BAG TECHNIQUE PROCEDURE

DEFINITION: A tool making use of a public health nurse bag through which the nurse, during his/her
visit can perform nursing procedures with; ease and depthness; saving time and effort with the end
view of rendering effective nursing care to clients.

ASSESSMENT
1. Review the available health record of the client/family to be visited

PLANNING
1. Check the completeness of the content of the CHN bag.
2. Arrange the materials and equipment inside the CHN bag
FRONT OF BAG (LEFT TO RIGHT) Thermometer in case (oral, axillary, rectal), Tape measure,
Adhesive plaster, Cotton applicator
Right REAR OF THE Bag Test tube(2) + holder(1), Medicine dropper, Alcohol lamp
LEFT REAR of Bag Medicine glass, Baby scale, Bandage scissors, Rubber
suction
BACK OF THE BAG (left to right) 1. 70% alcohol 2. Betadine solution 3. H2O2 4. Terramycin
Opth. Oint. 5. Zephiran 6. Spirit of ammonia 7. Acetic acid 8.
Benedict’s solution 9. Liquid soap 10. Cotton , sterile water
In the CENTER OF THE BAG 1. Two pairs forceps (curved, straight) 2. Surgical scissors 3.
Sterile dressing (OS and cotton balls) 4. Roller bandage 5.
Hypodermic needles (g. 19, 22, 23, 25) 6. Sterile syringes
( 2ml, 5ml, 10ml - 2 pieces. each) 7. Sterile cord clamp 8.
Kidney basin
On the Top pile, CENTER OF THE 1. Hand towel in plastic bag 2. Soap in a soap dish (place in a
BAG separate plastic bag) 3. Apron 4. Plastic or linen lining
ADDITIONAL MATERIALS 1.Flashlight, Penlight 2. Tongue depressor 3.
STETHOSCOPE and SPHYGMOMANOMETER will be
placed on a separate bag. 4. Long black umbrella note:
Folded paper lining inserted between the flaps and cover of
the bag
POCKET OF THE BAG 1. Surgical Gloves 2. Waste paper receptacle

IMPLEMENTATION
CRITERIA RATIONALE
1. Introduce self to the client/ family and This action will help establish rapport and gain
explain the purpose of the home cooperation of the client’s family.
visitation. Provide opportunity for the
client /family to verbalize
understanding of the procedure.
2. Provide privacy for the client by closing Asking visitors to leave the room and closing the
the door and curtain or asking any door and curtain protect the person’s right to
visitor to wait. privacy.
3. Take the paper lining from the bag and Protects the bag from contamination.
place it on a table or any flat surface
(box or if not available, you may use
the floor), clean side out.
4. Place the bag on the upper left side of
paper lining with the bag opening
facing the working area and the bag’s
handles or strap tucked carefully
beneath the bag.
5. Open bag, take the linen/plastic lining The bag and its content should be well protected
and spread over the paper lining with from contact with any article in the client’s house
clean side out.
6. Take out hand towel, soap dish and To prepare for handwashing.
apron and place them at one corner of
the work area.
 7. Close the bag without locking and
perform handwashing.
8. After handwashing, put the soap and
soap dish outside the plastic lining with
hand towel on top of the soap dish.
9. Put on apron right side out and wrong
side with crease touching the body,
sliding the head into the head strap.
Neatly tie the straps at the back.
10. Remove from bag articles needed for
care and place at one corner of the
work area (inside the plastic lining).
11. Place paper receptacle outside the
work area.
12. Close the bag and complete the
nursing care.
13. After completing the nursing care,
clean and alcoholize all the articles
used including the top of the plastic
lining
14. Close and discard the paper
receptacle..
15. Perform handwashing and return all
the articles in their proper places inside
the bag.
16. Return the soap and soap dish inside
the bag last with the hand towel under
the soap dish.
17. Remove apron folding away from the
body, with soiled side folded inward
and clean side out. Place it in the bag.
18. Fold the plastic lining with clean side
out and return inside the bag. Close
and lock the bag.
19. Fold the paper lining with used side
inside and return to outside
pocket( discard if grossly
contaminated).
Washing hands and taking standard precautions
prevent the spread of infection.
To protect the nurse’s uniform as well as for
purposes of infection control.
Only items needed are taken from the bag in order
to avoid confusion and promote efficiency.
Paper receptacle is placed outside the working area
to prevent cross contamination.
Closing the bag reduces the possibility of
contamination.
All used articles are washed and sanitized to
prevent contaminating the bag and its content.
Used paper receptacles should be properly
discarded because it contains contaminated
materials used for providing care to the client
Handwashing is one of the most important steps
that anyone can take to avoid the spread of
infection.
Folding the contaminated side inward will confine
the contaminated surface.
Correct folding of the plastic lining will prevent
contamination of the bag and its content.
Correct folding of the paper lining will prevent
contamination of the bag and its content.

EVALUATION AND DOCUMENTATION

1. Record nursing care rendered.
2. Take note of the environmental factors which affect the client/family health.
3. Include quality of nurse-patient relationship.
4. Assess effectiveness of nursing care provided.
 URINE COLLECTION
Importance of Urine Examination
1. Detection of disorders of the urinary tract
2. To determine the presence of microorganisms, the type of organisms, and the antibiotics to
which the organisms are sensitive.
3. Detection of presence of metabolic disorders ( EX: Diabetes mellitus, hepatitis, etc.)
4. Detection of complications during pregnancy ( Pre-eclampsia, Eclampsia, Pregnancy Induced
Hypertension, Gestational diabetes)

Methods of Urine Collection:

1. First morning urine specimen
2. Fasting urine specimen ( second morning urine specimen)
3. Random urine specimen
4. Catheterized urine specimen
5. Midstream Clean catch

ASSESSMENT
1. Checks doctor’s order for urine examination.
2. Identify the client and explain the purpose of urine collection and examination.
3. Determine voiding habits and any current or past voiding difficulties and urine output of the
client.

PLANNING
1. Gathers equipment and supplies to be needed for urine collection.
a. soap and soap case
b. small towel
c. specimen container
d. tissue paper
e. labeling tape
f. pentel pen
g. laboratory request form
2. Provides equipment for cleaning the genitalia before patient urinates as well as the materials for
urine collection

IMPLEMENTATION
CRITERIA RATIONALE
1. Identifies the client. To ensure that the ordered procedure will be
performed to the right client
2. Explains the purpose of the To eliminate client’s anxiety and to ensure cooperation
procedure to the client .
3. Provide equipment for cleaning the Enhances efficiency and decreases possibility of cross
genitalia before patient urinates contamination
(soap and water) as well as the
materials for urine collection.
4. Instruct client to perform personal To prevent contamination/ infection
hand hygiene before urine
collection.
5. Instruct client to clean the perineal
area before urine specimen
collection.
6. Provide client with the following
instructions on how to collect the
midstream clean catch urine.

6.1. After the cleansing 6.1. To avoid any fecal matter to flow with the urine.
procedure, separate the
labia majora using the thumb
and index finger of one
 hand. Passes first small
amount of urine in the toilet
bowl then stop urinating.
6.2. Using the other hand, put the 6.2 The first flow of urine washes microorganisms and
urine container under the debris from the urinary tract. Midstream collection
genital area to catch the ensure a sterile specimen is obtained.
middle portion of the
urination directly into the
sterile specimen container
(at least 30-50 ml.). Do not
let the hand or perineal area
come in contact with the
interior of the container.
6.3. Any remaining urine is
passed into the toilet bowl
and should not be included
in the specimen collection.
6.4. Cover the specimen 6.4 Capping of specimen container prevents
container and wipe the inadvertent spilling and possible contamination.
outside of the container with
a tissue paper and submit it
to the nurse
7. Check the appropriateness of the To ensure specimen integrity
urine specimen submitted .
8. Labels specimen with the client’s To prevent interchanging of specimen
complete name, age, birthdate and
date and time of urine collection.
9. Sends the specimen promptly to the To prevent alteration of results
laboratory together with the
completely filled up request form.
10. Dispose/Clean all used equipment. To decrease transmission of microorganisms
11. Removes gloves and performs hand It is a standard precaution, it decreases possibility of
hygiene. transmission of microorganisms

EVALUATION
1. Documents the procedure and other pertinent findings based from the data obtained during the
assessment of the client.
RATIONALE: Documentation serves as legal record and for continuity of care of client.
 HEAT AND ACETIC TEST
Importance of Heat and Acetic Acid Test in Urine
1. To detect presence of protein in urine ( Ex: Albumin, Bence-Jones Protein, Mucin,etc.)
2. Used as a screening test for pre-eclampsia and eclampsia

CRITERIA RATIONALE
ASSESSMENT
1. Identify the client and explain the To ensure that the ordered procedure will be
purpose of the test. performed to the right client
To eliminate client’s anxiety and to ensure
cooperation
2. Determine if client has history of pre-
eclampsia or eclampsia from previous
pregnancies or has family history of
hypertension.
3. Assess client for signs and symptoms
accompanying proteinuria such as
increase blood pressure, blurring of
vision, and edema.
PLANNING
4. Prepares the materials and reagent
needed for the test.
 13x100mm test tube
 Test tube rack
 Test tube holder
 5 ml. syringe
 Match
 Alcohol lamp
 Labeling tape
 Pentel pen
 Dropper
 Soap and soap case
 Small towel
 5-10% acetic acid
 Urine specimen
 Clean gloves
IMPLEMENTATION
5. Performs hand washing and wears clean To prevent contamination/ infection
gloves.
6. Mixes the urine well and fill test tube up Mixing urine ensure equal distribution of its
to 2/3 of its size with clear urine. Hazy or constituents prior to sampling .Filtering remove
turbid urine specimen should be filtered unwanted materials which interfere with the
first before getting the representative correct interpretation of result.
sample.
7. Labels the test tube with the To prevent interchanging of specimen
corresponding specimen number.
8. Heat the upper third portion of the test To avoid forming of precipitate
tube until the urine boils. Lower portion is
not heated to serve as control.
9. If cloud forms, add 5 drops of 10% acetic Cloudy urine is often due to phosphate
acid. Heat again and allow to cool. Take precipitation in alkaline urine, the phosphates and
note for cloudiness or presence of carbonates are re-dissolved when acetic acid is
precipitate / flocculi and interpret as added and provided optimum pH
follows:
Negative : No visible cloudiness
Trace : Barely visible cloudiness
Positive + : Distinct cloudiness that
is non granular against light
Positive ++ : Distinct cloudiness that
 is granular against light
Positive +++ : Heavy cloudiness with
distinct flocculi
Positive ++++ : Dense heavy cloudiness
with large flocculi which may solidify
10. Disposes all used materials, removes It is a standard precaution, it decreases possibility
gloves and performs personal hand of transmission of microorganisms
hygiene.
EVALUATION
11. Documents the result of the test and Documentation serves as legal record and for
other pertinent findings based from data continuity of care of client.
obtained during the assessment of the
client.

BENEDICT’S TEST
Importance of Benedict’s Test
1. To assess presence of reducing sugar in the urine
2. Screening tool for diabetes ( Diabetes mellitus, gestational diabetes)

CRITERIA RATIONALE
ASSESSMENT
1. Identify the client and explain the purpose of To ensure that the ordered procedure will be
the test. performed to the right client
To eliminate client’s anxiety and to ensure
cooperation
2. Determine if client has history of gestational
diabetes from previous pregnancies or if has
family history of diabetes mellitus.
3. Assess client for signs and symptoms
accompanying glucosuria such as polyuria,
polydipsia, polyphagia , pruritus and weight
loss
PLANNING
4. Prepares the materials and reagent needed
for the test.
 16x150mm test tube
 Test tube rack
 Test tube holder
 5 ml. syringe
 Match
 Alcohol lamp
 Labeling tape
 Pentel pen
 Dropper
 Soap and soap case
 Small towel
 5-10% acetic acid
 Urine specimen
 Clean gloves
 Benedict’s reagent
IMPLEMENTATION
5. Identifies the client To ensure that the ordered procedure will be
performed to the right client

6. Explains the purpose of the test to the
client.
7. Performs hand washing and wears clean
gloves.
8. Labels the test tube with the corresponding
To eliminate client’s anxiety and to ensure
cooperation
To prevent contamination/ infection
To prevent interchanging of specimen
 specimen number.
9. Places 5cc of Benedict’s reagent in the Benedicts reagent is used to detect presence of
labeled test tube and heat. If color changes, reducing sugars in urine. If its color changes, the
discard the reagent and secure a new one. solution is contaminated.
10. Adds 8-10 drops of urine and mix The sugar that may occur in the urine ( glucose,
thoroughly. fructose, lactose, galatose, sucrose, etc.) can be
distinguished as the basis of the test
11. Boils the test solution for at least 2 minutes. Boiling ensure an accurate result.
Allow to cool and interpret as follows:
Negative : No change in color, the solution
remains blue
Trace : Green opacity without precipitate
Positive + : Green solution with yellow
precipitate
Positive ++ : Green to yellow solution with
yellow precipitate Positive +++ : Muddy orange
solution with yellow precipitate
Positive ++++: Orange to brick red precipitate
12. Cleans and disposes used materials.
13. Disposes all used materials, removes It is a standard precaution, it decreases possibility
gloves and performs personal hand of transmission of microorganisms
hygiene.
EVALUATION
14. Documents the result of the test and other Documentation serves as legal record and for
pertinent findings based from data obtained continuity of care of client.
during the assessment of the client.