College of Nursing Bag Technique Checklist Name: - Date: - Year/Section/ Group: - Definition

UNIVERSITY VISION UNIVERSITY MISSION
The premier University in CaviteStateUniversity shall provide

Historic Cavite recognized equitable and relevant educational
opportunities in the arts, sciences and
for excellence in the
technology through quality instruction
development of globally
and responsive research and
competitive and morally College of development activities.
upright individuals.
Nursing skilled
It shall produce professional,
and morally upright
Bag Technique Checklist individuals for global
competitiveness.
Name: _____________________________________ Date: __________________

Year/Section/ Group: _________________________
Definition:
 It is a tool making use of a public health bag through which the nurse, during his/her
home visit can perform nursing procedures with ease; less time and effort and renders
effective nursing care.
Purpose:
 To render effective nursing care to clients and/or members of the family during home
visit.
CONTENTS OF BAG AND ITS ARRANGEMENT

Front of bag, left to right
- Oral thermometer
- Rectal thermometer
·On right near end of bag

- Test tube and holder
-Medicine dropper
On left near end of bag

-Medicine glass
- Weighing scale
-Bandage scissors
Back of bag(left & right)

-Alcohol 70% -Opthalmic ointment
- Acetic acid -Hydrogen Peroxide
-Aromatic spirit of ammonia -Zephran Solution
-Benedict's solution -Spirit of ammonia
-Betadine -Acetic Solution
Center of bag
-Forceps (straight & curved) -Syringe and needles in container 5 & 2ml
-Roller bandage -Tape measure
-Alcohol lamp with - Cord clamp
denatured alcohol
- Kidney basin -Rubber gloves
On top file center bag
- Hand towel -New paper to serve as lining
- Soap on a soap dish -Apron
-Paper waste bag in -Plastic lining
pocket of bag
NOTE: Blood pressure apparatus and stethoscope are carried separately.

 Package containing a sterile drape
 Sterile equipments as needed,wrapped sterile gauze,antiseptic solution
Procedure Rationale
1. Upon arriving at the client’s home, place To protect the bag from contamination
the bag on the table or any flat surface lined
with paper lining, clean side out (Folded
part touching the table). Put bag’s handles
or strap beneath the bag.
2. Ask for a basin of water and a glass of To be used for hand washing
water if faucet is not available. Place To protect the work field from being wet.
these outside the work area.
3. Open the bag, take the linen/ plastic To make a non- contaminated work field or
lining spread over work field or area. area.
The paper lining, clean side out (folded
part out).
4. Take out hand towel, soap dish and To prepare for hand washing
apron and place them at one corner of
the work area (within the confines of
the linen/ plastic lining).
5. Do hand washing. Wipe, dry with Hand washing prevents possible infection from
towel. Leave the plastic wrappers of the care provider to the client.
towel in soap dish in the bag.
6. Put on apron right side out and wrong To protect the nurse’s uniform. Keeping the
side with crease touching the body, crease creates aesthetic appearance.
sliding the head into the neck strap.
Neatly tie the straps at the back.
7. Put out things most needed for the To make them readily accessible.
specific case (e.g. thermometer, kidney
basin, cotton ball, waste paper bag) and
place at one corner of the work area.
8. Place waste paper bag outside of work To prevent contamination of clean area.
area.
9. Close the bag. To give comfort and security, maintain
personal hygiene and hasten recovery.
10. Proceed to the specific nursing care or To prevent contamination of bag and contents.
treatment.
11. After completing nursing care or To protect care giver and prevent spread of
treatment, clean and alcoholize the infection to others.
things used.
12. Do hand washing again.
13. Open the bag and put back all articles in

their proper places.
14. Remove apron folding away from the
body, Keep/discard all soiled materials
use in the Paper waste bag.
15. Fold the linen/ plastic lining, clean;
place it in the bag and close the bag.
16. Make past visit conference on matters To be used as reference for future visit and
relevant to health care, taking anecdotal follow up
notes preparatory to final reporting.
17. Record all relevant findings in client To provide data for the next visit or follow up
and members of family and document care.
all nursing care treatment done.
18. Make appointment for the next visit To ensure client’s availability.
(either home or clinic), taking note of
the date, time and purpose.
After care
1. Before keeping all articles in the bag, clean and alcoholize them.
2. Get the bag from the table, fold the paper lining (and insert), and place in between the
flaps and cover the bag.
Evaluation and documentation
3. Record all relevant findings about the client and members of the family.
4. Take note of environmental factors which affect the clients/ family health.
5. Include quality of nurse- patient relationship.
6. Assess effectiveness of nursing care provided.
UNIVERSITY VISION UNIVERSITY MISSION

The PremierUniversity in Republic of the Philippines Cavite State University shall provide
Historic Cavite recognized for
excellence in the development
CAVITE STATE UNIVERSITY excellent equitable and relevant
educational opportunities in the arts,
of globally competitive and Don Severino de las Alas Campus science and technology through quality
morally upright individuals. Indang, Cavite instruction and responsive research and
development activities. It shall produce
professional, skilled and morally upright
individuals for global competitiveness.
(046) 415-0010 / (046) 415-0011
www.cvsu.edu.ph
cvsu.op206@gmail.com
COLLEGE OF NURSING
Name: _____________________________________ Date: __________________

Year/Section/ Group: _________________________
BAG TECHNIQUE CHECKLIST
PROCEDURE Very Good Fair Needs

Good 3 2 Improvement
4 1
1. Upon arriving at the client’s home, place the bag
on the table or any flat surface lined with paper
lining, clean side out (Folded part touching the
table). Put bag’s handles or strap beneath the bag.
2. Ask for a basin of water and a glass of water if
faucet is not available. Place these outside the
work area.
3. Open the bag, take the linen/ plastic lining
spread over work field or area. The paper
lining, clean side out (folded part out).
4. Take out hand towel, soap dish and apron and
place them at one corner of the work area
(within the confines of the linen/ plastic
lining).
5. Do hand washing. Wipe, dry with towel.
Leave the plastic wrappers of the towel in soap
dish in the bag.
6. Put on apron right side out and wrong side
with crease touching the body, sliding the head
into the neck strap. Neatly tie the straps at the
back.
7. Put out things most needed for the specific
case (e.g. thermometer, kidney basin, cotton
ball, waste paper bag) and place at one corner
of the work area.
8. Place waste paper bag outside of work area.
9. Close the bag.
10. Proceed to the specific nursing care or
treatment.
11. After completing nursing care or treatment,
clean and alcoholize the things used.
12. Do hand washing again.
13. Open the bag and put back all articles in their
proper places.
14. Remove apron folding away from the body,
Keep/discard all soiled materials use in the
Paper waste bag
15. Fold the linen/ plastic lining, clean; place it in
the bag and close the bag.
16. Make past visit conference on matters relevant
to health care, taking anecdotal notes
preparatory to final reporting.
17. Record all relevant findings in client and
members of family and document all nursing
care treatment done.
18. Make appointment for the next visit (either
home or clinic), taking note of the date, time
and purpose.
19. Upon arriving at the client’s home, place the bag
on the table or any flat surface lined with paper
lining, clean side out (Folded part touching the
table). Put bag’s handles or strap beneath the bag.
TOTAL SCORE__________
Remarks: _____________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Total Score: 76
Passing Score: 53
____________________________ ______________________________
Clinical Instructor Signature Student Signature

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UNIVERSITY VISION UNIVERSITY MISSION

The premier University in CaviteStateUniversity shall provide

Name: ___________________ Date:

CONTENTS OF BAG AND ITS ARRANGEMENT

·On right near end of bag

On left near end of bag

Back of bag(left & right)

NOTE: Blood pressure apparatus and stethoscope are carried separately.

13. Open the bag and put back all articles in

Evaluation and documentation

UNIVERSITY VISION UNIVERSITY MISSION

Name: ___________________ Date:

BAG TECHNIQUE CHECKLIST

PROCEDURE Very Good Fair Needs

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