Nursing Procedure Checklist
Administering an Ear Irrigation
   Instruction: Check under Correctly Done if identified skill is correctly performed; Incorrectly Done if
   skill is not performed correctly; and Not Done if the student failed to perform the skill.
                                                                         Correctly Incorrectly Not Done
                                Procedure                                  Done         Done
   1. Gather equipment. Check the original physician’s order for
   the irrigation according to agency policy. Clarify any
   inconsistencies. Check the patient’s chart for allergies.
   2. Identify the patient. Usually, the patient should be identified
   using two methods. Compare information with the MAR or
   CMAR.
   a. Check the name and identification number on the patient’s
   identification band.
   b. Ask the patient to state his or her name.
   c. If the patient cannot identify him or herself, verify the
   patient’s identification with a staff member who knows the
   patient for the second source.
   3. Explain procedure to patient.
   4. Assemble equipment at patient’s bedside.
   5. Perform hand hygiene and put on gloves.
   6. Have patient sit up or lie with head tilted toward side of
   affected ear. Protect patient and bed with a waterproof pad.
   Have patient support basin under the ear to receive the
   irrigating solution.
   7. Clean pinna and meatus of auditory canal as necessary with
   moistened cotton-tipped applicators dipped in warm tap water
   or the irrigating solution.
   8. Fill bulb syringe with warm solution. If an irrigating container
   is used, prime the tubing.
   9. Straighten auditory canal by pulling cartilaginous portion of
   pinna up and back for an adult.
   10. Direct a steady, slow stream of solution against the roof of
   the auditory canal, using only enough force to remove
   secretions. Do not occlude the auditory canal with the irrigating
   nozzle. Allow solution to flow out unimpeded.
   11. When irrigation is complete, place cotton ball loosely in
   auditory meatus and have patient lie on side of affected ear on
   a towel or absorbent pad.
   12. Remove gloves and perform hand hygiene.
   13. Assist the patient to a comfortable position.
   14. Evaluate patient’s response to the procedure. Return in 10
   to 15 minutes and remove cotton ball and assess drainage.
Comments:
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Score : ________________________________________
   Evaluated by: ________________________________ Date of Evaluation: ________________
                     (Signature over Printed Name)