1. NACES Contacts
Jean Morita, MSN, MBA, NEA-BC, RN Program Director Linda Sue White, BSN, RN Associate Program Director Marilyn Golden, BSN, RN Rolando Gonzalez Program Coordinator Kristen Duplechian Administrative Assistant

2. MISSION
To provide qualified nurse aide candidates the opportunity to achieve certification by demonstrating their skills in a supportive and objective environment so the state’s most vulnerable citizens are assured safe and competent care.

3. Candidate Examination Expectations – Written Exam Page 10 -13 of Candidate Handbook
Check-in (candidate needs to arrive 30 minutes prior to start of exam time)
If arrive even one minute past the exam time, NAE is not permitted to admit the candidate and they will have to reschedule at their own cost
2 forms of current, not expired, official signature bearing ID’s, one must be U.S. government- issued social security card, signed and non-laminated and one must be a photo bearing ID from the approved list

4. Candidate Examination Expectations – Written Exam Page 10 -13 of Candidate Handbook
Check-in
Sign roster – names on roster and IDs must match!
If hyphen/suffix is in IDs for first or last name, must be on roster (how candidate registered)
NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually)
Seated 3’ apart facing same direction
Candidate has up to 2 hours to complete exam

5. Candidate Examination Expectations – Skills Exam Page 20-24 of Candidate Handbook
Check-in (candidate needs to arrive 30 minutes prior to start of exam time)
2 forms of current, not expired, official signature bearing ID’s, one must be U.S. government- issued social security card, signed and non-laminated and one must be a photo bearing ID from the approved list
Sign roster – names on roster and IDs must match!
If hyphen is in IDs for first or last name, must be hyphen on roster (how candidate registered)
If skills only, NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually)
Candidates will be brought into testing area in pairs

6. Skills Exam Expectations (Continued)
NAE will read “client” instructions aloud to both candidates
NAE will identify and demonstrate all equipment and supplies in testing area to both candidates
NAE will read specific instructions to testing candidate aloud and provide written skills card
Candidates may ask questions about supplies and equipment prior to the beginning of the exam
NAE will use a timer, will provide a 5 minute remaining reminder
NAE may stop the timer and halt the exam in certain circumstances BP skill, Mannequin placement, Equipment malfunction, etc.

7. Skills Exam Expectations (Continued)
Candidates may be stopped to don or remove gloves for sanitary reasons
NAE may not answer candidate questions about skills before, during or after the exam!
Guests, visitors, pets, or children are NOT allowed at the testing site – guest would include program personnel. We do not want the program personnel engaging the NAE during a testing event.
Questions regarding the testing event or any grievances from candidates should be directed to Pearson VUE or NACES in writing following the testing event.

8. Candidate Grievance Procedure Page 44 of Candidate Handbook
NAEs are not permitted to discuss the candidate’s exam results with candidate or instructors
If candidate determines a grievance needs to be submitted, it must be written and sent (along with Score Report(s) to NACES or the State within 30 days of exam date -NACES APD reviews grievance to determine whether or not it is substantiated. Resources used for this determination may include but are not limited to:
Order and review of Score Report(s) and Measurement sheet
Contact NAE and review of NAE’s detailed notes
Review NAE Incident Report
Call and survey other candidates on their test experience
Reference testing materials and Candidate Handbook
Review findings with other APD(s) and Program Director (PD)
Determination letter is written and sent to candidate including detailed resolution of grievance within 30 days of NACES receipt
State is notified of resolution

9. All Skills mentioned in remaining slides can be found in Candidate Handbook pages 25-40
There is a table of contents for the skills in the CTE electronic program!

10. High School vs State July 2013 – June 2014 Five Skills with Lowest Pass Rates HS
High School Pass %
State
Pass %
Provides Mouth Care
78%
75%
Provides Perineal Care
79%
70%
Gives Modified Bed Bath
80%
Positions on Side
83%
Provides Catheter Care
Overall Pass Rate
61%
Positions on Side not one of the lowest performing skills state wide.
Do not have stats for steps missed for this skill. You will need to add your thoughts on this skill the same as you did for Urinary Output

11. #49 Provides Mouth Care Step # Step Description 2 19% 3 10% 8 11% 11
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 2
Privacy is provided with a curtain, screen, or door
19% 3
Before providing mouth care, client is in upright sitting position (75-90 degrees)
10% 8
Cleans mouth (including tongue and surfaces of teeth), using gentle motion
11% 11
Candidate wipes mouth and removes clothing protector
13% 12
After rinsing toothbrush, empty, rinse, and dry the basin and place used toothbrush in designated basin/container
24% 15
After placing basin and toothbrush in designated dirty supply area and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands
18% 16
Signaling device is within reach and bed is in low position

12. #49 Provides mouth Care
Step #2 – Privacy is provided with a curtain screen or door
Candidates may forget for this skill as it is not one where the client will be ‘exposed’. Remember, if candidate provides privacy for first skill it is required and never pulls curtain back to un-provide, they will receive credit for any other skill it is required.
Step #12 – After rinsing toothbrush, empty, rinse and dry the basin and place used toothbrush in designated basin/container.
Candidate has to do all components to get credit – many will throw the toothbrush away, or they forget to rinse the toothbrush or dry the basin.
Step #15 – After placing basin and toothbrush in designated dirty supply area, and disposing of used linens, removes and disposes of gloves (without contaminating self) into waste container and washes hands
Candidates must do all components to get credit – many miss this one automatically due to throwing the toothbrush away or again, they contaminate themselves when removing their gloves.

13. Skills Clarifications
Provides Mouth Care Step 13: Places basin and toothbrush in designated dirty supply area.
Previously: If candidate starts to store toothbrush in area other than basin or designated dirty supply area, direct candidate to place in basin or dispose of into wastebasket and mark “YES” for this step.
NCSBN clarification (10/5/2013): The toothbrush is to be placed in the basin and disposed of in the designated dirty supply area not the waste basket. If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step.
Step 13 is missed by 9% of candidates in NC

14. #50 Provides Perineal Care for Female
Step #
Step Description
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 3
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
20% 9
Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke
14% 11
After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel
22% 13
Empties, rinses, and dries basin
16% 14
After rinsing and drying basin, places basin in designated dirty supply area
13% 15
Disposes of used lined into soiled linen container and disposes of linen protector appropriately
11% 17
After disposing of used lined and placing equipment, in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes hands 18
Signaling device is within reach and bed is in low position
10%

15. #50 Provides Perineal Care for Female
Step #3 - Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
Candidate had to do all components to get credit -usually does one or the other but not both. Make sure they are very obvious about this to the NAE.
Step #11 – After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel.
Candidate has to do all components to get credit – sometimes they forget to do this step entirely. Sometimes they do it all correct except they forget to dry using a towel. Sometimes they do not wipe anywhere near the rectum, just the buttocks or they wipe back to front.
Step #13 – Empties, rinses, and dries basin
Candidate will forget to either rinse or dry or sometimes, both and just place in dirty supply area after emptying
Step #17 – After disposing of used linen, and placing used equipment in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes hands
Candidates must do all components to get credit – many contaminate themselves while removing gloves (must be glove to glove then skin to skin). Can also miss automatically if they forget to dispose of the linens.

16. Skills Clarifications
 Provides Perineal Care for Female Client
Step 14: After rinsing and drying basin, places basin in designated dirty supply area. Previously: If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “YES” for this step.
NCSBN clarification (10/5/2013): If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step. 
Step 14 is not a frequently missed step but 13% of candidates in NC miss this step

17. #40 Gives Modified Bed Bath (Face & One Arm, Hand & Underarm)
Step #
Step Description
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 2
Privacy is provided with a curtain, screen, or door
11% 3
Removes gown while keeping client covered
35% 4
Before washing checks water temperature for safety and comfort and asks client to verify comfort of water
14% 6
Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each eye, washing inner aspect to outer aspect then proceeds to wash face.
12% 7
Dries face with towel
16% 13
Puts clean gown on client
32% 14
Empties, rinses, and dries basin 15
After rinsing and drying basin, places basin in designated dirty supply area 18
After placing basin in designated dirty supply area, and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands
15%

18. #40 Gives Modified Bed Bath (Face & One Arm, Hand & Underarm)
Step #3 –Removes gown and places in soiled linen container, while avoiding overexposure of the client
Forget to take the gown off all together
Only partially remove off arm being washed and then once bath is finished they just put dirty gown back on
Take gown off but then do not immediately place in soiled linen container
Step #7 - Dries face with towel
Candidate must use a towel (can be hand towel)
Step #13 – Put clean gown on client
If candidate forgets to take the gown off, they will miss this step
No skills clarifications for this skill

19. #46 Positions on side Step # Step Description 2 12% 6 19% 7 10% 8 10
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 2
Privacy is provided with a curtain, screen or door
12% 6
Places or adjusts pillow under head for support
19% 7
Candidate positions client so that client is not laying on arm
10% 8
Supports top arm with supportive device 10
Places supportive device between legs with top knee flexed; knee and ankle supported

20. #46 Positions On Side
Step #6 –Places or adjusts pillow under head for support
Forget to ‘touch’ the pillow (even if ends up correctly placed after turning on side, candidate must touch it)
Step #8 – Supports top arm with supportive device
Candidates forget to do this step or some place it under the bottom arm

21. Skills Clarifications
Positions on Side
Step 5: Slowly rolls onto side as one unit toward raised side rail.
Question: Is it acceptable to cross ankle and/or reposition client’s knee prior to turning/perform log roll for this step?
Clarification (06/02/14): Lateral positioning (this skill) is not the same as logrolling. The reference specifies that “the upper leg is in front of the lower leg,” which may make it make it wrong to cross the client’s ankles.
Step 7:Candidate positions client so that client is not lying on arm
Previously: candidate had to touch the client’s arm
NCSBN clarification (11/13/13): The candidate may observe that the client is not lying on his or her arm without having to actually touch it. As long as proper placement of the client lying on arm has been met, this step has been met.

22. #47 Provides Catheter Care for Female
Step #
Step Description
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 3
Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
23% 5
Places line protector under perineal area before washing
12% 8
While holding catheter at meatus without tugging, cleans at least 4 inches of catheter from meatus moving in only 1 direction (away from meatus) using a clean area of the cloth for each stroke
16% 9
While holding catheter at meatus without tugging, rinses at least 4 inches of catheter from meatus, moving only in 1 direction, away from meatus, using a clean area of the cloth for each stroke
17% 10
While holding catheter at meatus without tugging, dries at least 4 inches of catheter moving away from meatus
15% 11
Empties, rinses, and dries basin 12
After rinsing and drying basin, places basin in designated dirty supply area 13
Disposes of used lined into soiled linen container and disposes of linen protector appropriately
14% 15
After disposing of used lined and cleaning equipment, removes and disposes of gloves (without contaminating self) into waste container and washes hands

23. #47 Provides Catheter Care for Female
Step #3 - Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water
Candidate usually does one or the other but not both –make sure they are very obvious about this to the NAE
Steps # 8 & #9 - While holding catheter at meatus without tugging, cleans/rinses at least four inches of catheter from meatus, moving in only one direction (i.e., away from meatus) using a clean area of the cloth for each stroke
For both steps, Candidate has to hold at the Meatus, no tugging, wash/rinse front to back. Ok to use the one or three swipe technique.
Step #11 – Empties, rinses, and dries basin
Candidate will forget to either rinse or dry or sometimes, both and just place in dirty supply area after emptying

24. Skills Clarifications
Provides Catheter Care for Female Step 12: After rinsing and drying basin, places basin in designated dirty supply area.
Previously: If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “YES” for this step.
NCSBN clarification (10/5/2013): If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step.
This step is missed by 12% of candidates in NC

25. #33 Assists with use of Bedpan
Step #
Step Description
Fail rate for the step is
10% - 15%
Fail rate for the step is 16% -25%
Fail rate for the step is >26% 4
Puts on clean gloves before handling bedpan
13% 6
Removes and disposes of gloves (without contaminating self) into waste container and washes hands
42% 7
After positioning client on bedpan and removing gloves, raises head of bed
26% 9
Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished
16% 12
Head of bed is lowered before bedpan is removed 14
Empties and rinses bedpan and pours rinse into toilet
17%

26. #33 Assists with use of bedpan
Step #6 – Removes and disposes of gloves (without contaminating self) into waste container and washes hands
Candidate has to do all components to get credit –many forget to remove their gloves before continuing with the skill and/or contaminate themselves when they do. Remember, if the NAE has to remind the candidate to remove their gloves, they can’t correct it and get a ‘no’.
Step #7 - After positioning client on bedpan and removing gloves, raises head of bed
Candidate forgets to raise the head of the bed
Step #9 – Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished.
Candidate has to do all components to get credit – many forget to instruct the client what to do with the wipe
Step #14 – Empties and rinses bedpan and pours rinse into toilet
Candidate will forget to pour the rinse into toilet

27. Skills Clarifications
Assists with Use of Bedpan Step 15: after rinsing bedpan, places bedpan in designated dirty supply area.
Previously: If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “YES” for this step.
NCSBN clarification (10/5/2013): If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step.
Step 15 is missed by 7% of candidates in NC