Transcription of Ear Care Guidelines - Southern Health NHS …
1 1 Ear care Guidelines Version 1 June 2016 SH CP 196 Ear care Guidelines Version: 1 Summary: These Guidelines are to ensure the provision of evidence based practice, which will ensure that all patients who are require ear care receive the best quality of evidence based care , minimising risk and potential adverse effects and maximising quality of life. Keywords: Aural toilet, cerumen, ear care , ear examination, ear syringing, ear irrigation, ear wax, wax softening, wax removal, Target Audience: This guideline extends to cover those people who are registered with General Practitioners within the geographical Boundaries of Southern Health Foundation Trust (SHFT) and the responsibilities of those staff providing such service.
2 Next Review Date: October 2019 Approved & Ratified by: Quality Improvement and Development Virtual Policy Group Date of meeting: April 2016 Date issued: June 2016 Author: Mandy Lyons, Clinical Trainer Director: Lesley Stevens, Medical Director 2 Ear care Guidelines Version 1 June 2016 Version Control Change Record Date Author Version Page Reason for Change 10/5/18 Review date extended from June 2018 to October 2018 22/8/18 Review date extended for 1year to October 2019 Reviewers/contributors Name Position Version Reviewed & Date Steve Coopey Head of Clinical Development Bands 5 and Above V1 - 2016
3 Sharon Guy Lead Clinical Trainer V1 - 2016 Wendy Eastman GP Development lead V1 - 2016 Theresa Lewis Lead Nurse Infection Prevention & Control V1 - 2016 Marie Corner Medical Device Lead V1 - 2016 3 Ear care Guidelines Version 1 June 2016 Contents Section Title Page 1. Introduction 4 2. Who does this policy apply to? 4 3. Definitions 4 4. Duties and responsibilities 6 5. Main policy content 6 6. Training requirements 10 7.
4 Monitoring compliance 10 8. Policy review 11 9. Associated trust documents 11 10. Supporting references 11 APPENDICES A1 Training needs analysis 12 A2 Ear care nursing record 13 A3 Procedure for Ear Examination (Otoscopy) 16 A4 Guidance for wax softening 18 A5 Procedure for Aural Toilet 19 A6 Procedure for Ear Irrigation 21 A7 Cleaning Guidelines for an Electronic Irrigator 24 A8 Referral Guidelines 28 A9 Ear care Patient Information Leaflet 32 4 Ear care Guidelines Version 1 June 2016 Ear care Guidelines 1.
5 Introduction The purpose of this guideline is to support staff to provide safe, effective ear care to adults, either in a clinic or domiciliary setting, in line with best current evidence base. It aims to reduce litigation risk in ear irrigation and to provide the patient with a positive experience of ear care . This document provides guidance on the following subjects Cerumen management History taking and assessment Ear examination Softening agents Aural toilet/ removal by instrumentation Ear irrigation Patient referral and advice Documentation The Ear care Guidance Document (revised in 2014) by The Rotherham Primary Ear care Centre is the nationally recognised protocol for ear care .
6 It is endorsed by The Royal College of General Practitioners, The Royal College of Nursing, and the Medical Devices Agency, and has been recognised as the key evidence base for this guideline. Every year in the UK, over two million people have problems with earwax and need it removed. Complications of syringing are a common cause of complaints and litigation in primary care . A study examining ear syringing in UK general practice estimated that the rate of complications requiring specialist referral was about in 1/1000 ears syringed.
7 These complications included perforation, canal lacerations, and failure of wax removal. Otitis externa may also complicate ear syringing. 2. Who does this policy apply to? This guideline is intended for all members of staff employed by Southern Health NHS Foundation Trust who are required to undertake ear care . This includes registered nurses in all aspects of ear care , and any Bands 3 and 4 who have undergone specific training and been assessed as competent to undertake ear assessment and examination and give advice regarding management options and the administration of ear drops as appropriate.
8 3. Definitions and abbreviations Areas of tympanic membrane - Pars flaccida, Pars tensa, Anterior recess, Light reflex Handle of malleus Audiology - field of Health care that deals with hearing and balance disorders Aural Toilet (also known as Dry mopping) - a procedure used to clear the External auditory meatus of debris, discharge, soft wax or excess fluid following irrigation, using cotton wool. Aural speculum - A funnel shaped piece of plastic on a light source (otoscope) that is inserted into the auditory canal of the ear, allowing the examiner to look at the ear canal and ear drum.
9 Cerumen (Ear wax) - a normal wax-like substance that protects the ear canal 5 Ear care Guidelines Version 1 June 2016 Cerumenolytics - agents that soften hardened cerumen (earwax) and make it easier for it to be removed from the ear. Crocodile forceps- instrument used in ear care Ear Nose and Throat (ENT) - the area of medicine that deals with disorders and conditions of the ear, nose, and throat Ear irrigation ( formerly known as ear syringing) - a routine procedure used to remove excess earwax, or foreign materials from the ear External auditory meatus- (EAM) also known as the ear canal- a tunnel running from the outer ear to the middle ear Grommets - a tube surgically implanted in the eardrum to drain fluid from the middle ear.
10 Hygroscopic foreign bodies - (eg: peas and lentils) will absorb water and expand making removal difficult. Jobson Horne- a probe with a serrated end used in ear care Mastoid process - a large, bony prominence on the base of the skull behind the ear, containing air spaces that connect with the middle ear cavity Microsuction - a wax-removal technique using a binocular operating microscope (which allows depth-perception and magnification) to look straight into the ear canal and a very fine sterile suction device at low pressure to remove the wax.
