A nursing bag, medical supply kit or healthcare bag is essential to delivering effective home health care. Like concussion protocols in sports, proper home health bag technique keeps caregivers and patients safe and protected. In this article, we’ll outline its essential objectives, components, procedures to follow and best practices.

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Article Roadmap

• What Is the Bag Technique?
  • Principles
  • Procedure
  • Essential Supplies
• Best Practices
• FAQs
• Next Steps

What Is the Bag Technique?

The home health bag technique is a method used by nurses and caregivers to deliver medical care at home and avoid cross-contamination or spreading infections. It involves stocking the bag, following a specified procedure and cleaning it afterward.

Principles

Like BODMAS or PEMDAS in mathematics, the bag technique follows a few major rules. Nailing the following principles is key to executing the proper bag technique:

• Hand hygiene: Performing hand hygiene is critical to preventing infection. Your patients might not touch your nursing bag, but you’ll be in contact with both. Wash your hands before you make contact with patients, after contact with patients, before entering the bag and after contact with objects near patients.
• Bag placement: Where you put the as important as what you put in it. During home visits, place the bag on a visibly clean, dry surface. If you can’t find a surface that meets those criteria, use a surface barrier or hang the bag on a doorknob or sturdy furniture.
• Bag placement en route and storage: Store the bag on a clean, flat surface in your vehicle. Be sure to factor car cleanliness and temperatures into your bag placement. Some supplies may react to extreme temperatures, so a non-temperature-controlled location, like the trunk, isn’t ideal. The journal Home Healthcare Now recommends placing the bag in a plastic container if there’s a risk of bedbugs.
• Cleaning the bag: Bakunas-Kenneley and Madigan’s study exposed nursing bags as a potential reservoir for multi-drug resistant organisms. The solution? Cleaning the interior and exterior of the bag whenever it’s visibly soiled, on a monthly basis if you use a surface barrier regularly, or on a weekly basis if you don’t routinely use a surface barrier.
• Maintaining the equipment and supplies: Apart from disinfecting reusable equipment and replacing disposable equipment, you’ll need to check when medical supplies expire and visit the supply center to restock. Healthcare professionals recommend dividing supplies into single-use items and reusable items.
• Managing the equipment and supplies removed from the bag: As a general rule of thumb, “dirty items” don’t belong in the bag. Disinfect all items before you put them back. The only medical waste should be regulated medical waste used by the clinician and placed in the sharps container in a red biohazard bag. Any other medical waste, like in the case of wound care, should also be placed in the red biohazard bag. The red biohazard bag should be carried out by hand and not placed in the nursing bag.

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Procedure

Now that you’ve got the principles down – let’s dive into a step-by-step procedure to execute the proper bag technique:

1. Place the bag on a clean surface. It should be close to the patient, near a body source and out of the reach of children or pets. You may use surface barriers to protect the bag from contamination.
2. Perform hand hygiene. According to the WHO, proper hand washing includes the following steps:
   1. Stand in front of the sink and ensure no part of your hand or uniform touches the sink.
   2. Turn on the tap and wet your hands. Keep your hands and forearms below your elbow to avoid backwash.
   3. Apply three to five milliliters of antiseptic solution and lather for a minimum of 15 seconds. Interlace your fingers and rub the palms and back of your hands at least five times.
   4. Rinse your hands, ensuring you wash all the soap off.
   5. Dry your hands with disposable paper towels.
   6. Use a towel to turn off the faucet so you don’t recontaminate your hands.
3. Open the bag and remove any supplies you need to provide care. This step includes removing any protective equipment you may require.
4. Close the bag. It may sound obvious, but it’s important to keep the bag closed as much as possible to avoid contamination.
5. Treat patient according to their care plan.
6. Perform hand hygiene again if you need to retrieve additional supplies from the bag.
7. Dispose of any waste, including medical. Place sharps in the sharps container and any waste generated by patients in the red biohazard bag and set it aside.
8. Perform hand hygiene and put any unused reusable equipment back in the bag.
9. Sterilize and disinfect any soiled reusable items (this step includes your mobile and laptop). If you can’t clean a reusable item for any reason, put it in a biohazard bag but do not put it back in the healthcare bag.
10. Repack and close the bag.
11. Take clinical notes and give instructions for continued care.

Essential Supplies

To paraphrase Brad Pitt’s iconic line from “Seven”, “What’s in the bag?” An effective medical bag needs certain essentials to help caregivers and nurses meet the needs of their patients. Although your agency’s focus determines some supplies, some staples everyone needs. Use the checklist below to prepare your bag:

• Hand soap, disinfectant and towels
• Disposable bags and barriers
• One oral and one rectal thermometer (in cases)
• Stethoscope
• Blood pressure cuff
• Oximeter
• Nursing scissors
• Forceps
• Sterile dressings
• Medical tape
• Latex gloves
• Adhesive plaster
• Syringes
• Alcohol swabs
• Biohazard bag and sharps container
• Penlight
• Documentation device
• Digital or paper reference resources
• Protective mask/eye gear
• Tweezers
• Medications
  • Betadine
  • 70% surgical spirit
  • Zephiran chloride
  • Hydrogen peroxide
  • Spirit of ammonia
  • Ophthalmic ointment
  • Acetic acid
  • Benedict’s solution

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Best Practices

A basic understanding of the right procedure isn’t the end of the line. Like a first draft, there’s always a way to clean up the edges. Make it easier to execute the proper bag technique with the following tips:

Select the Right Bag Surface

What’s in a medical bag’s surface? Well, quite a bit, actually! Critically, you’ll want to pick a bag surface that’s easy to clean. The best bags have an exterior that’s non-porous (leather or vinyl). Porous materials like canvas or fabric are harder to disinfect by wiping the surface.

Clean the Bag Properly

It doesn’t matter how closely you follow the bag technique if the bag itself is a walking health hazard. While debates rage on how often to clean the bag, healthcare professionals agree on using the following methodology to ensure things are squeaky clean:

1. Choose a non-porous surface large enough to clean and disinfect the bag and empty out the contents.
2. Disinfect the surface with a cleaner recommended by the CDC and leave it on for the contact time the instructions suggest.
3. Place the bag on the surface and remove all contents.
4. Clean the interior of the bag using a wet disinfectant wipe while using gloves, and allow it to dry.
5. Hand wipe the exterior of the bag with a disinfectant wipe or wash the bag with warm water and antibacterial soap.
6. Remove your gloves and perform hand hygiene.
7. Sterilize vital signs equipment as per your agency’s regulations.
8. Check expiration dates, discard unusable supplies and restock the bag.

Compartmentalize

Compartmentalization is the key to a healthy work-life balance – and minimal cross-contamination. Divide your bag into three compartments:

1. Soap, disinfectant and towels
2. Non-critical, reusable items like a blood pressure cuff or oximeter
3. Single-use sterile items and protective equipment, for example, alcohol swabs, bandages, and facemasks

Additionally, consider including a lockable compartment for patient records and care plans.

Use a Surface Barrier

Home health care professionals are divided on whether using a surface barrier is a good or bad idea. However, the consensus seems to land on using a caregiver’s discretion to keep patients and healthcare professionals safe, i.e., in unhygienic homes or after visiting a contaminated home.

Remember, an effective surface barrier is water-resistant and disposable after a one-time use. Ideal barriers include:

• Plastic sheets
• Waterproof changing table liners
• Wax paper
• Sheet pan liners
• Poly-backed towels

Access Digital Records and Care Plans

Lugging around extensive patient records and care plans leaves you open to compliance breaches. It’s also one more item that’s not the easiest to sterilize. Home health care software makes accessing digital records and care plans easy. Smartphones are also much easier to disinfect.

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FAQs

What are the benefits of using the bag technique?

The benefits of using the bag technique include:

• Minimized Infections: Did you know a study found 83.6% of nursing bags tested positive for human pathogens? The right technique reduces the spread of bacteria and infection in the field.
• Protected Caregivers and Patients: The patient’s well-being is a top priority. Ensuring the right tools and equipment are available on the go helps ensure good outcomes. Proper hand hygiene and disinfection processes prevent organisms from passing from patient to caregiver and vice versa.
• Saved Time and Effort: Implementing clear steps to follow reduces caregivers’ cognitive load. They can spend more time with the patient instead of wasting energy following their process, which may be less efficient.

When should I leave the nursing bag outside the home?

Don’t bring the nursing bag into a patient’s house in the following circumstances:

• You know the patient is infected with an MSRO.
• The home has a bug or insect infestation.
• The patient is on contact precautions.
• You encounter extremely unhygienic conditions.
• You believe there’s a risk of contamination.

What are the pros and cons of using a surface barrier?

The pros of using a surface barrier include:

• Reduced contact with human pathogens in home environments.
• Increased protection for patients by not placing an item that may be contaminated directly in their home.
• Adherence to organization policy.

The cons of using a surface barrier are:

• Wasted time as the bag is a non-critical environment that never comes in direct contact with a patient.
• Minimal evidence-based guidelines and regulations to support barrier usage.

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Next Steps

The well-being of your patients and caregivers is a top priority. Implementing the proper home health bag technique helps you treat patients, minimize infection spread, and eliminate potential hazards. A little help from home health software streamlines the process with remote communication, reminders and training. We have a free requirements template to pinpoint the right software that fits your needs.

How can the right home health bag technique benefit your agency? Let us know in the comments below.