Name : __________________________________ Yr.& Sec . __________Date :_________ C.I.

_____________

RUBRICS ON BAG TECHNIQUE

CRITERIA
4 3 2 1
Proficient Approaching Developing Beginning Rating
proficiency
PROCEDURE Independently Performs Performs Performs
performs all skills with skills with skills with
skills fluently assistance of assistance assistance
and without faculty 1 - 2 of faculty 3 - of faculty
difficulty. times during 4 times greater
simulation.  during than 4
simulation times
during
simulation

1.Greets the client and family.

2.Explains the purpose of
Home Visits.
3.Places the Nursing Bag on
the table lined with a clean
paper/plastic upon arrival at
the patient’s home .The clean
side must be out and the
folded part, touching the
table.
4. Asks for a basin of water or
a glass of drinking water if tap
water is not available.
5. Opens the bag and take
out the towel and soap.
6. Washes hands using soap
and water, wipe to dry.
7. Takes out the apron from
the bag and put it on with the
right side.
8. Puts out all the necessary
articles needed for the
specific care.
9. Closes the bag and put it in
one corner of the working
area.
10. Proceeds in Performing
NURSING PROCEDURES

11. Cleans all things that were

used and perform hand
washing after wound dressing
12. Opens the bag and
returns all things that were
used in their proper places
after cleaning them.
13. Removes apron, folding it
away from the person, the
soiled side in and the clean
side out.
14. Folds the lining, place it
inside the bag and close the
bag.
15. Writes down all the
necessary data that were
gathered, observations,
nursing care and treatment
rendered.
16.Gives instructions for care
of patients in the absence of
the nurse.
17. Makes appointment for
the next visit (either home or
health center) taking note of
the date and time.

Prepared by : Lecturer

Belinda R. Rosales, RN , MAN, Ed.D

Noted by:

Jill Marie C. Hermogenes , RN , MAN, Ed.D

Assistant Dean

Approved by:

Michelle B. Yu , RN , DM

Dean