Practicum 13-1:
Procedure 37-4
Perform Instillation of Eye Medication
Objective: The student, using the supplies and equipment listed below, will
perform eye medication instillation.
Supplies: prescription medication (drops or ointment), disposable gloves, tissues,
patient chart
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances the patient encounter. These behaviors may also display sensitivity to patient’s rights and enhance communication. Pay close attention to these skills which will be in bold, italicized font.
Notes to the Student:
Skills Assessment Requirements
Read and familiarize yourself with the procedure; complete the minimum practice requirements. Document each MPR using proper charting technique. Complete each procedure within a reasonable amount of time, with a minimum of 85% accuracy.
|1. ( |Wash your hands. Gather equipment and | | | | |
| |supplies. | | | | |
|2. ( |Take the medication from the storage shelf. | | | | |
| |Check the label against the physician’s | | | | |
| |order. | | | | |
|3. ( |Identify the patient and guide him or her to | | | | |
| |the treatment area. Check the patient’s | | | | |
| |identification against the physician’s order | | | | |
| |and medication name. | | | | |
|4. ( |Note the medication dosage to be | | | | |
| |administered. | | | | |
|5. ( |Ask the patient about allergies. Explain the | | | | |
| |entire procedure. | | | | |
|6. ( |Wash your hands and put on disposable gloves.| | | | |
|7. ( |Ask the patient to lie down or sit with the | | | | |
| |head tilted back with both eyes open. (It may| | | | |
| |be necessary to ask the sitting patient to | | | | |
| |look at the ceiling.) If the patient is | | | | |
| |wearing an eye patch, remove it. | | | | |
|8. ( |Give the patient a tissue to hold in each | | | | |
| |hand until after the procedure. With your | | | | |
| |nondominant hand and a tissue, press on the | | | | |
| |lower cheekbone and gently pull the lower | | | | |
| |eyelid down to expose the cornea and | | | | |
| |conjunctival sac. | | | | |
|9. ( |To administer eye drops: | | | | |
| |Fill the eyedropper with your dominant hand. | | | | |
| |Hold the dropper approximate 1/2 inch away | | | | |
| |from the patient’s eye, and administer the | | | | |
| |prescribed dose into the conjunctival sac. | | | | |
| | | | | | |
| |To administer the ointment: | | | | |
| |Rest your dominant hand on the patient’s | | | | |
| |forehead, hold the tube, and lightly squeeze | | | | |
| |ointment into the conjunctival sac from the | | | | |
| |inner to outer corner of the patient’s eye. | | | | |
|10. ( |Release the patient’s lower eyelid and tell | | | | |
| |the patient to close the eye. | | | | |
|11. ( |Repeat the procedure in the other eye, if | | | | |
| |ordered by the physician. | | | | |
|12. ( |Instruct the patient to use a separate tissue| | | | |
| |for each eye to wipe away excess medication. | | | | |
|13. ( |Apply an eye patch, if ordered by the | | | | |
| |physician. | | | | |
|14. ( |Provide a waste container for the patient to | | | | |
| |discard the used tissue into. Dispose of the | | | | |
| |gloves and tissue. | | | | |
|15. ( |Wash your hands. Prior to leaving the | | | | |
| |examination room, ask the patient if he or | | | | |
| |she has any questions. | | | | |
|16. ( |Document the patient’s tolerance of the | | | | |
| |procedure, the amount and kind of medication | | | | |
| |administered, and the eye(s) treated. Sign | | | | |
| |the entry with your name and credentials. | | | | |
Document: Enter the correct information in the chart below.
| | |
| | |
| | |
| | |
| | |
Grading
|Points Earned |________ | | |
|Points Possible |________ |108 |108 |
|Percent Grade |________ | | |
|(Points Earned/Points Possible) | | | |
|PASS: |________ |( YES |( YES |
| | |( NO |( NO |
| | |( N/A |( N/A |
Instructor Sign-Off
Instructor:___________________________________________ Date:___________
-----------------------
POINT VALUE
( = 3-6 points
( = 7-9 points
NOTES:
GRADED
TRIAL
# 2
GRADED
TRIAL
# 1
PRACTICE
TRIAL
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