Community

1. BAG TECHNIQUE
The bag
(1) The bag should be made of canvas, leather or light metal.
(2) It should be such that it can be carried by the hand or on the shoulder.
(3) The bag should have outside pockets for keeping a note-book, tape measure, newspaper or
plastic sheet, towel, soap in a soap dish, and a nail brush.
Bag technique
As the same bag may have to be used in Several homes, every effort should be made to keep the
bag as clean as possible.
(1) First spread the newspaper or plastic sheet on a flat surface in a clean area and place the bag on
it. It should be kept away from children and animals.
(2) Wash hands with soap and water each time before opening the bag.
(3) Remove only what is needed.
(4) Carry out the nursing procedure.
(5)After finishing the work; wash hands, open the bag and replace them in the bag. When this is
not possible. place them in a separate bag. Wash and boil all the instruments after
(6) Burn the soiled dressings.
(7) Fold the used newspaper with used side inside and keep it in the outer pocket.
Equipment
No home visit should be made without bag or kit. There are two separate kits – one for deliveries
(Delivery Kit) and the other for general nursing and tor prenatal and postnatal visits.
1. Delivery kit
The UNICEF kit is widely used for deliveries and is most suitable. The
equipment is contained in an aluminium box.
2. Nursing bag
If no separate bag is should supplied, the nurse improvise, using a tin with an air-tight lid. or a
plastic bag. As the equipment may have to be carried by hand for long distances and for long
periods, the tin or bag should be as light as possible and should contain only essential articles.
Unless the whole container can be completely disinfected, a separate cotton lining should be used.
The nurse must also carry separately (not in her kit) a pen or pencil, a notebook or diary in
which to note down observations and enter records before leaving the patient's home. Some clean
newspapers in which to wrap soiled dressings in the home are useful.

2. 3. Care of the equipment
Regular care of equipment is most important:
(a) To prevent any possibility of cross infection by carrying contaminated articles from house
to house;
(b) To preserve the equipment for use as long as possible; and
(c) To put it to the best possible use.
It should be remembered that the purpose is to keep the contents of the kit clean and in good
condition but not and necessarily sterile.
The following practices are:
(a) Bag
If the bag is metal it may be well washed with soap and water or boiled. If canvas it should not be
boiled but can be dried in the sun after cleaning and washing Except where the whole has been
boiled. the bag must have a clean boiled lining of cotton which can be removed easily and often
replaced An outer pocket can be made for keeping soap. towel and newspaper.
b) Rubber goods
All should be well washed in soap and water and rinsed Tubes and catheters must be hung to drain
Plastic apron and sheetings should be hung in the shade to dry Gloves should be dried with a cioth
both inside and outside and aired for a few hours before being put away in cotton cases. For getting
rubber goods sterilized. put them in boiling water and boil them for ten minutes.

3. (c) Thermometer
The thermometer and the case may be soaked in an antiseptic solution, after washing with soap and
water.
d) Bottles
All bottles should be emptied once a month after the corks are removed, the bottles and the corks
should be boiled Clean well-marked labels should then be affixed on the bottles giving the contents
and dosage before filling them up.
e) Enamelware and stainless steel
Boil such ware for twenty minutes, dry with a clean towel while the ware is still hot In an
emergency, it may be flamed (For this. rinse the bowl with a little spirit then set fire to it with a
match. being careful to do this only where there is no danger of setting fire to anything else)
f)Cord ligatures
Remove the screw from the bottles and boil the bottles, the top and the threads for twenty minutes.
Then place thread. into the bottle (spirit, if available, may be added) either by using sterile forceps
or with well scrubbed hands. Replace the cork and screw it tightly. Small round rubber bands may
also be used for this purpose. Threads, when used should be strong.
(g) Eye antiseptic
If a silver nitrate preparation is used, it must be renewed approximately every week. It is very
important that this bottle be well labeled. Now-a-days, freshly prepared lotion of penicilline 1/100
is generally used.
(h) Instruments
All instruments should be washed well with cold water after use (the forceps opened up) boiled for
twenty minutes and dried with a clean towel before being replaced. Do not boil the scissors. These
can be thoroughly washed with soap and water, flamed or put in an antiseptic solution before use.
After use, wash clean and dry. A little oil can be added at the joints and blades to keep the scissors
free of rust.
i)Dry dressing and swabs
There are several methods of sterilizing dressing and swabs:
Arrangements can be made with the local hospitals or primary health centres to sterilize dressings
at regular intervals, if they have the facilities. The swabs or dressings can be packed in small
cotton bags or paper packets which can then be placed in lined biscuit tins or packs made of at
least two thicknesses of cotton material and autoclaved in the usual way.
- Dressings or swabs can be baked| in the tins or packs, in an oven " available. In this case,
thick linen linings will be necessary. The bottom and top of the tins must be perforated, and
the lid left open. during baking. The instructed mother can be to prepare their own
dressings, linen, etc., for delivery and the midwife can get them sterilized whenever
needed.
- Dressings., old linen and cotton material be scorched. The material should be well washed,
boiled, ironed with a hot iron to scorch and placed in small bags. In an emergency,
scorching may be carried out in the home at the time the dressings are needed.
G) Blood-Pressure measuring instrument
The cotton arm-band should be separated from the rubber bag and then washed and ironed in
the usual way. The rubber bag, tubing, etc., may be washed over with a cloth, using either
an antiseptic or a soap solution and rinsed. Never immerse the bag or tubing in water. Hang to
dry.
(k) Stethoscopes

4. The chest piece may be immersed in soapy water or an antiseptic solution; the tubing should be
wiped with a clean cloth and dipped in this solution. Metal foetal stethoscopes may be boiled.
If the correct techniques are used, a nursing kit so prepared should not become a source of
infection. Full disinfection will not be necessary daily, unless the kit has been used in a house
where there is infection. Daily treatment of the kit consists of renewal of towels swabs and
dressings, and any necessary renewal of drugs, antiseptics, etc. Once a week the bag and its
contents must be given full treatment.
The kit must be placed in a safe and Clean place and not locked away, as it must be
available at all times.
The delivery bag should be completely disinfected after each use. If the same bag is also
used for nursing care, daily preparation will be a necessary precaution.
(a) Method of disinfecting the bag
Empty the bag completely and boil all boilable articles. Soak other equipment in antiseptic
or soapy water. Wash the bag. When all is disinfected, wash your hands well Place a clean
towel or a cover on a table. and build up the bag once again The contents will not be sterile
but will be free from infection; antisepsis is the aim. Once this is completed. close the bag
and place a clean newspaper near it, so that it will be ready for use.
If the equipment has been used for an infected patient, the nurse who carried out the
treatment should consider herself also as a possible source of infection. She should take a
bath, wash her hair and put on clean clothes before handling the articles which have been
disinfected. She can start the process of preparing the equipment and. While everything is
boiling or soaking. Have her bath.
(b) Points to remember
Do not carry in the bag anything which cannot be disinfected. Such as paper cartons, notebooks.
etc.. and never put any personal items such as handkerchiefs or money.
Do not handle the contents of the bag without first having washed your hands well. Procedure open
bag; wash hands: remove article or articles required: close the bag
Do not remove from the bag more than what is required for the particular nursing care to be carried
out. The less you put in and take out, the less is the danger of infection
Do not replace in the bag any article that has not first been thoroughly cleaned. It there is
something that cannot be boiled or washed, it is better to carry it outside the bag.
Always put the bag on a stool, cot or box, after placing a clean paper, and not directly on the
ground.