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    CHN Checklist

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    jhelairheine.alde.mnl
    checklist that can be use for retdem and interview

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    CHN Checklist

    Uploaded by

    jhelairheine.alde.mnl
    2 views5 pages
    checklist that can be use for retdem and interview

    Original Title

    CHN-Checklist

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

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    checklist that can be use for retdem and interview

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2 views5 pages

    CHN Checklist

    Uploaded by

    jhelairheine.alde.mnl
    checklist that can be use for retdem and interview

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    PERFORMANCE CHECKLIST

    BAG TECHNIQUE

    Name: __________________________________ Date: _____________


    Instructor: ______________________________ _ Section: ___________

    Objective: At the end of the discussion and demonstration students will be able to perform the proper
    execution of bag technique and identify the nursing responsibilities it entails towards its goals of
    rendering effective nursing care to the family while maintaining cleanliness to minimize spread of
    microorganisms.

    Equipments
    CHN Bag

    PRE – HOME VISIT

    Available and Available but not Not available/not


    CONTENTS OF THE Functioning Functioning observed Initial and
    PHN BAG Date
    (2) (1) (0)

    1. Asses
    completeness of the
    PHN bag

    1.1 Front of the


    PHBN Bag (L-R)

    a. Thermometer

    b. Tape Measure

    c. Adhesive Tape

    d. Cotton Applicator

    1.2 Right rear of the


    PHN Bag

    a. 2 test tube and 1


    holder
    b. Medicine Dropper

    c. Alcohol Lamp

    1.3 Left Rear of the


    PHN Bag

    a. Medicine Glass

    b. Baby Scale

    c. Bandage Scissors

    d. Rubber Suction

    1.4 Back of the PHN


    Bag

    a. 70% Alcohol

    b. Betadine Solution

    c. Hydrogen
    Peroxide

    d. Terramycin
    Ophthalmic
    Ointment

    e. Zephiron Solution

    f. Spirit of Ammonia

    g. Acetic Acid

    h. Benedict Solution

    i. Liquid soap

    j. Cotton in Sterile
    Water

    1.5 Center of the


    PHN Bag

    a. 2 pairs of forceps
    (straight and curved)

    b. Surgical Scissors
    DURING HOME VISIT

    PROCEDURE Able to Able to Unable to


    BAG TECHNIQUE Perform Perform with Perform Initials
    Assistance And
    Date
    (2) (1) (0)

    1. Place the bag on the table or any flat


    surface lined with paper lining, clean
    side out (folded part touching the
    table). Put bag’s handles or straps
    beneath the bag.

    2. Ask for a basin of water if faucet


    is not available. Place these
    outside the work area.

    3. Open the bag, take the linen or plastic


    lining and spread over work field.
    the paper lining clean side 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 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 (ex. thermometer,
    kidney basin, cotton ball, waste
    paper bag) and place at one corner
    of the work area.

    8. Place waste 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
    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 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.

    17. Make appointment for the next


    visit (either home or clinic),
    taking note of the date, time
    and purpose.

    After Care

    18. Before keeping all articles in the


    bag , clean and alcoholize them.
    19. 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

    20. Record all relevant findings,


    about the client and members
    of the family.

    21. Take note of environmental


    factors which affect the
    clients/family health.

    22. Include quality of nurse-


    patient relationship.

    23. Assess effectiveness of


    nursing care provided.

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