Ear Irrigations 

Purpose: 

To cleanse the external auditory canal. 

Equipment: 

• Ear Syringe 

• Towel 

• Solution as ordered 

• Basin 

• Gloves 

Procedure: 

1. Authorization: 

• Ear irrigations will be done by the licensed nurse upon a physician’s order. 

2. Preparation: 

• Place the resident in an upright position with their head turned to the side being treated. 

• Prepare the solution as ordered. 

• Protect the resident’s clothing with a towel. 

3. Irrigation Process: 

• If able, allow the resident to hold the return flow basin close to their face just below the ear. 

• Straighten the auditory canal by pulling the ear lobe upward and backward. 

• Fill the syringe and direct the flow of solution against the side of the canal, being careful not to occlude the opening. DO NOT inject the fluid forcefully or direct it toward the eardrum. 

• Watch for symptoms of pain, dizziness, or nausea during the procedure. If present, discontinue irrigation. 

4. Completion: 

• When irrigation is completed, turn the resident so the affected ear is downward to facilitate drainage. 

• Wipe excess fluid from the ear and make the resident comfortable. 

• Dispose of the syringe appropriately. 

5. Examination and Documentation: 

• Examine the contents of the return solution. 

• Document the procedure on the Treatment Kardex. 

• Document the description of returns in Narrative Nurses Notes. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the ear irrigation procedure, including the resident’s response and any observations, in their medical record. 

• Note any abnormalities or difficulties encountered during the procedure. 

• Regularly review and update techniques for ear irrigation according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper ear irrigation procedures to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.