Goal: Drops are administered successfully.
1. Gather equipment. Check medication order against the original order in the medical record, according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medication to be administered. Consider the appropriateness of the medication for this patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the CMAR/MAR and select the proper medication from the patient’s medication drawer or unit stock.
8. Compare the label with the CMAR/MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required.
9. When all medications for one patient have been prepared, recheck the label with the CMAR/MAR before taking them to the patient.
10. Lock the medication cart before leaving it.
11. Transport medications to the patient’s bedside carefully, and keep the medications in sight at all times.
12. Ensure that the patient receives the medications at the correct time.
13. Perform hand hygiene and put on PPE, if indicated.
14. Identify the patient. Usually, the patient should be identified using two methods. Compare information with the CMAR/MAR.
a. Check the name and identification number on the patient’s identification band.
b. Ask the patient to state his or her name and birth date, based on facility policy.
c. If the patient cannot identify him- or herself, verify the patient’s identification with a staff member who knows the patient for the second source.
15. Complete necessary assessments before administering medications. Check the patient’s allergy bracelet or ask the patient about allergies. Explain the purpose and action of each medication to the patient.
16. Scan the patient’s bar code on the identification band, if required.
17. Put on gloves.
18. Cleanse external ear of any drainage with cotton ball or washcloth moistened with normal saline.
19. Place patient on his or her unaffected side in bed, or, if ambulatory, have patient sit with head well tilted to the side so that affected ear is uppermost.
20. Draw up the amount of solution needed in the dropper. Do not return excess medication to stock bottle. A prepackaged, monodrip plastic container may also be used.
21. Straighten auditory canal by pulling cartilaginous portion of pinna up and back for an adult.
22. Hold dropper in the ear with its tip above the auditory canal. Do not touch the dropper to the ear. For an infant or an irrational or confused patient, protect the dropper with a piece of soft tubing to help prevent injury to the ear.
23. Allow drops to fall on the side of the canal.
24. Release pinna after instilling drops, and have patient maintain the position to prevent escape of medication.
25. Gently press on the tragus a few times.
26. If ordered, loosely insert a cotton ball into the ear canal.
27. Remove gloves. Assist the patient to a comfortable position.
28. Remove additional PPE, if used. Perform hand hygiene.
29. Document the administration of the medication immediately after administration.
30. Evaluate the patient’s response to medication within appropriate time frame.
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