Nasal drop instillation

Authors: Rednenko V.V., Rednenko L.I.

Editor: Rednenko V.V.

Equipment for the practical skill:

• patient or simulator for nasal drop instillation sitting on a chair or lying on a bed
• manipulation table (bedside table)
• sterile solution of medication
• small gauze squares or cotton balls
• PPE: medical gown, hat, mask, non-sterile gloves
• MAR
• waste containers (tray)

Clinical situation:

• You are a nurse at a hospital. Install nasal drops 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:

• Provide patient with tissues and ask that they blow their nose. Clean the patient's nasal cavity if necessary (see Hygienic care of the nasal cavity)
• Help the patient to get into the required position:
  • Tilt the patient's head back slightly if he is sitting
  • If he's lying, remove the pillow from under his head.
• Instill the drops
  • Draw fluid into medication dropper with enough for both nostrils (if you use it). Do not return excess fluid into stock bottle.
  • Ask patient to breathe through the mouth.
  • Place 4 fingers on the patient's forehead, and with your thumb slightly lift the tip of the nose up.
  • Insert the tip of the dropper or the nozzle of the bottle turned upside down gently into the nasal passage to a depth of 1-1.5 cm, trying not to touch its walls.
  • Drop medication into one nostril and then the other.
• Ask patient to keep this position  with head back for 2 to 3 minutes
• Wipe off excess solution with gauze or cotton balls.

Final stage:

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