EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

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• If hard, impacted wax is identified, advise the use of olive oil drops for 5 days and reassess after this time (avoid extra virgin olive oil). Instill one to two drops, twice a day for five to seven days and then re-assess • If soft wax is present and risk assessment (Appendix 1) does not indicate any contraindications then ear / ears may be irrigated EAR IRRIGATION Ear irrigation must only be undertaken using the propulse electric ear irrigator provided by the PCT. Syringes must not be used to irrigate ears. Do not irrigate ear if any of the following contraindications are noted: • The patient has previously experienced complications following ear irrigation in the past • There is a history of middle ear infection in the past 6 weeks • The patient has undergone any ear surgery (excluding grommets that have extruded at least 18 months previously and the patient has been discharged from Ear, Nose and Throat services) • The patient has a perforation or there is a history of a mucous discharge in the last year • The patient has a cleft palate (whether repaired or not) • Acute otitis externa with pain and tenderness of the pinna is noted • Patient is currently taking anticoagulant therapy • A patient who has hearing only in one ear if it is the ear to be treated, as there is a remote chance that irrigation may cause permanent deafness • Acute undiagnosed hearing loss that is not related to the accumulation of ear wax • There is insufficient light Equipment Required • Otoscope • Speculae - single use items only after the 1 st April 2007 Propulse electric irrigator and other equipment (cleaned in accordance with this policy – see page 12) • Propulse electronic ear syringe cleaning procedure • Jug • Bath thermometer • Trough / Receiver • Tissues • Clean towel • Protective clothing PROCEDURE Verbally check the identity of the patient by asking for full mane and date of birth. Check with carer/family if not able to confirm identity To confirm identity RATIONALE EAR CARE PROCEDURE 4/13
PROCEDURE Ask patient occupation or previous occupation/s Obtain valid and informed consent for procedure and document assessment using risk assessment form. Inform patient that there is slight risk that ear irrigation may cause infection, injury to the ear canal and perforation of the ear drum Decontaminate hands Put on protective clothing Ask patient to sit in chair with head tilted towards the ear that is to be syringed Place towel on patient’s shoulder and ask patient to hold receiver under same ear Fill the reservoir of the ear irrigator with water – water temperature must be checked and should be approximately 40°C Set pressure of machine to minimum Attach new jet tip applicator to machine Run the machine for 10-20 seconds, directing the tip into the receiver. Inform patient that procedure is about to start and encourage patient to indicate if pain or dizziness is experienced Pull the pinna upwards and outwards and insert the tip of the nozzle into the ear canal Begin irrigating using the foot control to operate the machine – the nozzle should be directed so that the stream of water is directed along the roof of the ear canal towards the posterior canal wall at approximately a 30 o angle Increase pressure control gradually if wax is difficult to remove ( Do not use maximum) If patient complains of water in the back of their mouth, stop procedure and refer to GP RATIONALE Informs clinical decision making To allow the patient / client to make an informed decision To prevent spread of micro-organisms Protect from splashing and potential contamination during procedure To encourage water to flow back out of ear Collection of water and patient comfort Water above or below this temperature may cause discomfort and / or dizziness To reduce the potential for trauma Single use only jet tips Patient becomes accustomed to the noise of the machine Cold water and air locks are removed Procedure must be stopped if these symptoms are experienced Straightens the ear canal Directs flow of water to encourage best removal of wax To help remove wax Patient may have perforated ear drum EAR CARE PROCEDURE 5/13
Page 1 and 2: EAR CARE PROCEDURE FOR COMMUNITY NU
Page 3: Documentation Nursing Management of
Page 7 and 8: NURSING MANAGEMENT OF EAR WAX - DOC
Page 9 and 10: Patients Full Name: NHS Number:- DO
Page 11 and 12: EAR IRRIGATION PATHWAY FOR COMMUNIT
Page 13: DECONTAMINATING THE MACHINE AT THE

EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

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