assignment on bag technique

Bag Technique in Nursing

The nursing bag has been an essential tool for public and community health nurses since the early 20th century. It is designed to help prevent the spread of infections and ensure that nurses can provide safe and effective care to patients in various settings especially during home or community visits. This technique involves the systematic organization and use of a nursing bag containing essential medical supplies and equipment required for patient care .

Table of Contents

What is bag technique in nursing, principles of bag technique, contents of a public health nurse bag, usages of items in a public health nurse bag, best practices for bag technique, steps in performing bag technique, references and sources.

The bag technique is a tool by which the nurse , during the visit, will be able to perform a nursing procedure with ease and agility, to save time and effort to render effective nursing care to clients. It is a systematic approach used by nurses, particularly those working in home health care and community settings, to prevent the spread of infections and ensure the safe, efficient delivery of care. It involves the careful organization, use, and maintenance of a nursing bag that contains all the necessary medical supplies and equipment needed for patient care .

The public health bag also known as a nursing bag or home visit bag is an essential and indispensable equipment used by public health nurses and other healthcare professionals during home visits and community health interventions. The bag contains essential medical supplies, equipment, and documentation materials necessary to provide comprehensive and efficient care in various community settings. It plays a crucial role in infection control, ensuring that nurses can deliver safe and effective care while minimizing the risk of cross-contamination.

Exceptional graduates from Memorial Hospital Training School in Richmond, VI, received a nursing bag and uniform upon graduation (Training School Notes, 1905). The bag soon became synonymous with the district nurses’ identity, as noted by C. Keith in 1905: “They become acquainted with the nurse, recognize her visage, and identify her by the bag she bears.”

The bag technique in nursing is guided by several fundamental principles designed to maintain cleanliness, prevent infection, and ensure efficient and safe patient care . Here are the core principles:

1. Infection Control . The primary goal of the bag technique is to minimize the risk of cross-contamination between patients and from the nurse to the patient. By following strict procedures for handling and using the contents of the nursing bag, nurses can significantly reduce the likelihood of infection transmission. The concept of effective bag technique for infection prevention, first discussed in a 1956 publication by Smendik and Kurtagh, emphasized maintaining distance between the bag and the client, utilizing newspaper as a protective barrier, and highlighting the importance of handwashing. In 1961, a public health nurse illustrated improved shigellosis control methods to families by utilizing the items from her nursing bag to demonstrate proper handwashing techniques and specimen management (Levin, 1961).

• Asepsis. Always maintain an aseptic technique to prevent contamination of the bag and its contents. Use hand hygiene protocols rigorously, including handwashing with soap and water or using alcohol-based hand sanitizers before and after patient contact.
• Barrier Protection. Use barriers such as disposable underpads or clean towels to place under the nursing bag to avoid contamination from surfaces in the patient’s environment.
• PPE Usage. Utilize personal protective equipment ( PPE ) as necessary to protect both the patient and nurse from potential infections.

2. Organization and Accessibility . The nursing bag is systematically organized so that all supplies are easily accessible and can be used efficiently. This organization helps nurses deliver care quickly and effectively, ensuring they have all necessary items at hand.

• Systematic Organization. Keep the contents of the bag well-organized so that items are easily accessible and can be found quickly when needed. This helps prevent unnecessary handling and potential contamination.
• Stock Management. Regularly check and replenish supplies to ensure that the nursing bag is always ready for use. Discard expired or contaminated items promptly.

3. Minimize Cross-Contamination. Minimizing cross-contamination is a critical aspect of the bag technique in nursing, particularly in home health and community care settings. Cross-contamination can lead to the spread of infections, posing a risk to both patients and healthcare providers.

• Selective Use. Only take out the supplies necessary for the procedure at hand to minimize the risk of contaminating other items in the bag.
• Single-Use. Avoid reusing disposable items. Once an item has been exposed to the patient environment, it should not be returned to the nursing bag.
• Proper Disposal. Dispose of used supplies, including PPE and waste, in designated disposal bags or containers to prevent contamination.

4. Patient and Environment Safety. In the bag technique, ensuring patient and environment safety is paramount to providing effective care while minimizing the risk of infection transmission.

• Safe Placement. Choose a clean and stable surface to place the nursing bag, away from potential contaminants and within easy reach for the nurse.
• Environmental Cleanliness. Ensure the patient’s environment is as clean as possible to reduce the risk of contamination during care activities.

5. Documentation and Monitoring. Documentation and monitoring play integral roles in the bag technique, ensuring accountability, continuity of care, and adherence to infection control protocols.

• Accurate Documentation . Keep accurate records of supplies used, procedures performed, and any changes in the patient’s condition. This helps maintain accountability and ensures continuity of care.
• Regular Monitoring. Routinely inspect the nursing bag and its contents for cleanliness and integrity. Address any signs of contamination or wear and tear immediately.

6. Education and Training. Proper instruction and ongoing learning ensure nurses have the knowledge and skills needed to perform this technique effectively and safely.

• Continuous Education. Stay updated on the latest best practices in infection control and bag technique. Engage in continuous professional development and training.
• Patient and Caregiver Education. Educate patients and their caregivers about infection control practices to maintain a clean and safe environment.

The Manual of Public Health Nursing offered standardized lists of nursing bag supplies and guidance on recommended care and utilization of the bag for public health nurses nationwide.

• Paper lining
• Extra paper for making waste bag
• Plastic/linen lining
• 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
• Micropore plaster
• Tape measure
• 1 pair of sterile gloves
• Baby’s scale
• Alcohol lamp
• 2 test tubes
• Test tube holders
• 70% alcohol
• Zephiran solution
• Hydrogen peroxide
• Spirit of ammnonia
• Ophthalmic ointment
• Acetic acid
• Benedict’s solution

* BP apparatus and stethoscope are carried separately and are never placed in the bag.

The following are the contents of a Public Health Nurse bag and their usage.

1. Paper Lining. Provides a clean surface for organizing and preparing supplies, minimizing the risk of contamination from surfaces in the patient’s environment.

2. Extra Paper for Making Waste Bags. Enables nurses to create disposable waste bags for proper disposal of used supplies and biohazardous materials, promoting infection control and environmental safety.

3. Plastic/Linen Lining. Acts as a barrier between supplies and potentially contaminated surfaces, maintaining the cleanliness and integrity of the contents of the nurse bag.

4. Apron. Protects the nurse’s clothing from spills, splashes, and soiling during patient care activities, ensuring personal hygiene and professionalism.

5. Hand Towel. Allows nurses to dry their hands after handwashing or using hand sanitizers, promoting proper hand hygiene and reducing the risk of infection transmission.

6. Soap in a Soap Dish. Provides a means for handwashing with soap and water, a critical component of infection control and preventing the spread of pathogens.

7. Thermometers (Oral and Rectal). Essential for measuring body temperature accurately, aiding in the assessment and monitoring of patient’s health status, and detecting signs of fever or hypothermia .

8. Scissors (Surgical and Bandage). Facilitate the safe and precise cutting of medical materials such as dressings, bandages, and tapes during wound care and other procedures.

9. Forceps (Curved and Straight). Assist in handling sterile supplies and instruments safely, reducing the risk of contamination and ensuring aseptic technique during procedures.

10. Disposable Syringes with Needles. Used for administering medications, vaccines, or other injectable treatments, allowing for precise dosage delivery and minimizing the risk of needlestick injuries.

11. Hypodermic Needles. Come in various gauges to accommodate different injection sites and medication viscosities, ensuring safe and effective medication administration .

12. Sterile Dressing. Provides a sterile covering for wounds or incisions, promoting wound healing and preventing infection by protecting the area from contamination.

13. Cotton Balls. Used for wound cleaning , applying topical medications, or removing debris, providing a gentle and absorbent material for various patient care needs.

14. Cord Clamp. Essential for clamping and securing the umbilical cord after childbirth, preventing excessive bleeding , and ensuring the newborn ‘s health and safety.

15. Micropore Plaster. Offers a hypoallergenic adhesive tape for securing dressings or medical devices, providing gentle adhesion without causing skin irritation.

16. Tape Measure. Allows for accurate measurements of various body parts, aiding in assessments such as growth monitoring, wound size evaluation , and proper placement of medical devices.

17. Sterile Gloves. Provide a protective barrier for the nurse’s hands during invasive procedures or when handling potentially infectious materials, reducing the risk of cross-contamination.

18. Baby’s Scale. Enables accurate measurement of infant weight, essential for monitoring growth and assessing nutritional status during well-child visits or postnatal care.

19. Alcohol Lamp. Provides a source of heat for sterilizing instruments or materials in a controlled manner, ensuring aseptic technique during minor procedures or wound care .

20. Test Tubes and Test Tube Holders. Used for collecting, transporting, and storing biological samples or specimens for laboratory testing, facilitating diagnostic assessments and treatment planning .

21. Solutions (Betadine, 70% Alcohol, Zephiran Solution, Hydrogen Peroxide, Spirit of Ammonia, Acetic Acid, Benedict’s Solution). Various solutions serve different purposes such as wound cleansing, disinfection, sterilization, or diagnostic testing, supporting comprehensive patient care and treatment protocols.

22. Ophthalmic Ointment. Used for prophylactic treatment of newborns to prevent ophthalmia neonatorum, a bacterial eye infection transmitted during childbirth, promoting newborn eye health.

From organization and infection control to adaptability and continuous education, the following topics guide nurses in maintaining high standards of care delivery during home visits and community health interventions.

1. Comprehensive Preparation .

The bag should be stocked with all necessary articles, supplies, and equipment required to address emergency needs effectively. This ensures that the nurse is equipped to handle various situations that may arise during home visits or community health interventions. After extensive experimentation, the Nurses’ Settlement in New York (Henry Street Settlement) developed a district nurses’ bag that appears to be comprehensive (Brewster, 1901).

2. Regular Maintenance.

Both the bag and its contents should undergo frequent cleaning and maintenance. Supplies should be replaced as needed to ensure they are in optimal condition and ready for immediate use at any time. This practice promotes readiness and preparedness for emergent situations.

3. Prevention of Contamination.

The bag and its contents must be safeguarded from contact with any potentially contaminated articles in the patient’s home. This prevents cross-contamination and maintains the integrity of the supplies, ensuring their effectiveness in providing safe and hygienic care.

4. Differentiation of Clean and Contaminated Items.

Nurses should perceive the bag and its contents as clean and sterile, contrasting them with articles belonging to the patients, which are considered dirty and contaminated. This distinction helps maintain infection control standards and prevents the spread of pathogens.

5. Efficient Organization.

The arrangement of the bag’s contents should be tailored to the user’s preferences and needs. An organized layout enhances efficiency during patient care activities, minimizing the risk of confusion and streamlining the delivery of care.

6. Patient-Centered Approach.

Tailor the contents of the bag to meet the specific needs of the patient population being served. Consider factors such as age, medical condition, and cultural preferences when selecting supplies and equipment.

7. Documentation and Accountability.

Maintain accurate documentation of the supplies used during each patient encounter. Document any procedures performed, medications administered, and changes in the patient’s condition to ensure continuity of care and accountability.

8. Adaptability and Preparedness.

Be prepared to adapt the contents of the bag based on the unique requirements of different patient care settings and situations. Anticipate potential emergencies and ensure that the bag is equipped to address emergent needs effectively. Since the early 1900s, the nursing bag has served as an essential tool for visiting nurses in the United States, coinciding with the establishment of public health nursing as a professional field. Nurses at the Visiting Nurse Association of Chicago meticulously prepared their bags prior to embarking on a day of home visits, customizing the contents based on the nature of the visits. For instance, if a maternity client was scheduled for a visit, oakum pads for use as sanitary pads were among the supplies included in the bag (Moore, 1900).

9. Communication and Collaboration.

Foster open communication and collaboration with other members of the healthcare team. Share information about the contents of the bag and coordinate care delivery to ensure seamless and comprehensive patient care.

10. Continuous Education and Training.

Stay updated on best practices, guidelines, and advancements in nursing practice related to the bag technique. Participate in ongoing education and training opportunities to enhance proficiency and maintain competence in patient care delivery . Over time, the contents of nursing bags underwent continuous evolution. The advent of disposable items prompted public health nurses (PHNs) at the Allegheny County Health Department in Pennsylvania to discard the “bulky, heavy, old bag” in favor of a modernized alternative. Nevertheless, it was acknowledged that periodic reassessment by the nursing bag committee would be necessary to ensure its ongoing effectiveness and adaptation to evolving service responsibilities (Everett, 1965).

In 1970, UCOM Educational Inc. in Rochester, NY, released a self-instructional unit titled “Nurse’s Bag Technique.” This resource aimed to facilitate the learning of proper bag technique among public health nurses (PHNs) and student nurses , emphasizing principles of asepsis and familiarity with essential equipment found in the nurse’s bag (Sullivan & Weber, 1970). The following are steps in performing the bag technique and the rationale for each action:

1. Upon arrival at the patient’s home, place the bag on a table lined with clean paper, ensuring the clean side is facing out and the folder part touches the table. Placing the bag on a clean surface prevents contamination and maintains the integrity of the supplies within the bag.

2. Request a basin of water or a glass of drinking water if tap water is not available. Access to clean water facilitates proper hand hygiene , a crucial step in infection prevention during patient care.

3. Open the bag, take out the towel and soap, and wash hands using soap and water. Dry hands thoroughly. Handwashing removes pathogens from the hands, reducing the risk of transmitting infections to the patient or contaminating supplies. The Home Care National Patient Safety Goal 7, as outlined by The Joint Commission in 2007, advocates for minimizing the risk of healthcare-associated infections in homecare settings and adhering to the current hand hygiene guidelines provided by the CDC. The nursing bag has historically been advocated as a resource for promoting regular handwashing practices.

4. Put on the apron with the clean side facing outward, protecting the nurse’s uniform. Wearing an apron prevents soiling of the nurse’s clothing and minimizes the risk of contamination during care delivery.

5. Lay out all necessary articles needed for the specific care task, ensuring they are readily accessible. Having supplies readily available streamlines care delivery and reduces the need for unnecessary movement during the procedure.

6. Close the bag and place it in a designated corner of the working area to prevent contamination. Proper bag management minimizes the risk of contamination and maintains the cleanliness of the supplies within the bag.

7. Proceed with performing the necessary nursing care treatment according to the patient’s needs. Providing appropriate care promotes patient comfort , security, and recovery while addressing health needs effectively.

8. After providing treatment, clean all used items and perform handwashing to prevent infection transmission. Cleaning used items and practicing hand hygiene reduces the risk of cross-contamination and ensures the safety of both the caregiver and patient.

9. Open the bag and return all used items to their proper places after cleaning them. Close the bag securely. Organizing the bag and closing it securely maintains the cleanliness and organization of supplies for future use.

10. Remove the apron, folding it with the soiled side in and the clean side out. Place it in the bag for disposal. Proper disposal of the apron prevents contamination and maintains cleanliness in the patient’s environment.

11. Document all necessary data, observations, care rendered, and instructions for patient care in the record. Provide education and instructions for patient care in the nurse’s absence. Documentation ensures continuity of care and facilitates communication among healthcare providers, while patient education promotes self-care and adherence to treatment plans.

12. Make an appointment for the next visit, whether at home or the clinic, noting the date and time. Scheduling follow-up appointments ensures ongoing monitoring and continuity of care for the patient’s health needs.

• Pamela Aaltonen; Elizabeth (Libby) Richards; Kay Webster; Lynn Davis (2009). Use of the Public Health Nursing Bag in the Academic Setting. , 26(1), 88–94. doi:10.1111/j.1525-1446.2008.00757.x

5 thoughts on “Bag Technique in Nursing”

would u plz differentiate the parts or chamber of bag

tnx for the rationale sir matt

thanx really helped

Why are we not placing Bp cuff and stethoscope in the bag? In home health care, after cleansing and sanitizing hands our practice is to place equipment back into the clean side of the bag.

Are you kidding with this? A soap dish? Putting on an apron? Where are the gloves? Where is the hand sanitizer? I’d never get through my day with this technique. This is like a 1950 tutorial.

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COMMUNITY BAG – Importance of Community Bag, Principles of Bag Techniques, Articles Used in Community, Steps of Procedure with Community Bag, Home Health Nursing Procedure and Principles to be observed (Community Health Nursing)

Updated 2024

Community Bag Technique

The community health nurse requires some tools and instruments for doing procedures during home visits. The purpose of community bag is to carry out nursing procedures in home, which includes weighing the children, performing minor dressing and to conduct delivery in emergency situations

The “community bag technique” in nursing often refers to a method used to organize and carry essential supplies during community health nursing visits or home health visits. The purpose is to ensure that healthcare professionals have all the necessary tools and resources readily available when providing care in the community.

The community health bag can be made of khaki material or any material with an aluminum or iron frame to fit inside. Leather bags can also be used if the agency can afford this. it is designed to carry equipment and material needed during a visit to the home, school or factory

The nursing bag is a vehicle for carrying the material and equipment needed during. The bag should have outside packets for keeping a note book, waste paper bag, folder, newspaper, stationeries, and tablet container

IMPORTANCE OF COMMUNITY BAG

• It is essential during each home visit, school and industrial visit to do some nursing procedures
• The community bag and material required are kept ready to use at any time
• The community bag helps to demonstrate some nursing procedures during home visit
• The community bag acts as a vehicle for carrying the tools during a home visit

PRINCIPLES OF BAG TECHNIQUES

• The community bag must be kept scrupulously clean ad ready for use at all times
• The community bag should be kept in clean areas without danger of being contaminated by the children or domestic animals
• Clean or boil the instruments after use and replace it safely
• Avoid unnecessary exposure while doing procedure
• Secure the bag by often cleaning and cover it properly
• The community bag placed on a clean surface or on a piece of newspaper or a plastic sheet
• Remove the soap, towel and nail brush and wash the hands well
• Open the bag and remove only the needed articles and close the bag
• Carry out the procedure placing soiled swabs inside a newspaper bag for disposal by burning or any other suitable method
• Fold used paper or plastic sheet with exposed side innermost and keep it in the outside pocket of the bag
• Write brief note of the observation, procedure done or instructions given
• Check the bag daily, washing hands before opening it and make necessary replacements

ARTICLES USED IN COMMUNITY BAG

• Outside pocket: newspaper, stationeries, family folders, flash cards and waste paper bag
• Side flap: tablets containers should have paracetamol, septran, multivitamin or B-complex, anti-inflammatory, etc. solutions antiseptic, savlon, betadine, Benedict’s solution, acetic acid, methylated spirit and eye drops  or ointment
• Lower compartment: urine analysis kit, specimen bottle, kidney tray, test tubes, test tubes holder, spirit lamp and match box. The hand washing items-soap, towel, nail brush, small mackintosh or plastic sheet and plastic aprons
• Physical assessment instruments: fetoscope, inch tape, shakir tape and spring balance to check weight
• Sterile compartment: instruments-artery forceps, thumb forceps, small towel and scissors. A pair of disposable glove or paper gloves
• Miscellaneous articles: mucous suckers, tallquist paper for checking hemoglobin and small catheter

STEPS OF PROCEDURE WITH COMMUNITY BAG

• Select a work area according to the convenient of the family
• Place the bag in a mat in a veranda on newspaper
• Unbutton the bag of lower compartment
• Remove hand washing equipment and wash hands properly
• Remove apron from the bag and put it on
• Remove the need items from the outside compartment
• Give nursing care based on the plan
• When procedure is over, wash hands with soap and water
• Place the articles to the bag after cleaning
• Fold used newspaper with used side inside
• Close the bag
• Record your procedures and observation and instructions given

HOME HEALTH NURSING PROCEDURES

The community health nurse primary responsibility to meet health needs of the family, it is necessary to provide nursing care on a selective basis and to demonstrate the care to some responsible members of the family. It is recognized that nurses working in the community health field have been trained in many different hospitals and schools; they were taught procedures have changed community

PRINCIPLES TO BE OBSERVED

• Resources usage: standard procedures should be followed as far as possible utilizing materials and equipment found in the home
• Demonstration: demonstration of nursing care in the home is most effective method of teaching
• Standing orders: medical instructions in the form of standing instructions or individual instructions must be available before administering medicine or treatment
• Prevent spread of disease: the health worker must know to check the disease at its sources. The practice of medical asepsis and the habit of thorough cleanliness at all time is basic to all procedures
• Respect the families: practice as far as possible custom and habits are scared to the family. Habit changes are slow and come with knowledge and action which the nurse may initiate and/or participate in through individual and group teaching
• Comfort and relationships: consider comfort and relationship when selecting the patients unit. The nurse must select the place where the patient will get rest, privacy and clean air. The sick person may be housed comfortably and at the same time, prevent the spread of infectious material
• Economical use: supplies and equipment economically, always consider the high cost of fuel, the hardship in getting water and the family economics
• Teaching: the community health nurse should teach the patient and responsible member of the family, teach with proper demonstration and also encourage to do return demonstration
• Record keeping: adequate records and reports are an integral part of every good nursing service. Records should be maintained up to date
• Prevention of accidents: write name of the drug and instructions for taking using the language of the people. Inform the family to keep all drugs locked in their cupboards and out of reach of children
• Health promotion: safe water, latrines, drainage, cooking arrangement, bathing, absence or presence of animals within the compound or in the house is of major importance in the promotion of health
• Nutritional observation: observation and action relative to the nutritional status of the family is a primary responsibility of the nurse

NURSING PROCEDURES LIST CLICK HERE

NURSING IMPORTANT QUESTIONS – CLICK HERE

NURSE FUNDAMENTAL PROCEDURES

MEDICAL SURGICAL NURSING

OVERVIEW OF COMMUNITY BAG

Here is a general outline of the community bag technique:

1. Purpose and Preparation:

• Identify the purpose of the visit, whether it’s a routine assessment, health education, or specific care needs.
• Review the patient’s health record and care plan to determine the required supplies.

2. Selecting the Bag:

• Choose a durable and easily portable bag with compartments or pockets to organize different types of supplies. Backpacks or tote bags with multiple sections are commonly used.

3. Essential Supplies:

• Basic assessment tools (e.g., stethoscope, blood pressure cuff, thermometer).
• Dressings and wound care supplies.
• Medication administration tools.
• Health education materials.
• Gloves and hand hygiene items.
• Documentation tools (e.g., notepad, forms, pens).
• First aid kit.

4. Organizing Compartments:

• Keep assessment tools together in one section.
• Separate wound care supplies from medications.
• Allocate space for personal protective equipment (PPE).

5. Mobile Technology:

• If applicable, bring mobile devices (e.g., tablets, smartphones) for accessing electronic health records, documenting care, and obtaining information.

6. Patient-Specific Items:

• Include patient-specific items based on individual needs and care plans. This may involve specialized equipment or materials.

7. Emergency Supplies:

• Include emergency supplies such as a basic first aid kit, emergency contact information, and any necessary rescue equipment.

8. Personal Comfort Items:

• Consider adding personal comfort items such as water, snacks, or a small first aid kit for the nurse’s own well-being during visits.

9. Check and Replenish:

• Regularly check the community bag to ensure that supplies are not expired and are in good condition.
• Replenish items as needed, and keep the bag well-stocked for the next visit.

10. Infection Control: – Practice infection control measures, including proper hand hygiene and the use of personal protective equipment as needed.

11. Flexibility and Adaptability: – Be prepared to adapt the contents of the bag based on unexpected situations or changes in the patient’s condition.

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1. Upon arriving at the client’s home, place the bag on the table or any flat surface lined with paper lining, clean side out (folded part touching the table). Put the bag’s handles or strap beneath the bag. To protect the bag from contamination. 2. Ask for a basin of water and a glass of water if faucet is not available. Place these outside the work area. To be used for handwashing.
To protect the work field from being wet. 3. Open the bag, take the linen/plastic lining and spread over work field or area. The paper lining, clean side out (folded part out). To make a non-contaminated work field or area. 4. Take out hand towel, soap dish and apron and the place them at one corner of the work area (within the confines of the linen/plastic lining). To prepare for handwashing. 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 wrong side with crease touching the body, sliding the head into the neck strap. Neatly tie the straps at the back. To protect the nurses’ uniform. Keeping the crease creates aesthetic appearance. 7. Put out things most needed for the specific case (e.g.) thermometer, kidney basin, cotton ball, waste paper bag) and place at one corner of the work area. To make them readily accessible. 8. Place waste paper bag outside of work area. To prevent contamination of clean area. 9. Close the bag. To give comfort and security, maintain personal hygiene and hasten recovery. 10. Proceed to the specific nursing care or treatment. To prevent contamination of bag and contents. 11. After completing nursing care or treatment, clean and alcoholize the things used. To protect caregiver and prevent spread of infection to others. 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 matters relevant to health care, taking anecdotal notes preparatory to final reporting. To be used as reference for future visit. 17. Make appointment for the next visit (either home or clinic), taking note of the date, time and purpose. For follow-up care.

• Before keeping all articles in the bag, clean and alcoholize them.
• 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

• Record all relevant findings about the client and members of the family.
• Take note of environmental factors which affect the clients/family health.
• Include quality of nurse-patient relationship.
• Assess effectiveness of nursing care provided.

Reference: Community Health Nursing Services in the Philippines, DOH

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Bag Technique 101 for Home Care Nurses

This article explores the six basics principles for bag technique for the home care nurse. Specialties Home Health Article

• Home Health Nursing
• Community Nursing
• Bag Technique

Updated: Feb 12  

You enter Mrs. Jones' home to do your Start of Care assessment. She opens the door to reveal a maze of newspapers and other memorabilia that she's been keeping since at least 1929. You begin surveying the scene for a place to put your nursing bag.

Just as you think you've found a spot on a table at the end of the couch, 4 cats pop out of nowhere and begin to inspect you and your bag. What do you do?

Here are a few things you should know about bag technique in the home care setting.

Is Bag Technique Important?

There are no confirmed reports of patients becoming ill due to pathogens brought into their home on a nursing bag. However, there is some research about what grows on the outside and inside of your bag. One study reports that 83.6% of the exteriors of nursing bags cultured were positive for human pathogens and 15.9% of these pathogens were multidrug-resistant organisms.

The inside of nursing bags was not clean either. The study found that 48.4% of the inside of nursing bags were positive for human pathogens, with 6.3% being multi-drug resistant. How do you limit the number of organisms you carry from one home to the next?

It's simple - Bag Technique.

What is Bag Technique?

Bag technique is used to prevent the transmission of pathogens while making home visits. There are a few basic principles involved in bag technique:

• Hand hygiene
• Bag placement while in patient homes
• Bag placement during storage
• Cleaning interior and exterior surfaces of the bag
• Handling equipment and supplies in the bag
• Handling equipment and supplies after they are removed from bag

Your home care agency will have a policy and procedure on the exact steps to take when performing bag technique . Here, we will explore the basic ideas behind the principles of getting in and out of your nursing bag.

Hand Hygiene

Your hands become a vector that can transmit pathogens from your bag to the patient. The reverse is true too. Similar to other clinical areas, hand hygiene is of the utmost importance.

The CDC reports that healthcare providers clean their hands less than half of the times they should. They also recommend washing your hands before any contact with the patient.

Your agency may also recommend that you wash your hands -with soap and water or hand sanitizer- before entering the inside of your nursing bag too. The more you wash your hands before contact with the patient and your bag the more you decrease the risk of transmitting bacteria to your patients.

When working inside the bag, be sure to never place "dirty" items inside the bag. If you have a sharps container, place into an exterior compartment of the nursing bag, but never stored inside the bag.

Bag Placement

Place your bag on a clean, dry surface, if available. If not available, place a clean barrier down first before putting your bag on a table or other surface. Another option is to hang the bag from a doorknob or over a door. Keep the bag closed when you are not working inside of the bag, especially if there are pets near.

If you have a bag with wheels, you can leave it on the floor with a barrier underneath. Pay close attention that items don't fall out onto the patient's floor and that exterior pockets never come in contact with the floor when they're unzipped.

Vehicle Storage

Your bag should be stored in your vehicle on a clean, dry surface. If you have supplies in your bag that may be temperature-sensitive, you will need to keep the bag inside your car versus the trunk. Be sure that the bag is always kept on the "clean" side of your vehicle.

If you are concerned about bed bugs or other insects, place your bag inside a large plastic container inside your car.

Cleaning the Bag

The outside of your bag is important. Chose a bag that's made of smooth, non-canvas nylon or polyester or other materials that can be wiped down to decrease the number of pathogens you carry from one home to the next.

When to Leave Your Bag in Your Vehicle

There will be times when your nursing bag is best left in your vehicle. These times include:

• Known infestations with bedbugs or other insects
• Homes that are contaminated with excrement
• Patients known to have a multi-drug resistant organism
• Patients on transmission-based precautions

You always have the right to leave your nursing bag in your vehicle. In these situations, double-bag all items so that you can throw one away in the patient's home and use the other to carry items back to your car. Be sure to disinfect all equipment in the bag before placing it back into your nursing bag.

Do you have any tips and tricks you can share to help others use bag technique in their nursing practice?

About Melissa Mills, BSN

Melissa is a Quality Assurance Nurse, professor, writer, and business owner.

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There are also considerations to how equipment is removed, placed next to the patient, disinfected and replaced in the bag as well as clean and dirty pockets of the bag and which equipment goes where.

Hanging a bag on a doorknob is not an option with our policy, fomite on the bag strap promotes transfer of pathogens. Our bags are wheeled and dental drapes for a clean and dirty surface barrier and disinfectant wipes are provided for management of all equipment. Our staff receive routine education on proper bag technique and they are expected to follow our policy.

Melissa Mills, BSN

126 Articles; 373 Posts

Libby1987 - Thanks for the extra thoughts. Yes, each agency will have their own policies and should be followed first and foremost. ~Melissa

The bag in a car...

I hate to leave it in the car.

Especially when bag and/or car are recognizable HomeHealth.

Such cars are faster broken up as you can turn around.

After a looong negotiation with our management we´ve got "neutral" cars, bags and rags. - Frieda

Elfriede said: The bag in a car... I hate to leave it in the car. Especially when bag and/or car are recognizable HomeHealth. Such cars are faster broken up as you can turn around. After a looong negotiation with our management we´ve got "neutral" cars, bags and rags. - Frieda

Elfriede - I agree that leaving the bag in your car is not always the best answer. Trying placing it in a bin with a lid. This keeps pests from roaming around you car and keeps others from recognizing the bag as something that belongs to a nurse.

Kitiger, RN

1,834 Posts

The outside of the bag should be waterproof and easily cleaned. In addition, the bottom should be sturdy. I don't understand why a bag cannot be placed on the floor - the same floor that we walk on. Is it because the bottom of the bag can carry pathogens that my shoes do not carry?

Kitiger said: The outside of the bag should be waterproof and easily cleaned. In addition, the bottom should be sturdy. I don't understand why a bag cannot be placed on the floor - the same floor that we walk on. Is it because the bottom of the bag can carry pathogens that my shoes do not carry?

I used to have that same question!

Bags can be placed on the floor if they're consistently placed on the floor ie wheeled bags.

Kitiger - These is likely agency specific. However, the reasoning behind not placing the bag on the floor is related to the amount of pathogens and just general dirt that you will find on floors. If you leave a bag on the floor, it must have a barrier under it, unless it is on wheels (which keeps it up off of the floor). For me, I would have never put my bag on the floor for several reasons:

1. The dirt

2. The bending - I was in and out of my bag alot, especially if I had dressing changes or other skills that required me to get supplies out.

3. You don't want the outside of your bag to touch the ground and become contaminated and then you take that with you to other places.

I think if you always put it on the ground, as you would with a wheeled-bag, it might be one thing. But, you would not want to leave it on the floor of one home and then place it on the kitchen table of the next.

As for shoes - lots of things can stay on your shoes (especially bed bug eggs - they wedge up in the tread of the sole of the shoe) - but you are not touching your shoes throughout your day, as you do with you bag. However, when I was doing home visits daily, I never wore my shoes in my home. I left them on the porch in the Summer or in the basement in a tub in the Winter and disinfected them often. I never wanted to bring home extra "friends". ?

Hope this makes sense. Again, each agency is going to have their own policies on this - this is solely my experience. ~Melissa

melissa.mills1117 said: I think if you always put it on the ground, as you would with a wheeled-bag, it might be one thing. But, you would not want to leave it on the floor of one home and then place it on the kitchen table of the next.

I fully agree. My bag is always on the ground. I would no more put it on the table than I would stand on the table, and for the same reason.

I do private duty home care, not home visits.