INTRODUCTION
This SOP is intended for registered nurses who are competent in carrying out safe and effective ear irrigation. It provides the nurses with guidelines in assessment and examination in adult ear irrigation.
Ear irrigation should only be considered when other conservative methods of wax removal have failed (e.g. use of softeners). Patients requiring ear irrigation should always receive education and advice, which may reduce contributory factors and therefore the need for ear irrigation
Ear irrigation is undertaken for the purpose of removing wax from the external auditory meatus where this is thought to be causing a hearing deficit and/or discomfort, or restricts vision of the tympanic membrane preventing examination in the adult patient
Nurses performing the procedure:
Should understand the normal and abnormal anatomy and physiology of the ear and need to be aware of the complications and contraindications of ear irrigation.
Must examine the ears, check the history, discuss complications, and obtain informed consent.
carry out the procedure as per clinic guidelines
record all findings and treatment in the patient’s records as per NMC (2008) guidance on record keeping
Nurses may accept self-referrals from patients although the protocol for self-referral must be agreed between the General Practitioners and nursing staff in individual surgeries or health centres.
Note
Metal syringes should not be used as they can create pressure up to 7.5 times atmospheric pressure 1(Sharp et al 1990) and is considered more difficult to control compared to the electric Propulse machine (Rogers 1997)2. Therefore, a Propulse 11 or 111 machines is recommended.