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- Hand hygiene
- Bag placement
- acceptable disposable, one-time-use surface-barrier materials include wax paper
- reusable surface barriers that contain antimicrobial additives work on contact with microorganisms
- if there is no visibly clean, dry, flat surface in the patient’s environment and a barrier is not available, the clinician should hang the bag on a doorknob or over-the-door hanger.
- Bag placement during interim storage
- Cleaning the interior and exterior surfaces of the bag
- when a surface barrier is routinely used under the bag, the recommendation for reducing the bioburden is to clean the interior and exterior of the bag minimally once a month
- when a surface barrier is not routinely used under the bag, the recommendation for reducing the bioburden is to clean the exterior of the bag minimally once a week.
- whenever a monthly time frame is selected for any cleaning activity, it should occur at the end of the month.
- Maintenance of equipment and supplies stores in the bag
- Management of equipment and supplies removed from the bag
***Currently, there are no data that serve as evidence of a home care or hospice patient developing an infection from a pathogenic microorganism brought into a patient’s home via a nursing bag. ***
However,
***When Bakunas-Kenneley and Madigan cultured nursing bags from four different home care agencies, they found that 84% of the outside of the bags cultured positive for human pathogens, and of the bags whose outside cultured positive, 15.9% of the organisms were multi-drug resistant. ***
***Before re-entering the nursing bag, clinicians should remove their gloves and perform hand hygiene. ***
