▪ prepare the patient for these four nursing practices

▪ collect and prepare the equipment

▪ carry out eye swabbing, eye irrigation, the instillation of eyedrops and the instillation of eye ointment.

Revision of ‘Administration of medicines’ (seep. 13) and ‘Aseptic technique’ (seep. 381).

▪ to soothe the eye when a patient is suffering from an insensitive or diseased eye

▪ to precede the instillation of an eyedrop or the application of an eye ointment

▪ to remove eye discharge and/or crusts.

1. Sterile eye dressings pack containing a gallipot, small and other gauze swabs, or gauze swabs and a disposable towel

2. Sterile swabbing solution, usually normal saline solution, to soften any crusted discharge

3. Good light source

4. Trolley or tray for equipment

5. Receptacle for soiled disposable items.

▪ collect and prepare the equipment to ensure that all the equipment is available and ready for use

▪ ensure the patient’s privacy to reduce anxiety

▪ prepare the patient by helping him/her into a comfortable position, either lying down or seated with his/her head inclined backwards, to allow the patient to maintain the position during the practice and permit easy access to the patient’s eyes

▪ observe the patient throughout this activity to note any signs of distress

▪ position the light source to allow maximum observation of the patient’s eyes without the beam shining directly into them

▪ open and arrange the equipment in preparation for the practice

▪ wash and dry the hands to reduce the risk of cross-infection (Jeanes 2005)

▪ place the disposable towel around the patient’s neck to catch any spillages and protect the patient’s clothing

▪ lightly moisten a cotton wool or gauze swab in the prescribed solution. Excess moisture will cause the patient’s face to be soaked with the cleansing solution

▪ ask the patient to close his or her eyes in order to reduce the risk of corneal damage (Watts 1998)

▪ gently swab from the inner canthus to the outer canthus of the eye, using each swab only once. This decreases the risk of cross-infection from one eye to the other or infection of the lacrimal punctum. (If both eyes are being swabbed, the healthy eye should be treated first as this again reduces the risk of cross-infection)

▪ gently dry the patient’s eyelids to remove excess moisture

▪ ensure that the patient is left feeling as comfortable as possible, maintaining the quality of this nursing practice

▪ dispose of the equipment safely to reduce any health hazard

▪ document the nursing practice appropriately, monitor the after-effects and report any abnormal findings immediately, providing a written record and assisting in the implementation of any action should an abnormality or adverse reaction to the practice be noted

▪ in undertaking this practice, nurses are accountable for their actions, the quality of care delivered and record-keeping according to the Code of Professional Conduct: Standards for Conduct, Performance and Ethics (Nursing and Midwifery Council 2004) and Guidelines for Records and Record Keeping (Nursing and Midwifery Council 2005).

▪ to aid the removal of a corrosive substance from the eye.

▪ collect and prepare the equipment to ensure that all the equipment is available and ready for use

▪ ensure the patient’s privacy to reduce anxiety

▪ observe the patient throughout this activity to note any signs of distress

▪ warm the irrigating fluid to 37.8°C, ensuring the comfort of the patient when the irrigating fluid is applied

▪ help the patient into a suitable position, either sitting or lying with the head and neck well supported, to allow the patient to maintain the position throughout the practice and permit easy access to the eyes