HOME VISIT STEPS

1. Greet the patient and introduce yourself.

2. State the purpose of the visit
3. Observe the patient and determine the health needs.
4. Put the bag in a convenient place and then proceed to perform the bag technique.
5. Perform the nursing care needed and give health teachings.
6. Record all important date, observation and care rendered.
7. Make appointment for a return visit.

Action Rationale

Upon arrival at the patient’s home, place the To protect the bag from getting contaminated.
bag on the table lined with a clean paper.
The clean side must be out and the folder
part, touching the table

Ask for a basing of water or a glass of To be used for hand washing.

drinking water if tap waster is not available.

BAG TECHNIQUE STEPS Points to consider

1. The bag should contain all the necessary articles, supplies and equipment that will be used to
answer the emergency needs
2. The bag and its contents should be cleaned very often, the supplies replaced and ready for use
anytime.
3. The bag and its contents should be well protected from contact with any article in the patient’s
home.
4. Consider the bag and its contents clean and sterile, while articles that belong to the patients as
dirty and contaminated.
5. The arrangement of the contents of the bag should be the one most convenient to the user, to
facilitate efficiency and avoid confusion.

Steps
The following are steps in performing bag technique and rationale for each action:

Action Rationale

To prepare for hand washing.

Open the bag and take out the towel and
soap.

Wash hands using soap and water, wipe to dry. To prevent infection from the care provider to the
client.

Take out the apron from the bag and put it on with To protect the nurse’s uniform.
the right side

Put out all the necessary articles needed for the To have them readily accessible
specific care.

Close the bag and put it in one corner of the To prevent contamination
working area.

Proceed in performing the necessary nursing care To give comfort and security and hasten recovery
treatment.

After giving the treatment, clean all things that were To protect the caregiver and prevent infection
used and perform hand washing.

Open the bag and return all things that were used in
their proper places after cleaning them.

Remove apron, folding it away from the person, the Remove apron, folding it away from the person, the
soiled side in and the clean side out. soiled side in and the clean side out. Place it in the
bag.

Fold the lining, place it inside the bag and close the
bag

Take the record and have a talk with the mother. Write down all the necessary data that were gathered,
observations, nursing care and treatment rendered. Give instructions for care of patients in the absence of
the nurse.

Make appointment for the next visit (either For follow-up care
home or clinic) taking note of the date and
time.

DRY (WOUND) DRESSING STEPS

Applying a Dry (Wound) Dressing

Dressing care may vary according to the surgeon’s preference and agency or institutional policy.
Cleaning solutions can dry the wound and interfere with wound healing at the cellular level.
Although they reduce the risk of infection, frequent application may not be necessary.

Materials
Clean exam gloves
Container for proper disposal of soiled dressing
Sterile 4 3 4 gauze pads
Washcloth (optional)
ABD pads (optional)
2-inch tape (foam or paper)

Client Education
1. Review where and how to obtain additional supplies.
2. Review how to properly dispose of contaminated dressings.
3. Review discharge instructions which should include how to care for the dressing at home,
and when and who to call if the client experiences problems with the dressing change or
wound care.
4. Review problems that might occur during dressing changes, including fever, bleeding,
infected wound, and pain management.

PROCEDURE
Action
1. Gather supplies.
2. Provide privacy; draw curtains; close door.
3. Explain procedure to client.
4. Wash hands.
5. Apply clean exam gloves.
6. Remove dressing and place in appropriate
receptacle. Remove soiled gloves with
contaminated surfaces inward and discard in
appropriate receptacle and apply clean gloves.
Rationale
1. Promotes a smooth work flow.
2. Maintains client comfort and privacy while
body is exposed during procedure.
3. Provides information about the procedure.
4. Reduces the transmission of microorganisms.
5. Infection control and protection from body
fluids.
6. Dressings and gloves soiled with body fluids
are considered contaminated and subject to
biohazard disposal in the correct manner per
institution protocol.
It is standard for the surgeon to do the first
postoperative dressing change. The initial
dressing is maintained for 24–48 hours
postoperatively,
unless conditions of the dressing call for
contacting the physician or qualified practitioner
for a dressing change order. Until the removal of
the initial dressing, the nurse will reinforce the
dressing as needed. The frequency of the
dressing change is dependent upon the needs of
the wound and the preference of the physician or
qualified practitioner. This will usually be
specified in the orders.

7. Assess the appearance of the undressed 7. Assess for signs of redness, foul odor,
wound bed for healing. swelling, irritation, drainage, dehiscence,
bleeding, or skin breakdown.
8. Cleanse the skin around the incision if 8. Dried blood or drainage on the surrounding
necessary with a clean, warm, wet washcloth.
• If the suture line requires cleansing, it
should be done gently. Use normal saline,
half-strength hydrogen peroxide, or Betadine
swab (consult orders of physician or qualified
practitioner and/or hospital policy regarding
antiseptic agents) and cotton tip applicators
using a rolling motion. Clean from cleanest to
dirtiest.
• Used applicators should not be reintroduced
into the sterile solution.
9. Remove used exam gloves.
10. Wash hands.
11. Set up supplies.
12. Apply a new pair of clean exam gloves.
13. Grasping just the edges, apply a new dressing
using 4 3 4 gauze pads folded in half to the 2 3 4
size. Place the folded gauze pad lengthwise on
wound and tape lightly or apply tubular mesh for
those with sensitive skin. Initial the dressing,
date and time it was changed.
Optional: An ABD pad may be applied on
top of the dressing for added protection over
sutures or for client comfort.
14. Remove gloves and dispose of appropriately,
then wash hands.
15. Conduct client/family education about the
dressing, which may include teaching the
dressing technique to the client/family.
skin can be an irritant and a medium for
microbes.
• The suture line itself should not be
disturbed unnecessarily.
• Reintroduction of the soiled applicator
into sterile solution will contaminate the solution.
9. Exam gloves used to remove the old dressing
are considered dirty and should be removed
and discarded appropriately.
10. Hands should be washed prior to setting up
dressing supplies to reduce the transmission of
microorganisms.
11. Following removal of the dressing, you will
have a better idea of what supplies are needed
and in what amount.
12. This is considered to be a clean procedure
after the initial dressing is removed if the skin
margins are approximated with the skin closures.
13. A light dressing of 4 3 4 pads may be the only
dressing that is needed to protect the incision
from clothing or to collect a small amount of
tissue drainage. This maintains a record of the
dressing change for the next nurse.
14. Reduces the transmission of microorganisms.
15. Educates the client/family and prepares for
discharge.