (hand sanitizing may not be substituted for hand washing) when hands are visibly soiled, after using the restroom, and when working with clients who are contaminated or suspected of being contaminated with norovirus or Clostridium difficile.

Why: Hand hygiene is the best way to stop the spread of infection, including nosocomial infections.

What: Supplies needed for this skill include:

  • Hand sanitizer

How:

  1. Determine that it is appropriate to hand sanitize versus hand wash.
  2. Apply a dime-size amount of decontaminate to the palm of one hand.
  3. Rub your hands together, including all surfaces of your hands—palms, top of your hands, and in between your fingers.
  4. Continue to rub until your hands are completely dry.

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Participate in Client Care Planning

When: On an ongoing basis as clients’ needs change.

Why: To holistically meet the needs of the client through interdisciplinary communications.

What: Supplies needed for this skill include

  • None

How:

  1. Complete caregiving needs for the client making note of level of assistance for ADLs, holistic wellbeing, and any changes of condition.
  2. Accurately document when within normal limits and there are no changes in condition, and report any findings outside of the normal limits or changes in condition to the nurse per your facility policy.
  3. Provide information for care planning purposes and participate in the care planning process as requested by the nurse.

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Closing Procedure

Ensure that the bedside table is within reach

Ask if the client needs anything before you go

Put bed in low position with side rail up, making sure bed is still locked

Remove gloves, if worn

Provide call light within reach

Open privacy curtain

Wash hands

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