Policy Manual sample

MDT Home Health Care Agency, Inc. 34 EAR IRRIGATION PURPOSE: Irrigation of the ear is done to remove discharge, cerumen, or a foreign body from the external auditory canal, to apply moist heat to the tissues of the canal, and to the correct hearing loss caused by accumulation of cerumen in the canal. A physician’s order is needed for this procedure. The order should specify amount of medication or solution, the times and frequency. The patient or caregiver should be asked if the patient has had a history of draining ears, earaches, ear infection, perforations or complications from other procedures relating to the ears. If the patient or caregiver affirms present or past symptoms, the physician should be informed before proceeding. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: Ear syringe, cotton-tipped applicators, towels, emesis basin or irrigating container, irrigating solution. SPECIAL CONSIDERATIONS: Assess the auricle and the meatus of the external auditory canal for redness, abrasions, drainage or discharge. Note color, odor and amount of discharge. Note signs of discomfort or pain. Assess the home environment for a setting which will allow the patient to sit or lie with his head tilted forward toward the affected ear. If the ear canal is impacted by foreign body, it is important to determine that the foreign body will not swell if contacted by water. This would increase the patient’s pain and increase the difficulty in removing the object. PROCEDURE: 1. Wash hands. 2. Explain procedure to patient. Set up equipment. 3. Assist patient to sitting or lying position with head leaning slightly to affected side. 4. Place protective towels on patient. 5. Cleanse outer ear with applicators. 6. Place emesis basin close to head and under ear. 7. Pour small amounts of solution on wrist. Temperature should be warm to prevent ear trauma. 8. Gently pull out ear upward and backward for adults and downward and backward for children. 9. Placing tip of syringe at ear opening, gently directing stream of fluid against sides of the canal. 10. Clean and store equipment. 11. Wash hands.