EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

Patients Full Name:
NHS Number:-
EAR IRRIGATED
DOB:
Left Ear
Right Ear
Yes No Yes No
Was wax successfully removed
Advice given:
Details
Is review of treatment requested:
Yes/No
Date of
review:
Yes
No
Leaflet given to patient following procedure and
contents discussed
Understanding checked
Nurse's Name
Signature Designation :-
Contact Number
The information above is adapted from guidance devised by the ‘Action
on ENT’ steering board and is endorsed by the Primary Care Ear
Centre – Rotherham. (See www.earcarecentre.com)
EAR CARE PROCEDURE
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