Ateneo de Zamboanga University

College of Nursing
PERFORMANCE EVALUATION CHECKLIST
BAG TECHNIQUE

NAME: _____________________________ DATE PERFORMED: _________________

YEAR & SECTION: ___________________________
Legend (Rating Criteria):
5 – Expert (student performs all tasks proficiently and independently).
4 – Competent (student performs efficiently in an effective and efficient manner).
3 – Progress Acceptable (performance is usually effective and but not always).
2 – Needs Improvement (progress in performance is too slow to judge satisfactorily; task performance is not
most of the time).
1 – Progress Unacceptable (no progress in performance has been demonstrated, and or performance is
consistently ineffective and inefficient).
Purposes:
1. To minimize if not prevent the danger of the spread of any infection.
2. To work efficiently and rapidly using technique as a tool to save time and effort.
Bag Technique
● The bag technique is a tool by which the nurse, during her visit will enable her to perform a nursing procedure
with ease and deftness, to save time and effort, with the end view of rendering effective nursing care to clients.
● The public health bag is an essential and indispensable equipment of a public health nurse which she has to
carry along during her home visits. It contains basic medications and articles which are necessary for giving
care.
Principles
• Performing the bag technique will minimize, if not, prevent the spread of any infection.
• It saves time and effort in the performance of nursing procedures.
• The bag technique can be performed in a variety of ways depending on the agency’s policy, the home situation,
or as long as principles of avoiding transfer of infection is always observed.
Preparation
1. Assemble the equipment of PHN bag
PROCEDURE 1 2 3 4 5
1. Upon arrival at the patient’s home, place the bag on the table lined with a clean
paper. The clean side must be out and the folded part, touching the table. Put the
bag’s handles or strap beneath the bag.
2. Ask for a basin of water or a glass of drinking water it faucet is not available. Put
this outside the work area.
3. Open the bag and take out the towel and soap.
4. Wash hands using soap and water. Wipe to dry.
5. Take out the apron from the bag and put on with right side out.
6. Put out all the necessary articles needed for the specific care.
7. Close the bag and put it on in one corner of the working area.
8. Proceed in performing the necessary nursing care and treatment.
9. After giving the treatment, clean all things that were use &perform hand washing.
10. Open the bag and return all things that were used in their proper places after
cleaning all the things that were used and perform hand washing.
11. Remove apron, folding it away from the person, the soiled side in and the clean
side out. Place it in the bag.
12. Fold the lining, place it inside the bag and close the bag.
13. Take and record and have a talk with the mother. Write down all the necessary data
that were gathered, observations, nursing care and treatment rendered.
14. Make appointment for the next visit (either home or clinic) taking note of the date
and time.
TOTAL

__________________________
Clinical Instructor
 (Sign over printed name)

Arrangement of Content of PHN Bag 1 2 3 4 5

A. TOP POCKET
1. Gloves (Sterile)
2. Waste Receptacle
3. Plastic Bag
B. FRONT OF BAG (Left to Right)
4. Oral Thermometer
5. Rectal Thermometer
6. Axillary Thermometer
7. Disposable Syringes with Needles
C. Left Rear (Rear to Front)
8. Medicine Glass
9. Rubber Pump/Suction
10. Baby Weighing Scale
11. Tourniquet
12. Tongue Depressor
D. Back of the Bag: (from Left to Right)
13. Sterile Cotton Balls Soaked in
a. Betadine Solution
b. 70% Alcohol
c. Hydrogen Peroxide
14. Lysole Solution
15. Spirit of Ammonia (optional)
16. Benedict’s & Acetic Acid Solutions
E. Right Rear (Rear to Front)
17. Two Test Tubes & Test Tube Holder
18. Three Medicine Droppers
19. Match
20. Alcohol Lamp with Denatured Alcohol
F. Center of the Bag (Bottom to Top)
21. Kidney Basin
● Cloth Bag with the following:
22. Kelly Straight
23. Kelly Curve
24. Umbilical Scissors
25. Thumb Forceps
26. Tissue Forceps
27. Cord Clamp
● Cloth Bag with:
28. Sterile OS
29. Bandage Scissors
30. Adhesive Bandage/Plaster
31. Cotton Applicator (Individually Wrapped)
32. Two Hand Towels (White)
33. Soap Dish with Soap
34. Apron (white)
TOTAL
*BP apparatus and stethoscope are carried separately and are never placed in the bag

_________________________
Clinical Instructor
(Sign over printed name)
 Arrangement of Content of PHN Bag 1 2 3 4 5

G. Left Rear
1. Baby’s scale
2. Bandage Scissors
H. Back of the Bag: (from Left to Right)
3. 70% alcohol
4. Betadine
5. Spirit of Ammonia (optional)
6. Hydrogen peroxide
7. Solution of Ophthalmic ointment
8. Solution of Benedicts solution
9. Bottle of Cotton Balls (Dry and with Alcohol)
I. Right Rear
10. Two test tubes
11. Test tube holders
J. Center of the Bag
12. Sterile dressing
13. Tape measure
14. Disposable syringes with needles (g 23 & g 25)
Hypodermic needles (g 19, 22, 23,25)
15. Microspore plaster
16. Cord clamp
17. One pair of sterile gloves
18. One pair of surgical scissors
19. Two pairs of forceps (curved and straight)
20. Alcohol lamp
K. Top of the Bag
21. Apron
22. Soap in a soap dish
23. Hand towel
24. Paper lining
Extra paper for making waste bag
Plastic/linen lining
L. Front of the Bag
25. Thermometers (oral and rectal)

TOTAL
 *BP apparatus and stethoscope are carried separately and are never placed in the bag

_________________________
Clinical Instructor
(Sign over printed name)

Bag Technique in Nursing

By
 Matt Vera, BSN, R.N.
 -
Updated on August 12, 2015
The bag technique is a tool by which the nurse, during her visit will enable her
to perform a nursing procedure with ease and deftness, to save time and effort
with the end view of rendering effective nursing care to clients.

The public health bag is an essential and indispensable equipment of a public

health nurse which she has to carry along during her home visits. It contains
basic medication and articles which are necessary for giving care.

Principles
● Performing the bag technique will minimize, if not, prevent the spread
of any infection.
● It saves time and effort in the performance of nursing procedures.
● The bag technique can be performed in a variety of ways depending on
the agency’s policy, the home situation, or as long as principles of
avoiding transfer of infection is always observed.

Contents
The following are the contents of a Public Health Nurse bag:

● Paper lining
● Extra paper for making waste bag
● Plastic/linen lining
● Apron
● Hand towel
● Soap in a soap dish
● Thermometers (oral and rectal)
● 2 pairs of scissors (surgical and bandage)
● 2 pairs of forceps (curved and straight)
● Disposable syringes with needles (g. 23 & 25)
● Hypodermic needles (g. 19, 22, 23, 25)
● Sterile dressing
● Cotton balls
● Cord clamp
● Micropore plaster
● Tape measure
● 1 pair of sterile gloves
● Baby’s scale
● Alcohol lamp
● 2 test tubes
● Test tube holders
● Solutions of:
o Betadine
 o 70% alcohol
o Zephiran solution
o Hydrogen peroxide
o Spirit of ammnonia
o Ophthalmic ointment
o Acetic acid
o Benedict’s solution
*BP apparatus and stethoscope are carried separately and are never placed in
the bag.

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

Upon arrival at the patient’s home, place the bag

on the table lined with a clean paper. The clean
To protect the bag from getting contaminated.
side must be out and the folder part, touching the
table

Ask for a basing of water or a glass of drinking

To be used for hand washing.
water if tap waster is not available.

Open the bag and take out the towel and soap. To prepare for hand washing.

To prevent infection from the care provider to the

Wash hands using soap and water, wipe to dry.
client.

Take out the apron from the bag and put it on

To protect the nurse’s uniform.
with the right side
 Action Rationale

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

To protect the caregiver and prevent infection
were 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,
soiled side in and the clean side out. Place it in the
the soiled side in and the clean side out.
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 home

For follow-up care
or clinic) taking note of the date and time.

====================================888888888888888=============

DEFINITON OF TERMS:
a. BAG TECHNIQUE- a tool use of a public health bag through whichthe public
health nurse, during his/ her home visitcan perform nursing procedures with
ease;knowing he/ she has with them their materials, itsaves time & energy with
the end view of rendering effective nursing care
b. PLAN OF VISIT- an essential tool in achieving the best results inhome visiting
c. HOME VISIT- a professional face to face contact made by a public health
nurse to the patient or the family to provide health care activities
d. FAMILY-NURSE CONTACT- the within or behalf of the particular family &the
nurse in achieving an important goal for thesuccess of delivering nursing care
e. PUBLIC HEALTH BAG- an essential & indispensible equipment for the public
health nurse which he/she has to carryalong he/ she goes home visiting-
contains basic medications which are needed for giving care
f. CASE LOAD- number & kind of families a caregiver willhandle at a given time
Purpose:
a. CHN Bag Serves as a first aid kit
 To work efficiently and swiftly during nursing
Procedures
To conserve time and energy
 To minimize or prevent the spread of infection
 To render effective nursing care to clients and/or members of the family
during home visit
b. Bag Technique
To minimize if not to prevent the spread of infection
To work efficiently and rapidly during techniques
For organization purposes
c. Home Visiting
It provides necessary health care activities
Impart health teachings to the family for maintenance of health
To evaluate results of the outcomes of the nursing care given
To know the health status of an individual or a family

DIFFERENT TYPE OF FAMILY- NURSE CONTACT:

Home Visit- health caregiver visits a home in the community
Clinic Visit- clients visit the health clinics to inquire or to seek health center
consultation, check-ups or treatments of health problem visit
Industrial Clinic Visit- nurses are hired by agencies or companies to do a
medical assessment on their employees for pre-employment check-up and
treatment on health problems
School Clinic Visit- it’s where students seek health care services from their
school- most schools have clinic wherein the nurse is always in contact with the
students who are prone to accidents

CONTENTS OF CHN BAG:

a. FRONT OF THE BAG (left to right)
- oral thermometer (facing down)
- rectal thermometer
- syringes & needles in a metal container
b. on the RIGHT SIDE OF THE BAG
- test tube & test tube holder
- medicine dropper
- match
- alcohol lamp & denatured alcohol

c. on the LEFT SIDE OF THE BAG (near to the front)

- medicine glass w/ suction inside
- baby weighing scale

d. BACK of the bag (left to right)

- betadine
- 70% alcohol
- hydrogen peroxide
- Lysol solution
- spirit of ammonia
- Benedict’s solution
e. on the CENTER OF THE BAG
- kidney basin
- cloth bag:
● Kelly curve & Kelly straight
● Umbilical scissors
● Bandages
- cloth bag w/ sterile OS, cotton balls, cotton applicators
- hand towel
- soapdish & soap
- apron

f. on the TOP POCKET

- sterile gloves
- French 12 catheter
- French 8 catheter
- cord clamp
- paper waste bags
- plastic bagsg.

TOP OF THE INNER COVER

- 5’- 8” paper soap dish lining
- 12 ½’ – 18 ½” paper lining
- 13 ½’– 19 ½” plastic lining
- 14’ – 20” paper lining- for the bottom

TYPES OF CASE LOAD:

1. morbid- for the diagnosed/ undiagnosed diseases (eg.Tuberculosis)
2. antepartum- for the pregnants
3. postpartum-after the mother’s delivery, 6 mos. after
4. health supervision- used for children under 6 years old & below
5. case finding- this is without the diagnosis by doctors or physicians
6. geriatric- for the olds, 65 years of age & above

SAMPLE PLAN OF VISIT

Name of Student: Dionne M. Perez Type of Case:Case Finding
Age: 17 Visit no.: 3
Address: Banilad, Mandaue City
Date of Visit:June 30, 2009
General Objectives:
After 2 weeks of home visiting, the family will beable to acquire adequate
knowledge, skills, and attitudes in the promotion of health, prevention of illness
and management of common diseases.
Specific Objective: After 45 minutes of nurse-client orientation, thenurse will
be able to:
1. establish rapport with the student nurse
2. explain the purpose and importance of homevisit
3. observe family’s behavior and surrounding
4. identify health related problems
5. plan appropriate nursing intervention fromidentified health problems
6. set another contact of visit
GUIDELINES IN USING THE CHN BAG
1. Perform handwashing as frequently as possibleor if the situation calls for the
help to minimize or avoid contamination of bag & its contents.
2. The CHN bag should contain all the necessaryarticles & equipment which may
be used toanswer emergency needs.
3. Contents of the bags should be protected fromcontact of different unsterilized
object.
4. The arrangement of the contents of the bagshould be the most convenient to
the users tofacilitate efficiency & so as to avoid confusion.
5. Bag technique should be performed in differentways depending upon the
policies.
6. Bag should be placed in a clean & warmtemperature.
7. Avoid shaking or swaying the bag whencarrying it.
8. The bag should be thoroughly cleaned &disinfected after using esp. if there is
acommunicable case in the area.