CNA Skill: Indirect Care | What Evaluators Look for on Every Skill

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Indirect Care is one of the two skills evaluated on every Florida CNA clinical skills test, along with handwashing. Unlike the other skills on the exam, Indirect Care is not a single procedure you perform at a specific time. Instead, it is a set of behaviors the two nurses evaluate throughout every skill you demonstrate during the test.

According to the Prometric Candidate Information Bulletin, Indirect Care covers care related to residents' rights and preferences, communication with the resident, resident safety, comfort and needs, and infection control. In our experience preparing students for Florida's CNA state exam since 2008, Indirect Care checkpoints are responsible for a large share of the points lost on the clinical test, because students focus on the specific skill steps and forget the fundamentals that run through all of them.

What the Evaluators Are Looking For

Every skill on the Prometric checklist includes Indirect Care checkpoints marked with "IC."

The official Prometric checklist scores exactly seven Indirect Care checkpoints, and they appear word for word on every skill:

1. Greet resident, address by name, and introduce self?
2. Provide explanations to resident about care before beginning and during care?
3. Ask resident about preferences during care?
4. Use Standard Precautions and infection control measures when providing care?
5. Ask resident about comfort or needs during care or before care completed?
6. Promote resident's rights during care?
7. Promote resident's safety during care?

The habits below are how we train students to satisfy those seven checkpoints consistently, along with the workplace fundamentals every facility expects. They fall into four categories.

Resident Rights and Preferences

• Knock on the door, ask permission to enter, and wait for an answer before walking in
• Greet the resident by their last name (Mr. González, Mrs. Smith) unless they ask you to use their first name
• Introduce yourself by name and title
• Explain the procedure before you begin: tell the resident what you are going to do
• Ask for the resident's cooperation and consent
• Provide privacy by closing the curtain or door
• Check the resident's identification bracelet
• Respect the resident's choices and preferences when possible

Communication

• Speak clearly and respectfully throughout the procedure
• Explain each step as you perform it so the resident knows what to expect
• Listen and respond to the resident's concerns or questions
• Encourage the resident to participate and do as much as they can independently
• Ask the comfort question that fits the skill before you begin: whether they feel dizzy before a transfer or a walk, whether a movement causes pain during range of motion, whether they are hungry before feeding, whether they have any mouth sores before mouth care

Safety, Comfort, and Needs

• Ensure the call light is within the resident's reach before you leave
• Check that the bed is in the appropriate position (lowered when done, raised for procedures as needed)
• Use side rails appropriately for safety, and keep the near rail up whenever you step away from the bedside, even briefly
• Use proper body mechanics to protect both yourself and the resident
• Ask the resident about their comfort throughout the procedure
• Leave the resident in a comfortable, safe position when you finish
• Before you place the call light in reach, ask whether the resident is comfortable and whether they need anything else, like a magazine or the television on

Infection Control

• Wash hands before and after every procedure
• Put on gloves before contact with body fluids, mucous membranes, or non-intact skin
• Remove and dispose of gloves properly
• Wash hands after removing gloves
• Handle soiled linens and equipment properly: dirty items go in the hamper, never on the floor
• Maintain clean and dirty separation throughout the procedure

Why Indirect Care Matters So Much

Many of our students are surprised to learn that Indirect Care checkpoints appear on every single skill's scoring sheet. You could perform the technical steps of a skill perfectly but still lose points, or fail, if you skip the Indirect Care basics. For example, failing to explain care before you begin, skipping Standard Precautions, or ignoring the resident's comfort, rights, or preferences are all Indirect Care failures that apply to every skill.

The good news is that once you internalize these behaviors, they become automatic. The same sequence (knock, greet, introduce, explain, provide privacy, wash hands, check ID) starts nearly every skill on the exam. We tell our students to think of it as a routine that bookends every procedure: the same opening steps and the same closing steps, with the specific skill in the middle.

Common Mistakes

Based on our experience, these are the Indirect Care mistakes we see most often:

• Forgetting to knock before entering: knocking is a rights-and-privacy habit that should open every skill, and nerves cause students to walk straight in and start the procedure.
• Skipping resident identification: checking the ID bracelet is standard practice in any facility and a habit worth building, though the checkpoint the evaluators score is greeting the resident by name and introducing yourself.
• Not explaining the procedure: you must tell the resident what you're going to do before you start, even if it seems obvious.
• Leaving without providing the call light: the call light is a scored checkpoint on the bedpan skill and an expected habit everywhere else, and it is one of the most commonly forgotten closing steps.
• Not washing hands at the right times: hands must be washed before and after the procedure, and after removing gloves; these fall under the Standard Precautions checkpoint.
• Forgetting to provide privacy: closing the curtain is expected for any skill involving personal care.

Test Day Tips

• Develop a mental routine for the opening and closing of every skill. Practice it until it's automatic: knock, greet by name, introduce yourself, explain procedure, provide privacy, wash hands, check ID.
• At the end of every skill, run through a quick mental checklist: call light within reach, bed lowered, resident comfortable, hands washed.
• If you realize you forgot a step (like checking the ID), you can go back and do it: the evaluator will note the correction. It's better to correct than to skip.
• Treat the person playing the resident as a real patient. Talk to them naturally and respectfully throughout the procedure.
• When in doubt, narrate what you're doing. Saying "I'm going to wash my hands now" or "Let me check your ID bracelet" helps you remember each step and shows the evaluator you're being deliberate.
• When you complete a skill, turn to the evaluator and say that you have finished. It marks the end of the skill clearly and shows you are in control.

Frequently Asked Questions

What is Indirect Care on the CNA exam?

Indirect Care is a set of behaviors evaluated throughout every skill on the Florida CNA clinical skills test. It covers four areas: residents' rights and preferences, communication, safety and comfort, and infection control. The two nurses evaluating your test score these checkpoints during every skill you perform.

Can you fail the CNA exam because of Indirect Care?

Yes. Indirect Care checkpoints appear on every skill's scoring sheet. If you consistently miss Indirect Care steps, like not washing hands, not providing privacy, or not checking the resident's ID, you can fail a skill even if the technical steps were performed correctly.

How do you practice Indirect Care?

The best way is to build the opening and closing sequences into every skill you practice. Every time you rehearse a skill at home, start with knock, greet, introduce, explain, provide privacy, wash hands, check ID, and end with call light, bed position, comfort check, wash hands. Our course walks through this routine with every skill demonstration so it becomes second nature.

Master Indirect Care with Video Demonstrations

Every skill demonstration in our online CNA course shows the full Indirect Care routine from start to finish, so you can see exactly how the opening and closing sequences look in practice. Our course includes:

• HD video demonstrations of all 22 clinical skills with Indirect Care steps included
• Detailed narration explaining each checkpoint the evaluator looks for
• Practice scenarios and tips from experienced CNA instructors
• Written exam preparation covering all five content areas

Start with a free course preview. See the quality of our video instruction before you commit.

All 22 CNA Clinical Skills

See the full CNA clinical skills guide, or jump to any skill: Handwashing · Mouth Care (Brushing Teeth) · Hand and Nail Care · Denture Care · Feeding a Resident · Taking a Pulse · Measuring Respirations · Changing an Occupied Bed · Dressing with One-Sided Weakness · Female Catheter Care · Bedpan Assistance · Emptying Urinary Drainage Bag · Female Perineal Care · Range of Motion (Lower Body) · Range of Motion (Elbow and Wrist) · Range of Motion (Shoulder) · Partial Bed Bath · Change of Position · Wheelchair Transfer · Foot Care · Ambulation with Gait Belt.