Bag technique procedure format ii
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bag technique format and evaluation format for assessment in community setup prepared by DR. Anjalatchi M.sc(N),MD(AM)
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Bag technique procedure format ii
- 1. BAG TECHNIQUE PROCEDUREFORMAT IDENTIFICATION OF THE PERSON: Name of the person:………………………………………………………………………………………. Age /sex of the person:…………………………………………………………………………………… Education of the person:…………………………………………………………………………………. Occupation of the person:……………………………………………………………………………….. Address of the person:……………………………………………………………………………………... ……………………………………………………………………………………… …………………………………………………………………………………….. Complaints of :……………………………………………………………………………………………... Community diagnosis:…………………………………………………………………………………….. Name of the procedure:……………………………………………………………………………………. Date of the procedure:…………………………………………………………………………………….. Time of the procedure:……………………………………………………………………………………. Procedure performed by:…………………………………………………………………………………. Procedure supervised by :…………………………………………………………………………………. Requirements of the procedure:………………………………………………………………………….. NEEDS AND PROBLEM TO BEASSESSED BASED ON THEFAMILYREQUIREMENTS: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- GOAL AND OBJECTIVES OF THE PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------
- 2. ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- PURPOSE OF THE PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- PRINCIPLES TO BE FOLLOWED WHILE CARING PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- LIST OF ARTICLES TO BE REQUIRED WITH RATIONALE: 1.--------------------------------------------------------------------------------------------------------------------------- 2. --------------------------------------------------------------------------------------------------------------------------- 3……………………………………………………………………………………………………............. 4……………………………………………………………………………………………………............. 5…………………………………………………………………………………………………………..... 6……………………………………………………………………………………………………………. 7…………………………………………………………………………………………………………...... 8……………………………………………………………………………………………………………. 9……………………………………………………………………………………………………………. 10…………………………………………………………………………………………………………… PREPARATION OF THEPERSON AND ARTICLES IN PROCEDURE AREA:
- 3. ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- HOWTO PERFORMED THE PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- AFTER CARE OF THE PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- HEALTH EDUCATIONRELATED TO PROCEDURE:
- 4. ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- RECORDING AND REPORTING OF PROCEDURE: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- SUMMARY: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------ CONCLUSION: ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- CHECKLIST FOR BAG TECHNIQUE PROCEDURE: S.NO: SKILLS PERFORMEDBYTHE STUDENTS MARKS ALLOTTED MARKS OBTAINED REMARKS
- 5. 1. Adequate supplies and equipment 1 2. Nursing diagnosis assessment 1 3. Need to be assessed based on family requirement 1 4. Appropriate to goal/purpose ofselection 1 5. Selection ofprocedure based on standing order 1 6. Type person selected for procedure 1 7. Explain the procedure to the person 1 8. Spreading and selection ofplace for keeping bag 1 9. Way of opening the bag technique 1 10. Hand washing articles taken from bag 1 11. Perform the hand washing in the community area 1 12. Articles arranged for the procedure with rationale 1 13. Maintain comfortable during the procedure for the person as well as her/him 1 14. Maintain good communication skills and used scientific knowledge 1 15. Performing allotted procedure 1 16. Assessed the accurate recording /finding ofthe procedure 1 17. Discard the waste 1 18. Frequent hand washing 1 19. Replacement ofarticles to the compartment ofbag 1 20. Folding of newspaper/washing the hands/replacement ofarticles 1 21. Health education appropriate to the procedure 1 22. Summating the procedure 1 23. Conclude the procedure 1 24. Recording the procedure 1 25. Plan for the next visit 1 Total: 25 Signature of the student with date: signature ofthe supervisor with date: Signature ofthe HODS with date: