Standing Orders for Ear Irrigation

[gre...@grace.edu]

I am the nurse for the health center at a small college and just finished my first year in this role. We have a collaborating Physician at a local urgent care who signs off on policies and standing orders, but I am responsible for writing them first.  Does anybody have an example of a standing order for Ear Irrigation to remove excess wax? 

Thanks,

Laura Green

RN, BSN

[cjhi...@ncsu.edu]

  SUBJECT: Nurse Procedures SOP: These are the Nurse Procedures. RNs, LPNs, and CMA/RMA’s may perform these tasks. RNs can delegate and will serve as a resource to the LPNs and CMA/RMAs. Nursing Staff will complete the documentation in the Electronic Health Record. (EHR).”

   Ear Irrigation A. Purpose: To loosen and remove impacted cerumen or foreign objects and to relieve localized inflammation and irritation in the ear canal. B. Equipment: 1. Elephant Ear Washer 2. Ear Irrigation Tray C. Procedure: Standing Order: When the cerumen needs to be softened, instill a small amount of Colace or hydrogen peroxide (H2O2) into ear canal with a medicine dropper. Place cotton ball in ear. Allow solution to remain in ear 10 to 15 minutes. Use warm water 98.6 - 105 degrees F. May use a small amount of Colace or H2O2 to the irrigation water. D. Care of equipment after each use: Person who uses the ear irrigation equipment is responsible for the following: Rinse and dry the graduated cylinder used to warm water for ear irrigation. Rinse the spray bottle with water and invert into the graduated cylinder (line with dry paper towel); rinse the medication dropper and allow to air dry and return equipment to the ear irrigation stock. The tip of the spray unit should be rinsed after the disposable cannula is removed and disposed of. Do not soak this equipment in Cavicide. The ear basin is washed with soap and water, rinsed and then sprayed with Cavicide. It is allowed to sit at least 20 minutes in the sink and then rinsed and dried in room 1717 by nursing staff assigned to the task. E. Documentation: Document in electronic health record. Provider will reevaluate patient following procedure. Report immediately any complaints of pain, dizziness or loss of hearing to the Physician. Reference: Ear Irrigation Up To Date

 Cathy Higginbotham, RN BSN MHA

Associate Director of Nursing 

Student Health Services

Division of Academic and Student Affairs
P: 919.513-3263
cjhi...@ncsu.edu

NC State University
Campus Box 7304
2815 Cates Ave
Raleigh, NC 27695