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Eye Irrigation Checklist

1. The document provides a procedural checklist for performing eye irrigation, outlining 15 specific steps of the procedure. 2. It includes criteria for evaluating performance of the procedure on a scale of 1 to 0.25 based on excellence, competence, need for improvement. 3. The checklist ensures all steps of preparing, performing, and documenting the eye irrigation are completed according to standards.

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Alma Janella TOSINO
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2K views3 pages

Eye Irrigation Checklist

1. The document provides a procedural checklist for performing eye irrigation, outlining 15 specific steps of the procedure. 2. It includes criteria for evaluating performance of the procedure on a scale of 1 to 0.25 based on excellence, competence, need for improvement. 3. The checklist ensures all steps of preparing, performing, and documenting the eye irrigation are completed according to standards.

Uploaded by

Alma Janella TOSINO
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Step-by-Step Procedure: Details the step-by-step tasks required to perform eye irrigation safely and efficiently.
  • Objectives and Criteria: Defines the objectives of eye irrigation and the criteria for successful evaluation within the procedure.
  • Procedural Checklist Overview: Introduces the procedural checklist for eye irrigation, including objectives, risks, benefits, and compliance.

Nursing Care Management 116

Care of Clients with Problems in Nutrition and Gastro-Intestinal, Metabolism,


Endocrine, Perception and Coordination (Acute and Chronic) LAB/RLE

Procedural Checklist in
Eye Irrigation

Name: _____ Date: ______Year/Sec: ___ Rating: ___________

General Objectives: To perform eye irrigation through the step by step procedure knowledgeable with its
principles and rationales.

Specific Objectives:
1. Identify the patient correctly
2. Explain the procedure to the patient including its risks, benefits, and complications
3. Gather equipment
4. Perform hand hygiene correctly
5. Don and Doff PPE accordingly
6. Perform the procedure correctly
7. Document findings accurately

CRITERIA
Item Weight Descriptors Verbal Interpretation
1 Excellent Performed the procedure with great ease and confidence, observing
work ethics (prudent, accepts criticisms and suggestions), able to
rationalize scientifically and shows diligence in documenting
observations at all times .
0.75 Very Performed the procedure with less confidence, observing work ethics
Satisfactory
(prudent, accepts criticisms and suggestions), able to rationalize
scientifically and shows minimal diligence in documenting observations.
0.5 Satisfactory Performed the procedure but requires close supervision and shows
potential for improvement.
0.25 Needs Failed to perform the procedure, unable to function well and needs
Improvement
repeated specific/ detailed guidance or direction.

Step by step procedures: 1 0.7 0.5 0.25 REMARKS


5
1. Introduce self and verify      
patient’s identity.

2. Verify doctor’s order and      


obtain patient’s consent by
explaining the procedure, risks,
benefits and complications.
3. Prepare the equipment:      
 Faceshield
 Irrigating Solution
 20 or 30ml syringe
 G16 or 18 IV catheter
 Kidney Basin
 Underpad
 Clean gloves
 Apron / gown
 4x4 gauze

4. Perform hand hygiene and don      


PPE (Personal Protective
Equipment).

5. Have the patient lie with the      


head tilted on the affected eye,
put on underpad under the
patient’s head.
6. Clean lids and lashes with      
gauze moistened with water or
normal saline. Wipe from the
inner to outer canthus and use
different corner of the gauze
with each wipe.
7. Place kidney basin at cheek on      
the side of the affected eye, if
the patient is able, ask him to
hold the kidney basin..
8. Place thumb near the margin      
of the of the lower lid and two
fingers above eye. Apply
pressure downward to expose
the lower conjunctival sac as
the lower lid is pulled down.
Hold upper lid open with your
fingers.
9. Fill the irrigation syringe with      
the prescribed fluid. Hold
irrigation syringe about 2.5 cm
(1in) from the eye. Direct flow
of solution from inner to outer
canthus along the conjunctival
sac.
10. Irrigate until the solution is      
clear or all the solution has
been used.
11. Pause the irrigation and have      
the patient close his eyes
periodically during the
procedure.
12. Dry the periorbital area after      
irrigation with gauze sponge.
Offer a towel to the patient if
needed.
13. Assist the patient to a      
comfortable position.
14. Doff PPE (Personal Protective      
Equipment).

15. Document the procedure and      


evaluate the patient’s
response.

Total points = 15 points     Passed: Failed:

Comments: (Strengths & Weaknesses)

Conforme: Evaluated by:


___________________ ____________________________________
Student’s Signature CI’s Signature over Printed Name
Date: Date:

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