You will need the following when Performing Hand and Nail Care on a Resident: 

• Barrier
• Towel
• Orangewood Stick
• Bath Basin
• Soap
• Emery Board
• 2 Washcloths
• Lotion
• Gloves

1. Preparation & Hand Hygiene

• Read and follow the Care Plan, the whole Care Plan, and nothing but the Care Plan
• Knock and announce yourself before entering.
• Greet the Resident by name and introduce yourself.
• Explain the task to the Resident and ensure their comfort and consent.
• Close the Privacy Curtain.
• Wash your hands thoroughly.
• Place Barrier on Bedside table.
• Gather your supplies
  • Do Not allow supplies to touch your Uniform. 
  • Do Not touch supplies until your hands are clean.
• Place Supplies on Barrier.
• Assess Glove Rules (Are Gloves required for this Resident?)

2. Performing Hand Care

• Retrieve Wash Basin and bring to the sink. 
• Use a paper towel to turn water on. 
• Using your forearm, verify water temperature. 
• Using Warm water, fill Wash Basin.
• Ask Resident to Check Water Temperature.
  • Adjust Temperature accordingly.
• Once Temperature is acceptable, ask Resident to submerge their hand in the water. 
• Place Washcloths in Basin. 
• Using one washcloth, wring it out over Basin, and use it to wet Resident’s Hand.
  • Place this washcloth on side of Wash Basin. 
• Lift Resident’s Hand and place gently on towel next to Wash Basin. 
• Using the other Washcloth, and the LEAVES Method:
  • Apply Soap to the washcloth and wipe down all areas of the Resident’s Hand.
  • Back of Hand
  • Front of Hand
  • In between fingers and thumb.
  • Palm
  • Fingertips.
• Place Resident’s Hand back into the Wash Basin.  
• Rinse Resident’s Hand using Rinse Washcloth.
• Gently Place Resident’s Hand back onto Towel next to Washbasin.
• Dry all areas of Resident’s Hand using the Towel. 

3. Performing Nail Care

• Using the angled side of the Orange Stick, gently clean  edge area underneath Resident’s Nails.
  • Careful not to tear Cuticles. 
  • DO NOT USE POINTED END.
• Wipe Orange Stick off on Towel between cleaning each Nail.
• Ask Resident about discomfort or pain throughout.  
• Using  the Emory Board,  gently AND slowly file down each nail.
  • ALWAYS file from the edge to the center. 
  • NEVER FILE SIDE TO SIDE.
• Apply a small amount of lotion to Resident, warming it up in your hands, before applying. 
• Wipe off Excess lotion with Towel. 

4. Supply Disposal

• Place towel and wash cloths in Soiled Linens. 
• Pour Wash Basin into Sink. 
• Clean Wash Basin per Facility guidelines.
• Use a Paper Towel to pick up Wash Basin
• Dry Wash Basin with Paper Towels. 
• Return to your supplies and place Lotion and Soap into Wash Basin.
• Use a paper towel to open Bedside Table 
• Place Wash Basin in Bedside Table.
• Dispose of Barrier, Orange Stick and Emory Board in the garbage. 
• Remove and dispose of Gloves. 

5. Addressing Resident Comfort & Closing

• Ensure Resident is comfortable.
• Ask about Resident needs and preferences.
• Provide Resident with Call light.
• Open Privacy Curtain and ensure bed is in lowest position.
• Thoroughly wash your hands.
• Think about the Steps of your Skill. Make any corrections. Tell the evaluator your Skills is complete

• Not reading and following the Care Plan, the whole Care Plan, and nothing but the Care Plan.
• Not greeting Resident or describing Task. 
• Not verifying Water Temperature with Resident
• Forcing Resident to use a Water Temperature that is uncomfortable/harmful. 
• Not thoroughly washing your hands.
• Not gathering your supplies. 
• Not thoroughly Washing/Applying soap/Rinsing Resident’s Hand.
• Jamming Wood Stick into Resident’s Nails. 
• Using pointed end of Wooden Stick to clean Resident’s Nails.  
• Aggressively Filing Resident’s Nails. 
• Not Filing towards the center when filing Resident’s Nails. 
• Not warming Lotion in your hands prior to applying to the Resident. 
• Not wiping off Excess Lotion from Resident’s Hand. 
• Not providing Resident with Call light.