Eye instillation and ointment

Instillation of eye drops and eye ointment..

1. INSTILLATION OF EYE DROPS & EYE OINTMENT

2. Definition Eye  drop instillation  is the dispensation of a sterile ophthalmic  medication  into a patient’s eye.

3. Purposes To treat a number of eye disorders To anesthetize an eye before treatment. During a routine eye examination During treatment for ocular disease. Diagnose ocular disease Treat glaucoma, uveitis , allergic reactions and infections. Dilatory eye drops may be instilled during an examination to achieve a better view of the retina.

4. Indications Eye examination and treatment of disease. Contraindications Allergies to the medications.

5. Charting Record time on which the medication was instilled. Type, strength and amount (dosage) of the medication The eye onto which the medication was instilled.

6. Equipment Sterile solution of medication Small gauze squares or cotton balls Gloves

7. Safety considerations Perform hand hygiene . Check room for  additional precautions . Introduce yourself to patient. Confirm patient ID using two patient identifiers (e.g., name and date of birth). Check allergy band for any allergies. Complete necessary  focused assessments  and/or  vital signs , and document Provide patient education as necessary. Plan medication administration to avoid disruption: Dispense medication in a quiet area. Avoid conversation with others. Follow agency’s no-interruption zone policy. Prepare medications for ONE patient at a time. Follow the RIGHTS of medication administration.

8. Nursing Interventions & Rationale The following are the nursing interventions and rationale for instilling eye drops.

9. Nursing Interventions   Check the patient’s name  Check physician’s directives.  Wash hands prior to instilling medication.   Cleanse the eyelids and lashes with cotton balls or gauze pledgets moistened with  normal saline .  Rationale For proper patient identification. To avoid  medication error .  To prevent transfer of microorganisms to the patient. Prevent debris to be carried into the eye when the conjunctival sac is exposed.

10.  Use each cotton ball or pledget for only one  stroke , moving from the inner to the outer canthus of the eye.   Tilt the patient’s head back slightly if he is sitting or place the head over a  pillow  if he is lying down.   Fill eye dropper with medication but prevent from flowing back into the bulb end. Prevents carrying of debris to the lacrimal duct. To prevent solution or tear from flowing towards the other eye.  Loose particles of rubber from bulb end may slip into medication

11. Using forefinger, pull lower lid down gently.   Instruct patient to look upward.  Hold the dropper close to the eye but avoid touching the eyelids.   Allow the prescribed number of drops to fall in the lower conjunctival sac but do not allow to fall onto the cornea. To expose inner surface of lid and cul-de-sac. Prevent medication from sensitive cornea. Touching the eyelids may startle the patient and cause him to blink.  It cases unpleasant sensation to the patient or may injure the cornea.

12. Release the lower lid after the drops are instilled. Instruct the patient to close eyes slowly, move the eye and not to squeeze or rub. Wipe off excess solution with gauze or cotton balls. Wash hands after instilling the medication. Squeezing or rubbing may irritate the eye tissue or would express the medication from the eye. Closing and moving the eye allow medicines to be distributed over the eye. Prevents possible skin irritation. Prevents transfer of microorganisms to self or to other patients.

13. Eye ointment: Apply about 1.5 cm of ointment along conjunctival sac, moving from inner to outer canthus .  

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