EYE SWABBING AND INSTILLATION OF EYE DROP/OINTMENT

Objectives
1. To clean the eye.
2. To reduce transmission of microorganism.
3. To dilate/constrict the pupil.
4. To relief pain and discomfort.
5. As an antiseptic in cleansing the eye.
6. To relieve inflammation and infection.
7. For soothing effect or as protection base.

Assessment
• Check doctor’s order and determine client’s condition.
• Assess client health status.
• Assess any crust or purulent discharge.

Equipment
Trolley – Top Shelf Trolley – Bottom Shelf

Eye swabbing pack consist of: Tray:

• 1 kidney dish (S) • pen torch

• 2 galipot (S) • extra swab (packet)

• cotton balls • scissors

Sterile towel • plaster (micropore)

Tray consist of: • eye pad (if necessary)

• eye drop / ointment Sterile solution – Normal Saline

• gauze Receiver

Receiver for clinical waste

Preparation
• Verify client and check doctor’s order.
• Perform hand hygiene.
• Gather equipment.
• Read the prescription instruction.
• Follow the TEN rights to prevent medication errors.

Implementation
NO Procedure Rational

1. Greet and explain the procedure to client. Establish rapport, gain cooperation
and minimizes anxiety.

2. Provide privacy. Maintain client’s dignity.

3. Check medication order for preparation, Prevent medication errors.

strength of medication, number of drops,
frequency of medication and eye to be
treated.
4. Assist the client to a comfortable position, Facilitate procedure and provide
either sitting or lying. comfort.

5. Perform hand hygiene. Reduce transmission of

microorganism.

6. Prepare trolley:
• open eye set
• pour solution
7. Perform hand hygiene/alcohol hand rub.

8. Prepare swabs:
• minimum 7-8 swab if both eye
• wet and squeeze one by one

9. Clean the eye from inner to outer canthus Prevent transfer of microorganism
as follow. to lacrimal duct.

9.1 Instruct client to look down and

swab the upper lid.
9.2 Instruct client to look up and clean the
lower lid.
 9.3 Clean the centre of the eye with eye
close.

9.4 Use one swab at a time.

10. Repeat step 8 if both eyes.

11. Instillation of eye drop / eye ointment.

11.1 Remove cap from container and place

cap on its side.

11.2 Discard the first drop of medication.
11.3 Expose the lower conjunctival sac by
placing the thumb or finger of non-
dominant hand on the cheekbone and
gently pull the lower lid.
11.4 With dominant hand, hold the
bottle/tube 1-2 cm above the eyeball.
The first drop is considered to
be contaminated.
To prevent person from blinking or
squinting
The tube must not touch the sac or
cornea to prevent injury.

Eye drop The tube must not touch the sac or

11.5 Instruct client to look up and instill one
or two drops into lower conjunctival
sac.
11.6 Instruct client to apply gentle pressure
over the inner canthus of the eye for
approximately one minute.
cornea to prevent injury.
To prevent the outflow of
medication into the nasal and
pharyngeal passages, thus reduce
systemic absorption.

Eye ointment
11.7 Instruct client to look up and squeeze
the ointment from the tube into
conjunctival sac from inner to outer
canthus.
12. Release lid and ask client to close the eye. To allow medication to be
distributed evenly over the eye.
 13. Repeat step 10 – 11 if both eyes.

14. Gently wipe away excess solution/ointment. Prevent possible skin irritation.

15. Make the client comfortable.

16. Tidy up unit.

17. Perform hand hygiene.

18. Document the following. For documentation and further

management.
17.1 Record administration of medication
in medication prescription sheet with
time, date and name.

17.2 Procedure performed.

17.3 Client’s assessment and response.

Evaluation
• Eye swabbing is done using correct technique.
• Correct eye drop is instilled/eye ointment is applied to correct eye using correct
technique.
• Conduct appropriate follow-up based on findings that deviate from expected or normal
for the patient/client. Relate findings to previous assessment data if available.
• Report any abnormalities or side effect of medication to staff in charge/doctor.