SILLIMAN UNIVERSITY COLLEGE OF NURSING

Dumaguete City

BAG TECHNIQUE & URINALYSIS

Performance Checklist

Student’s Name: _________________________________

Instructor’s Name: _______________________________

Instructor’s Signature: _____________________________ Date: _______________

STEPS SATISFACTORY UNSATISFACTORY REMARKS

1. Greet the client/patient.
2. Place bag on the table lined with clean
paper and tuck the handle.
1. Explain the procedure: urinalysis.
2. Provide a clean container and give proper
instruction.
3. Open the bag and take the hand washing
equipment.
4. Wash hands and wipe to dry.
5. Open the bag and Lay the cloth lining over
the paper lining.
6. Put on apron.
7. Put all the necessary equipment/supplies
needed for the care.
8. Perform the glucose, protein, specific
gravity and pH test.
a) Prepare the urine test strip.
b) Put on gloves.
c) Mix urine well.
d) Immerse the test areas of the strip &
remove immediately.
e) Run the edge of the entire length of the
strip against the rim of the container.
f) Lay the strip on a tissue paper/gauze for
1-2 seconds.
g) Read result of the test appropriately at
exactly 30 seconds.
9. Explain the results of the test to the
client/patient.
10.Do the necessary health teaching.
11.Discard the strip and urine properly.
12.Remove gloves and wash hands with soap
and water.
13.Open the bag and return the equipment
and unused supplies into their proper
places in the bag. Place wet/moist articles
inside a plastic bag.
14.Remove apron with technique.
15.Return folded cloth lining and close the
bag.
16.Lift the bag and do aftercare. Discard the
paper lining and waste receptacle.
17.Do the necessary recording.
Supplies are items of expendable nature that are consumed or worn out, deteriorate in use, or are easily broken,
damaged or lost. Examples include paper

equipment refers to the tools, machinery, devices that help create the product.