Eye ointment instillation

Authors: Rednenko V.V., Rednenko L.I.

Editor: Rednenko V.V.

Equipment for the practical skill:

• patient or simulator for eye drop instillation sitting on a chair or lying on a bed
• manipulation table (bedside table)
• ophthalmic ointment
• small gauze squares or cotton balls
• sterile normal saline solution or antiseptic water solution
• PPE: medical gown, hat, mask, non-sterile gloves
• MAR
• waste containers (tray)

Clinical situation:

• You are a nurse at a hospital. Install eye ointment to patient as physician’s directives

Order of the skill performance:

Preparatory stage:

• Check the equipment at the workplace, complete the workplace if necessary
• Put on your protective equipment
  • Perform hygienic handrub
  • Put on your gloves
• Identify the patient
  • Say hello to the patient, introduce yourself;
  • Specify the last name, first name and patronymic of the patient, check the prescription sheet
• Get informed consent
  • Inform the patient about the upcoming manipulation,
  • Obtain verbal consent to conduct it
• Check physician's directives.

Maine stage:

• Help the patient to get into the required position:
  • Tilt the patient's head back slightly if he is sitting
  • Place the head over a pillow if he is lying down.
• Cleanse the eyelids and lashes
  • take a cotton balls or gauze pledgets
  • moisten them with normal saline
  • use each cotton ball or pledget for only one stroke, moving from the the outer to inner canthus of the eye.
• Instill the ointment
  • Remove the cap from the ointment tube.
  • Before administration, wipe the tube with another cotton ball and discard a small amount of ointment.
  • Using forefinger, pull lower lid down gently till it forms a small pocket.
  • Instruct patient to look upward.
  • Carefully squeeze a 1 cm line of ointment inside of the lower eyelid. Make sure the tip of the tube doesn't touch your eye
  • Release the lower lid after the ointment are instilled.
• Ask the patient to blink his or her eye to spread the ointment. Explain the patient that his or her vision may be blurred at this point, but it will get clear if he or she keeps blinking
• Wipe off excess ointment with gauze or cotton balls.
• Replace the cap of the ointment tube

Final stage:

• remove gloves and place in waste container (tray)
• perform hygienic handrub