JOSE RIZAL UNIVERSITY

College of Nursing and Health Sciences

Performance Checklist
Bag Technique

Name of Student: GALAMITON, Hannah Faith Ashley P. Date: November 11, 2021
Year/Section/Group No.: BSN - 202N Grade:

PROCEDURE RATIONALE

A. KNOWLEDGE – 30%

1. States objectives of this activity. Performing the bag technique will minimize, if not,
prevent the spread of any infection.

2. Uses appropriate terms.

3. States steps of the procedure in correct order.

4. Explains the rationale of every step.

B. SKILLS – 60%

1. Prepares plan of home visit following the prescribed

format.

2. Identifies the client properly.

3. Introduces self and explains purpose of visit and Most people need an explanation of the physical
procedure. examination. Often clients are anxious about what the
nurse will find. They can be reassured during the
examination by explanations at each step.

4. Place the bag on the table or any flat surface To protect the bag from getting contaminated.
lined paper/plastic lining, clean side out (folded
part touching the table). Put bag’s handles/strap
under the bag.

5. Ask for a basin of water and a glass of water if To be used for hand washing.
faucet is not available. Place these outside the
work area.

6. Open the bag, take the paper/plastic lining and To protect the bag from getting contaminated.
spread over work field or area (the clean side out).
The paper lining, clean side out (folded part out).

7. Take out hand towel, soap dish and apron and

place them at one corner of the work area (within
the confines of the linen/plastic lining.)

8. Do hand washing. Wipe dry with towel. Leave the To prevent infection from the care provider to the
plastic wrappers of the towel and soap dish in the client.
 bag.

9. Put on apron right side out and wrong side To protect the nurse’s uniform.
with crease touching the body, sliding the head
into the neck strap. Neatly tie the straps at the
back.

10. Put out things most needed for the specific case To have them readily accessible
and place at one corner of the work area.

11. Place waste paper bag outside of the work area. To prevent contamination

12. Close the bag. To prevent contamination

13. Proceed to the specific nursing care or treatment. To give comfort and security and hasten recovery

14. After completing the nursing care or treatment, To protect the bag from getting contaminated.
clean and alcoholize the things used.

15. Do hand washing again. To prevent infection from the care provider to the
client.

16. Open the bag and put back all articles in their proper To be ready on the next use
places.

17. Remove the apron folding away from the body, To prevent contamination of other materials
with soiled side folded inwards and the clean inside the bag
side out. Place it in the bag.

18. Fold the linen/plastic lining; clean; place it in the bag To be ready on the next use
and close the bag.

19. Make post-visit conference on matters relevant To give instructions on how to take care of the
to health care, taking anecdotal notes client at home
preparatory to final reporting.

20. Make appointment for the next visit, taking note For follow-up care
of the date, time and purpose.