Central Philippine Adventist College School Of Nursing

CENTRAL PHILIPPINE ADVENTIST COLLEGE School of Nursing

BAG TECHNIQUE PERFORMANCE CHECKLIST

Name_______________________________Sec.______Date____________Score____________

ATTITUDE

PERFORME D

YES 1. Is self-motivated and shows eagerness to learn. 2. Shows professionalism in performing the skills a. Organizes working area. Applies proper time management (max of 15-20 mins in all). b. Presents complete uniform and paraphernalia. c. Observes privacy of the clients all through out. d. Observes asepsis principles at all time. PROCEDURE: 1.Performs the steps in Home Visits. 2. Places the bag on the table lined with a clean paper. 3. Assess the needs of the client to know what are the necessary items needed from the CHN bag. 4. Asks for a basin of water or a glass of water if faucet is not available. 5. Wash and dry hands. 6. Put out all the necessary items/ articles needed for the specific care. Keep the bag opening facing the working area. 7. Close the bag. 8. Proceed in performing the necessary nursing care and treatment. Give necessary health teachings. 9. Cleans all things that were used after giving nursing care. 10. Wash and dry hands again. 11. Return all things that were used in their proper places. 12. Fold the lining, place it inside the bag. 13. Write down all necessary data that were gathered, observations, nursing care and treatment rendered. 14. Make appointment for the next visit.

NO

MASTERED

COMMENTS

Recommendation___________________________________________________________________ _____________________________________________________________________________________ ___ Student’s Signature__________________________ Clinical Instructor’s Signature___________________