Bag Technique

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Definition

Bag technique - a tool making use of public health bag through which the nurse, during his/her home visit, can perform nursing procedures with ease and deftness, saving time and effort with the end in view of rendering effective nursing care.

Public health bag - is an essential and indispensable equipment of the public health nurse which he/she has to carry along when he/she goes out home visiting. It contains basic medications and articles which are necessary for giving care.

Rationale

To render effective nursing care to clients and /or members of the family during home visit.

Principles

1. The use of the bag technique should minimize if not totally prevent the spread of infection from individuals to families, hence, to the community.
2. Bag technique should save time and effort on the part of the nurse in the performance of nursing procedures.
3. Bag technique should not overshadow concern for the patient rather should show the effectiveness of total care given to an individual or family.
4. Bag technique can be performed in a variety of ways depending upon agency policies, actual home situation, etc., as long as principles of avoiding transfer of infection is carried out.

Special Considerations in the Use of the Bag

1. The bag should contain all necessary articles, supplies and equipment which may be used to answer emergency needs.
2. The bag and it’s contents should be cleaned as often as possible, supplies replaced and ready for use at any time.
3. The bag and it’s contents should be well protected from contact with any article in the home of the patients. Consider the bag and it’s contents clean and /or sterile while any article belonging to the patient as dirty and contaminated.
4. The arrangement of the contents of the bag should be the one most convenient to the user to facilitate the efficiency and avoid confusion.
5. Hand washing is done as frequently as the situation calls for, helps in minimizing or avoiding contamination of the bag and its contents.
6. The bag when used for a communicable case should be thoroughly cleaned and disinfected before keeping and re-using.

Contents of the Bag

• Paper lining
• Extra paper for making bag for waste materials (paper bag)
• Plastic linen/lining
• Apron
• Hand towel in plastic bag
• Soap in soap dish
• Thermometers in case [one oral and rectal]
• 2 pairs of scissors [1 surgical and 1 bandage]
• 2 pairs of forceps [ curved and straight]
• Syringes [5 ml and 2 ml]
• Hypodermic needles g. 19, 22, 23, 25
• Sterile dressings [OS, C.B]
• Sterile Cord Tie
• Adhesive Plaster
• Dressing [OS, cotton ball]
• Alcohol lamp
• Tape Measure
• Baby’s scale
• 1 pair of rubber gloves
• 2 test tubes
• Test tube holder
• Medicines
  • betadine
  • 70% alcohol
  • ophthalmic ointment (antibiotic)
  • zephiran solution
  • hydrogen peroxide
  • spirit of ammonia
  • acetic acid
  • benedict’s solution

Note: Blood Pressure Apparatus and Stethoscope are carried separately.

Steps/Procedures

Actions	Rationale
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 the bag’s handles or strap beneath the bag.	To protect the bag from contamination.
2. Ask for a basin of water and a glass of water if faucet is not available. Place these outside the work area.	To be used for handwashing. To protect the work field from being wet.
3. Open the bag, take the linen/plastic lining and spread over work field or area. The paper lining, clean side out (folded part out).	To make a non-contaminated work field or area.
4. Take out hand towel, soap dish and apron and the place them at one corner of the work area (within the confines of the linen/plastic lining).	To prepare for handwashing.
5. Do handwashing. Wipe, dry with towel. Leave the plastic wrappers of the towel in a soap dish in the bag.	Handwashing prevents possible infection from one care provider to the client.
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.	To protect the nurses’ uniform. Keeping the crease creates aesthetic appearance.
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.	To make them readily accessible.
8. Place waste paper bag outside of work area.	To prevent contamination of clean area.
9. Close the bag.	To give comfort and security, maintain personal hygiene and hasten recovery.
10. Proceed to the specific nursing care or treatment.	To prevent contamination of bag and contents.
11. After completing nursing care or treatment, clean and alcoholize the things used.	To protect caregiver and prevent spread of infection to others.
12. Do handwashing again.
13. Open the bag and put back all articles in their proper places.
14. Remove apron folding away from the body, with soiled sidefolded inwards, and the clean side out. Place it in the bag.
15. Fold the linen/plastic lining, clean; place it in the bag and close the bag.
16. Make post-visit conference on matters relevant to health care, taking anecdotal notes preparatory to final reporting.	To be used as reference for future visit.
17. Make appointment for the next visit ( either home or clinic), taking note of the date, time and purpose.	For follow-up care.

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.

Reference:

Community Health Nursing Services in the Philippines, DOH

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