Ear Drop Instillation Procedure

• Standard DOT procedure for instillation of ear drops, maintains DIPPS (Dynamics of Integrated Patient Process System) throughout the procedure.
• Goal: To provide appropriate instillation of ear drops.
• Schedule: doses are given TID (three times daily) by HCA (Health Care Aide) in the am and pm.

Supplies

• Ear drops
• Gloves
• Tissues or cotton balls

Reportable Observations

• Inability to complete task
• Change in client condition
• Observable drainage of ear(s)
• Client reports pain, itching, or change in vision

Storage Space

• Cupboard beside or above fridge
• Cupboard beside or above kitchen sink
• Lock box
• Other

Procedure and Rationale

• Wash hands to maintain cleanliness as per standard.
• Gather supplies and assemble on a clean, dry surface to complete task in an organized manner.
• Set out drop containers in order listed in Client Specific Instructions to ensure correct drops are given as ordered.
• Put on gloves to maintain cleanliness as per standard.
• Check #1 identify the rights of medication assistance to ensure safety.
• Place client in a comfortable position with head tilted to expose the ear requiring the drop; ear faces upwards to allow the solution to flow into the middle ear with gravity.
• Check #2: Identify the Rights of Medication Assistance to ensure Safety.
• Remove cap from bottle without touching the tip of the bottle and place cap on clean, dry surface on its side to prevent spread of infection.
• Check #3 Identify the Rights of Medication Assistance to ensure safety.
• Gently pull the upper ear up and back for adult clients; down and back for children to allow the solution to flow into the middle ear with gravity.
• Without allowing tip of bottle to touch the ear, instill ONE drop of medication inside the ear to ensure safety, promote comfort, and prevent contamination of the tip.
• Gently massage the outside of the ear (tragus) and apply a cotton ball for a few minutes to distribute drop(s) deep into the ear canal and prevent leakage.
• Repeat for subsequent drops of medication as required (per instructions) to ensure correct drops are given as ordered.
• Use a clean disposable tissue to blot away excess medication if needed to remove excess liquid and promote client comfort.
• Recap medication bottle is necessary to prevent deterioration of drops and maintain cleanliness of tip of bottle.
• Repeat steps 9 to 13 for other ear if required to ensure the correct drops are given as ordered.
• Repeat steps 4 to 15 for other medications as per Client Specific Instructions to ensure correct drops are given as ordered.
• Dispose of tissues and cotton balls into garbage, remove and dispose of gloves and wash hands to maintain cleanliness as per standard precautions.
• Return ear drops to storage area to ensure safe storage of ear drops.
• Document, report, and record any reportable observations to maintain accurate records.

Client Specific Instructions

• Sulfacort, dose is one drop to right ear in the morning and at night by HCA.

This lesson outlines the standard DOT procedure for ear drop instillation, emphasizing DIPPS (Dynamics of Integrated Patient Process System). It details necessary supplies like ear drops, gloves, and tissues, as well as reportable observations such as client discomfort or drainage. Proper handwashing and organization of supplies are highlighted to ensure cleanliness and accuracy.