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Definition Bag technique a tool making use of public health bag through which the nurse, during his/her

r 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 its contents should be cleaned as often as possible, supplies replaced and ready for use at any time. 3. The bag and its contents should be well protected from contact with any article in the home of the patients. Consider the bag and its 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 Babys scale 1 pair of rubber gloves 2 test tubes Test tube holder Medicines o betadine o 70% alcohol o ophthalmic ointment (antibiotic) o zephiran solution o hydrogen peroxide o spirit of ammonia o acetic acid o benedicts solution

Note: Blood Pressure Apparatus and Stethoscope are carried separately. Steps/Procedures Actions Rationale

1. Upon arriving at the clients home, To protect the bag from place the bag on the table or any flat contamination. surface lined with paper lining, clean side out (folded part touching the table). Put the bags handles or strap beneath the bag. 2. Ask for a basin of water and a glass To be used for handwashing. of water if faucet is not available. To protect the work field from being Place these outside the work area. wet. 3. Open the bag, take the linen/plastic To make a non-contaminated work

lining and spread over work field or field or area. area. The paper lining, clean side out (folded part out). 4. Take out hand towel, soap dish and To prepare for handwashing. apron and the place them at one corner of the work area (within the confines of the linen/plastic lining). 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 To protect the nurses uniform. wrong side with crease touching the Keeping the crease creates aesthetic body, sliding the head into the neck appearance. strap. Neatly tie the straps at the back. 7. Put out things most needed for the To make them readily accessible. specific case (e.g.) thermometer, kidney basin, cotton ball, waste paper bag) and place at one corner of the work area. 8. Place waste paper bag outside of work area. 9. Close the bag. 10. Proceed to the specific nursing care or treatment. 11. After completing nursing care or treatment, clean and alcoholize the things used. 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 To be used as reference for future matters relevant to health care, taking visit. anecdotal notes preparatory to final To prevent contamination of clean area. To give comfort and security, maintain personal hygiene and hasten recovery. To prevent contamination of bag and contents. To protect caregiver and prevent spread of infection to others.

reporting. 17. Make appointment for the next visit ( either home or clinic), taking note of the date, time and purpose. 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

For follow-up care.

Home Visits
The home visit is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing this activity, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.

Purpose of home visit


1. To give care to the sick, to a post partum mother and her newborn with the view teach a responsible family member to give the subsequent care. 2. To assess the living condition of the patient and his family and their health practices in order to provide the appropriate health teaching. 3. To give health teachings regarding the prevention and control of diseases. 4. To establish close relationship between the health agencies and the public for the promotion of health.

5. To make use of the inter-referral system and to promote the utilization of community services

Principles involved in preparing for a home visit


1. A home visit must have a purpose or objective. 2. Planning for a home visit should make use of all available information about the patient and his family through family records. 3. In planning for a home visit, we should consider and give priority to the essential needs if the individual and his family. 4. Planning and delivery of care should involve the individual and family. 5. The plan should be flexible.

Guidelines to consider regarding the frequency of home visits


1. The physical needs psychological needs and educational needs of the individual and family. 2. The acceptance of the family for the services to be rendered, their interest and the willingness to cooperate. 3. The policy of a specific agency and the emphasis given towards their health programs. 4. Take into account other health agencies and the number of health personnel already involved in the care of a specific family. 5. Careful evaluation of past services given to the family and how the family avails of the nursing services. 6. The ability of the patient and his family to recognize their own needs, their knowledge of available resources and their ability to make use of their resources for their benefits.

Steps in conducting home visits


1. 2. 3. 4. 5. 6. 7. Greet the patient and introduce yourself. State the purpose of the visit Observe the patient and determine the health needs. Put the bag in a convenient place and then proceed to perform the bag technique. Perform the nursing care needed and give health teachings. Record all important date, observation and care rendered. Make appointment for a return visit.

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 medication and articles which are necessary for giving care.

Principles of bag technique


1. Performing the bag technique will minimize, If not prevent the spread of any infection. 2. It saves time and effort in the performance of nursing procedures. 3. The bag technique can be performed in a variety of ways depending on the agencys policy, the home situation, or as long as principles of avoiding transfer of infection is always observed.

Contents of the public health 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 Babys 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 Benedicts solution

*Sphygmomanometer and stethoscope are carried separately.

Important points to consider in the use of the bag


1. The bag should contain all the necessary articles, supplies and equipments 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 patients home. Consider the bag and its contents clean and sterile, while articles that belong to the patients as dirty and contaminated. 4. The arrangement of the contents of the bag should be the one most convenient to the user, to facilitate efficiency and avoid confusion.

Steps in Performing the Bag Technique Action


1. Upon arrival at the patients home, place the bag on the table lined with a clean paper. The clean side must
be out and the folder part, touching the table. Rationale: To protect the bag from getting contaminated. 2. Ask for a basing of water or a glass of drinking water if tap waster is not available. Rationale: To be used for hand washing. 3. Open the bag and take out the towel and soap. Rationale: To prepare for hand washing. 4. Wash hands using soap and water, wipe to dry. Rationale: To prevent infection from the care provider to the client. 5. Take out the apron from the bag and put it on with the right side out Rationale: To protect the nurses uniform. 6. Put out all the necessary articles needed for the specific care. Rationale: To have them readily accessible 7. Close the bag and put it in one corner of the working area. Rationale: To prevent contamination 8. Proceed in performing the necessary nursing care treatment. Rationale: To give comfort and security and hasten recovery 9. After giving the treatment, clean all things that were used and perform hand washing. Rationale: To protect the caregiver and prevent infection 10. Open the bag and return all things that were used in their proper places after cleaning them. 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 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. Rationale: For reference in the next visit. 14. Make appointment for the next visit (either home or clinic) taking note of the date and time. Rationale: For follow-up care

Source: Public Heath Nursing Book

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