College of Nursing

Bag Technique Rubrics

Name of Student:_________________________________________________ Course Code: _____________________________

STEPS 2 1 0

A. Assemble equipment:
Paper lining
Extra paper for making waste bag/kidney basin
plastic/ linen lining
Apron
Hand Towel
Soap in 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 and 25)

Hypodermic needles g.29, 22, 23, 25
Sterile dressing
Cotton balls (dry and with alcohol)
Cord clamp
Micropore plaster
Tape Measure
Pair of sterile gloves
Baby’s scale
Alcohol lamp
(2) 10ml test tubes
Test tubes holder

Urine Specimen Solutions of:

Betadine
Zephiran solution
Spirit of ammonia
Acetic Acid
70% alcohol
Hydrogen peroxide
Ophthalmic ointment
Benedict’s qualitative reagent

B. Initial contact

1. Greet the client/family.

2. Introduce yourself to the family/client.

3. Explain the purpose & approval of the visit (If not approved, ask for an appointment).

4. Establish a contract between your visit & the family once approved.

4. Inquire about the overall health condition of the client & the family.

5. Encourages the client to verbalize thoughts and concerns.

6. Discuss the procedure with the client/family.

7. Appreciates client’s cooperation.

C. Procedure

8. Upon arrival at the patient’s home, place the bag on the table lined with clean paper. The clean side must be
out and the folded part, touching the table.

9. Ask for a basin of water or a glass of drinking water if tap water is not available.

10. Open the bag and take out the towel and soap.

MMC CAST College of Nursing Bag Technique Revised.2023 P1

 11. Wash hands using soap and water. Wipe to dry.

12. Take out the apron from the bag and put it on the right side.

14. Put out all the necessary articles needed for the specific care. ( sugar and albumin testing)

15. Close the bag and put it in one corner of the working area.
AFTERCARE

16. After giving the treatment, clean and put back all things that were used and perform handwashing.

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

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

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

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

21. Make an appointment for the next visit (either home or clinic) taking note of the date and time.
TOTAL SCORE =

Instruction: Rate the student’s performance by checking the appropriate box using the following criteria:
2 Performed The step in the procedure has been excellently executed; the
rationale has been stated.
1 Needs The step in the procedure was poorly executed; the rationale
Improvement has not been stated.
0 Not performed The step in the procedure has been missed.

Remarks:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Evaluated by: Student’s Signature:

____________________________________ ___________________________________
Clinical Instructor

Date: _______________________________

MMC CAST College of Nursing Bag Technique Revised.2023 P2