EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

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PROCEDURE Irrigation should never cause pain. if the patient complains of pain - stop immediately. Periodically inspect ear with otoscope during procedure and check irrigated water for presence of wax A maximum of one reservoir of water can be used per ear – stop irrigating after 5 minutes Dry excess water from external meatus once irrigation is complete Re-examine the ear, observing for any abnormalities – refer to GP if necessary If wax is removed due to the presenting complaint of hearing loss, ascertain whether good hearing is restored after treatment – refer to GP if hearing is not restored Decontaminate hands Dispose of contents of trough / receiver and decontaminate equipment Document all observations and actions including consent and patient perceptions RATIONALE To prevent damage to ear To identify if irrigation is effective or complete Further irrigation is likely to be ineffective – patient may require a further course of drops. (Further irrigation may be attempted 15 minutes after initial irrigation if appropriate) Stagnation of water and abrasion of skin predispose infection Irrigation can sometimes cause trauma Wax may hide evidence of abnormalities To ensure assessment of cause of hearing loss and possible referral to an ENT surgeon or Audiologist. To prevent spread of micro-organisms To prevent spread of micro-organisms Ensure compliance with NMC and local record keeping guidelines Provide post-procedure ear care information leaflet Ensure patient remains informed and involved with their care 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. www.earcarecentre.com EAR CARE PROCEDURE 6/13
NURSING MANAGEMENT OF EAR WAX – DOCUMENTATION (1/4 pages) (For patients over 18 years) Prior to undertaking ear examination the nurse should have a demonstrable knowledge of the tympanic membrane and auditory canal and should have attended appropriate training in ear care. Valid consent to any treatment must be obtained and documented. Patient Details: NHS No: Full Name Address Telephone Number: Date of Assessment: DOB: Referred by: Current & Previous Occupation: GP: Current Medication: Informed Consent ____________________________________________________ Each nurse must be confident they have the clinical competency and the underpinning knowledge to fulfil this role. Best practice would be for each nurse that undertakes this role to consider the disease processes that may require caution and the need for additional information about the patient and their treatment. This may include:- MEDICATION Diuretic Therapy Anticoagulant Therapy Long-term use of ototoxic drugs e.g. streptomycin RATIONALE May lead to hearing loss trauma hearing loss EAR CARE PROCEDURE 7/13
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EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

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