Eyedrop and Eye Ointment Administration Procedure

Initial Steps

• Ensure Privacy: Make sure the environment is private for the patient.
• Hand Hygiene: Perform hand hygiene before any interaction.
• Introduction and Patient Identification:
  • Introduce yourself (e.g., "My name is Becky, and I'm the nurse here to administer your eyedrops.").
  • Verify the patient's name and date of birth (e.g., "Can I verify your name and date of birth?").
  • Ask about allergies (e.g., "Do you have any allergies?").

Types of Eye Medications

• Over-the-Counter: Artificial tears.
• Prescription Agents: For infections and glaucoma.

Medication Preparation

• Verify Orders:
  • Check the Medication Administration Record (MAR) against provider's orders.
• Raise Bed:
  • Adjust the bed to a comfortable height to assist in medication administration.
• Medication Checks:
  • Follow the "six rights" of medication administration.
  • Conduct a third check of the medication at the bedside.
  • Verify expiration date of the medication.

Eye Cleansing

• If there is drainage or crust:
  • Gently wash from inner to outer canthus.
  • Loosen crusts with a warm washcloth or cotton ball (do not scrub the eyelid).
  • Dry eyes gently with a separate washcloth.

Instillation of Eyedrops

• Hand Hygiene and Gloves:
  • Perform hand hygiene and apply clean gloves.
• Patient Positioning:
  • Ask the patient to look up.
• Expose Conjunctival Sac:
  • Use non-dominant hand to hold a clean tissue on cheekbone and press down with thumb/finger.
• Instillation:
  • Hold container 1-2 cm above conjunctival sac.
  • Instill prescribed number of drops.
  • If patient blinks, repeat instillation.
  • Apply gentle pressure to nasolacrimal duct if drops have systemic effects.
• Post-Instillation:
  • Ask patient to close eyes gently and briefly.

Instillation of Eye Ointment

• Hand Hygiene and Gloves:
  • Perform hand hygiene and apply clean gloves.
• Patient Positioning:
  • Comfortable positions include supine, Fowler’s, or sitting upright.
• Application:
  • Ask patient to look up.
  • Apply a thin ribbon of ointment along the lower lid's conjunctiva from inner to outer canthus.
• Post-Application:
  • Ask patient to close eye and rub lightly in circles unless contraindicated.
  • Remove excess ointment.

Documentation and Follow-Up

• Document Administration:
  • Record medication administration in the MAR.
  • Note patient’s response and report adverse effects.
• Eye Patch Application:
  • If needed, place a clean patch over the affected eye and secure it with tape.
• Patient Education:
  • Encourage self-administration practice.
  • Reinforce teaching as needed (e.g., "Don’t forget to look up while placing the drop in.").