1 COMMUNITY HEALTH NURSING RLE

BAG TECHNIQUE
BAG TECHNIQUE

A tool making use of a public health bag through which the nurse, during his/her home visit, can
perform nursing procedures with ease and deftness, saving time and effort with the end in view of
rendering effective nursing care.

PUBLIC HEALTH BAG

Is an essential and indispensable equipment of the public health nurse which he/she has to carry along
when he/she goes home visiting. It contains medications and articles which are necessary for giving
care.

Rationale: To render effective nursing care to clients and/ or members of the family during home visit.

PRINCIPLES:

1. The use of the bag technique should minimize if not totally prevent the spread of infection from
individuals to families, hence, to the community.
2. Bag technique should save time and effort on the part of the nurse in the performance of
nursing procedures.
3. Bag technique should not overshadow concern for the patient rather should show the
effectiveness of total care given to an individual or family.
4. Bag technique can be performed in a variety of ways depending upon agency policies, actual
home situation, etc. as long as principles of avoiding transfer of infection is carried out.

Special Considerations in the Use of the Bag

1. The bag should contain all necessary articles, supplies and equipment which may be used to
answer emergency needs.
2. The bag and its contents should be cleaned as often as possible, supplies replaced and ready for
use at any time
3. The bag and its contents should be well protected from contact with any article in the home of
the patients. Consider the bag and its contents clean and/or sterile while any article belonging to
the patient as dirty and contaminated.
4. The arrangement of the contents of the bag should be the one most convenient to the user to
facilitate efficiency and avoid confusion.
5. Hand washing is done frequently as the situation calls for, helps in minimizing or avoiding
contamination of the bag and its contents
6. The bag when used for a communicable case should be thoroughly cleaned and disinfected
before keeping and reusing.

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CONTENTS OF THE BAG

∙ Paper lining
∙ Extra paper for making bag for waste materials (paper bag)
∙ Plastic/ linen lining
∙ Apron
∙ Hand towel in plastic bag
∙ Soap in soap dish
∙ Thermometers in case (oral and rectal)
∙ 2 pairs of scissors ( surgical and bandage)
∙ 2 pairs of forceps ( curved and straight)
∙ Syringes (5ml and 2ml)
∙ Hypodermic needles (g19, 22, 23, 25)
∙ Sterile dressings (OS, CB)
∙ Adhesive plaster (micropore)
∙ Dressing (OS)
∙ Alcohol lamp (with ethyl alcohol)
∙ Tape measure
∙ Baby’s scale
∙ 2 pairs of gloves (1 sterile and 1 clean)
∙ 2 test tubes
∙ Test tube holder
∙ Medicines
o Betadine
o 70% alcohol
o Ophthalmic ointment
o Zephiran solution
o Hydrogen peroxide
o Spirit of ammonia
o Acetic acid
o Benedict’s solution
∙ Cotton balls (in a container) – wet and dry
∙ Medicine dropper
∙ 70% alcohol

∙ NOTE: Blood pressure apparatus and stethoscope are carried separately

STEPS/PROCEDURES

1. Upon arriving at the client’s home, place the bag on the table or any flat surface lined with
paper lining, clean outside out (folded part touching the table). Put bag’s handle or strap
beneath the bag
2. Ask for basin of water or a glass of water if faucet is not available. Place these outside the work
area.
3. Open the bag, take the linen/plastic lining and spread over work field or area. The paper lining,

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clean outside out (folded part out)

4. 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)
5. Do hand washing. Wipe, dry with towel. Leave the plastic wrappers of the towel in soap dish in
the bag.
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.
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.
8. Place waste paper bag outside of work area.
9. Close the bag
10. Proceed to the specific nursing care or treatment.
11. After completing nursing care or treatment, clean and alcoholize (sanitize) the things used.
12. Do hand washing again.
13. Open the bag and put back all articles in their proper places
14. Remove apron folding away from the body, with soiled side folded 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.
17. Make appointment for the next visit (either home or clinic) taking note of the date, time and
purpose.
AFTER CARE

1. Before keeping all articles in the bag, clean and alcoholize them.
2. Get the bag from the table, fold the paper lining (and insert) and place in between the flaps and
cover the bag

EVALUATION

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

HOME VISIT
HOME VISIT
 Is a family and nurse contact
PURPOSE
1. To visit postpartum mother and newborn. (check the vital signs, pain lessen mortality)
2. To assess the living condition. (give health teaching)
3. Prevention and control diseases
 Environment – health teaching and intervention
4. Established close relationship
5. Inter referral system

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PRINCIPLES:
 Record – new – profile
 Names
 Study the case – ex. Dengue or malaria

1. Must have purpose and objective

2. Gather all available information
3. Priority – essentials needs
 Typhoon – basic needs and meals
4. Involve the individual and family
5. The plan should be flexible

GUIDELINES: FREQUENCY OF THE LIST

1. Physical needs
Psychological needs
Education needs
2. Acceptance
Willingness
Cooperation
3. Policy of specific agency – COVID (dswd)
4. Health agencies – DSWD
5. History taking
6. Own needs

STEPS:
1. Greet the family and introduce yourself
2. State the purpose
3. Observe and determine the health needs
4. Bag technique
5. Give health teaching

FAMILY PLANNING
What is family planning?
 Family planning is the voluntary and positive act of couples to plan and decide:
1. The number of children a married couples wants
2. When to have the next baby
3. To use responsible means to achieve the couple’s desired number of children
4. To seek help so the childless couple will have children

GOAL
 To provide universal access to FP information and services whenever and wherever these are
needed

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OBJECTIVES
 To help couples and individuals achieve their desired family size within the context of
responsible parenthood and improve their reproductive health to attain sustainable development.
 To ensure that quality FP services are available in DOH – retained hospitals, LGU managed
health facilities, NGOs and private sectors

TARGET

MWRA (Married Woman Reproductive Age) = 15 to 49 years old

 Couples
 Special population
Youth and adolescents
Women below 18 years old
Women over 35 years old
Women with medical conditions, obese, smoking

GUIDING PRINCIPLES
 Respect for life
 No to abortion; illegal in revised penal code
 Informed choice
 Full information and voluntary decision-making
 Birth spacing
 Birth spacing of 3 to 5 years
 Responsible parenthood.
 The right to determine family size according to couple’s capacity, beliefs, etc.

TEMPORARY METHODS

1. Natural family planning or fertility awareness – based method

 Is a collection of practices that help a woman know which days of month she is most
likely to get pregnant. A woman can learn when ovulation is coming by observing her own
body and charting physical changes. She can then use this information to avoid or
encourage pregnancy. The method’s effectiveness depend on the couple’s ability to
identify fertile periods and motivation to practice abstinence
2. Billings Ovulation method
 Is based on the daily observation of what a woman sees and feels at the vaginal area
throughout the day. Cervical mucus changes indicate whether days are infertile and can be
used to avoid or achieve pregnancy. With correct use, this method is 97% effective.
However, this typical use, it is 80% effective.
3. Basal body or Sympto – thermal method
 Is based on the combined technology of the basal body temperature and the billings
ovulation method, e.g., the resting body temperature and on the observation of mucus
changes at the vaginal are through the day together with other signs (breast enlargement,

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unilateral lower abdominal pain) which indicate that the woman is fertile or infertile. This
method is 98% effective as correctly used.
4. Standard days method
 Is based on the calculated fertile and infertile period for menstrual cycle lengths that are
26-32 days. Woman who are qualified (e.g., with 26-32 days menstrual cycles) to use this
method are counseled on days 8 to 19 to avoid pregnancy. Couples on this method use
devise, the color – coded “cycle beads” to mark the fertile and infertile days of the
menstrual cycle.

What is LAM
 LACTO – amenorrhea method
 NFP method based on breastfeeding

Can use LAM if:

1. Baby is less than 6months old
2. Exclusively breastfeeding
3. Menstrual period have not comeback

TEMPORARY ARTIFICIAL METHOD

What is a pill?
 Modern FP method taken daily at the same time of the day
 Stops ovulation & thicken cervical mucus
2 types:
1. COMBINED ORAL CONTRACEPTIVE (COC)
 Not for breast feeding women
 99.7% effective
2. PROGESTIN ONLY CONTRACEPTIVE (POP)
 Can be used by breastfeeding women
 99.5% effective

ADVANTAGES:
 Does not interfere with sex.
 Prevents anemia
 Can easily be stopped
 Reduces the risk of ovarian and endometrial cancer.

DISADVANTAGES:
 Need to remember to take the pill daily, same time of the day
 Effectiveness maybe reduced when taken with Rifampicin

What are its possible side effects & points to remember?

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Possible side effects:

 Upset stomach
 Spotting
 Mild headaches
 Tender breasts
 Dizziness
 Changes in weight.

Points to remember:
 Do not miss pills
 Require medical attention if with:
J – jaundice
A – abdominal pains
C – chest pain
H – headaches
E – eye problems
S – severe leg pains

What is an Injectable?
 FP method in injected to the women’s arm or buttocks to prevent pregnancy. It may be
administered every 3 months or monthly depending on the preparation. The injectable thickens
the cervical mucus which prevents sperm from entering the uterus, stops ovulation and causes
changes in the uterus and fallopian tube, which prevents fertilization.

2 types:

1. COMBINED INJECTABLE CONTRACEPTIVES (CIC)

- Not for breastfeeding
- 99.9 effective
2. PROGESTIN ONLY INJECTABLE (POI)
- Can be used by breastfeeding women
- 99.7 % effective

Advantages:
 Private. No one else can tell if the women is using it.
 Can be used by breastfeeding women (only POI)
 Allows some flexibility in return visits ( 2 weeks early or 2 weeks late for DMPA)
 Long term pregnancy prevention but reversible.

Disadvantages:
 Delayed return of fertility of about 8-10 months after its contraceptives effects (DMPA)
 Requires regular injections

What are its possible side effects & points to remember?

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Possible side effects

 Upset stomach
 Spotting
 Mild headache
 Tender breasts
 Dizziness
 Changes in weight

Points to remember:
 Name of your injectable
 Schedule of next injection
 Requires medical attention if:
- Has very heavy bleeding
- Has very bad head aches
- Skin or eyes are yellow
- Severe chest pain

What is condom?
 Is a rubber sheath worn over the penis during sexual intercourse thus preventing the sperm from
entering the vagina.
 98% effective (male condom)
 95% effective (female condom)

Advantages:
 Safe. No hormonal side effects
 Can be stopped at any time
 Can used as a back up method, can be used together with other methods
 Help prevent STI/HIV

Disadvantage:
 Interferes with sex
 May slip off or break
 May be embarrassing for some people to buy, ask partner to use, put on. Take away or throw
away.

What are its possible side effects & points to remember?

Possible side effects

- May cause allergy to people who sensitive to latex or the lubricant

Points to remember
- Use a condom EVERYTIME you have sex
- Make sure you always have enough supplies of condoms

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- Store condoms away from direct sunlight and heat

What is IUD?
Intra-Uterine Device
- CuT380A is made of plastic and copper shaped like a T with 2 nylon threads at end.
- 99.4% effective (up to 12 years of CuT380A)

Advantages:
 Long lasting prevention of pregnancy.
 Can be used by breastfeeding mothers.
 When the woman wants to get pregnant. The provider can easily remove the IUD.

Disadvantages
o A woman cannot use the IUD on her own
o Need to check the position of IUD strings from time to time.

What are its possible side effects & points to remember?

Possible side effects

 Changes in menstrual bleeding
 Vaginal discharge
 Lower abdominal pains
 Pelvic inflammatory disease (PID)

Points to remember
 Kind of IUD used: schedule for IUD removal
 Immediately return to clinic if there is :
P- period late
A- Abdominal pains
I – infections
N – not feeling well
S – string is missing

What Is Ligation Or female sterilization

 A small incision is made in the abdomen to gain access to fallopian tubes, which are then cut and
tied: requires local anesthesia.

Advantages
 Does not affect sexual activity
 Can be used by breastfeeding mothers.

Disadvantages
 Requires a trained surgeon to perform the procedure.

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What are its possible side effects & points to remember?

Possible side effects

- Post operative discomfort
- No long term side effects

Points to remember
- In the first week go to the health facility immediate if there is:
 High fever
 Pus or bleeding from the wound
 Pain and redness of the wound
 Worsening cramps
 Dizziness or fainting

What is vasectomy?
- A minor surgical operation wherein the vas deferens of the man are ties and cut.
- 99.9% effective

Advantages:
 Can immediately return to work two days after having vasectomy.
 Does not reduce a man’s ability to have sex.

Disadvantages
 Reconnecting the severed vas deferens is difficult
 Effective only after months from the procedure.

IEC and Advocacy

 Municipal pre-marriage counseling team conducts PMC to all would be couples a pre-requisite by
LCR for marriage license application
 Fertility awareness orientation to youth/adolescents (4 th year high school student)
 Lobby for adaptation men’s reproductive health
 Fertility orientation session to couples interested to practice NFP

Ivy Nicole Castillo | UNIVERSIDAD DE DAGUAPAN