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Student Name: _________________________________ Skills Lab/Date: ________________________
Eye Drop – Skill Performance Evaluation
Module 5
VNSG 2413
|Performance Points |S |U |Comments |
|*Wash hands. | | | |
|*Check medication order. Note eye to be treated. Note | | | |
|patient allergies. | | | |
|Prepare patient for medication | | | |
|instillation: | | | |
|Check patient’s identity using an identification bracelet or | | | |
|other accepted means. | | | |
|Explain procedure to patient in a calm and confident manner. | | | |
|Assist patient to sit or lie down with head slightly hyper | | | |
|extended. | | | |
|Put on gloves. | | | |
|Assess condition of the eye and wash away exudates, wiping | | | |
|from inner to outer canthus. | | | |
|*Administer medication: | | | |
|Remove cap from bottle and place it on its side. Fill | | | |
|medicine dropper (if used) to prescribed amount. | | | |
|With the head tilted back slightly, gently pull the lower lid | | | |
|down to form a pouch, exposing the conjunctival sac. | | | |
|Instill the prescribed number of drops. | | | |
|Have the patient close their eyes for 30 seconds. | | | |
|*Remove gloves and perform hand hygiene. | | | |
|*Document on MAR. | | | |
*ALL CRITICAL
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