Policy Manual sample

MDT Home Health Care Agency, Inc. 40 EYE DROP INSTILLATION PURPOSE: It is necessary to obtain specific physician’s orders for the instillation of ophthalmic medications. Eye drops or eye ointments are used to promote comfort by relieving eye irritation due to allergy or nasopharyngeal congestion, by lubricating the eye and by acting as a local anesthetic. Eye drops or eye ointments may also be used to dilate or contract the pupil so that the eye may be examined. They may be used as an antibiotic to combat infection, as an antiseptic in cleansing the eye, or to decrease intraocular pressure. RESPONSIBLE PERSONNEL : RN, LPN EQUIPMENT: Medication, washcloth, tissues SPECIAL CONSIDERATIONS: 1. Make sure the label reads “For Ophthalmic Use Only” and that it is not out of date. 2. The following abbreviations are approved for use: O.D. for right eye, O.S. for left eye and O.U. for both eyes. The abbreviations are easily confused. As often as possible, a full description (i.e., right, left, both) is preferred. 3. Examine medication solution carefully to determine that it is free of sediment or color change. 4. Examine the bottle to make sure it is free of chips, cracks, debris or rough edges. 5. The procedure for the administration of eye ointment is similar to that for eye drops. The ointment should be gently squeezed into the cul-de-sac so that the end of the tube touches neither the eye nor the surrounding tissue. PROCEDURE: 1. Explain the need and purpose of the procedure. 2. Wash hands thoroughly. 3. Have patient tilt head slightly backward. 4. Gently clean eyelids and lashes with washcloth as needed. The eyelid should be cleaned from the inner canthus to the outer canthus. 5. Ask the patient to tilt head back and slightly toward the affected eye. Note: Be especially careful about this if you are using a medication such as Atropine. 6. Ask your patient to look up and focus on a specific object. 7. Place the index finger of you non-dominant hand on your patient’s cheekbone and gently pull down the skin. 8. Using a side approach, with your other hand, hold the eyedropper or squeeze bottle near the outer canthus of the eye. Don’t let the tip touch the eyeball or eyelashes. 9. Squeeze the prescribed number of drops into the conjunctival sac. Never place drops directly onto the patient’s cornea. 10. Release the patient’s eyelid and instruct the patient to close but not squeeze the eyes. 11. Use a tissue to blot away any excess fluid, working away from the inner canthus to the outer canthus. 12. Repeat the entire procedure in the other eye, if ordered. Always use a fresh tissue to clean the other eye. 13. Caution your patients not to rub eyes. 14. Assess response to medication. Observe closely for any side effects to the medication.