Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

Instillation of Ear Drops

Ear-drop instillation places prescribed liquid medication into the external auditory canal. The nurse confirms the correct ear and medicine, assesses the ear, warms the preparation to room temperature when appropriate, positions the patient correctly and monitors for dizziness, nausea or other reactions.

Purpose

  • Deliver prescribed local treatment to the external ear canal
  • Provide therapeutic, cleansing or local anaesthetic effects when ordered
  • Support safe treatment while protecting the ear from contamination and trauma

Indications

  • A valid prescription for ear drops or an approved ear-care solution
  • An assessed ear condition for which the medication is appropriate
  • A patient able to cooperate or supported safely during positioning

Equipment

  • Prescribed ear drops and medication chart
  • Clean tray and dropper
  • Sterile gauze or swabs for external discharge
  • Water bath or approved method for bringing medication to room temperature
  • Disposable gloves when discharge or infection precautions require them
  • Tissues, waste receptacle and hand hygiene supplies

Procedure steps

  • Verify patient, medication, dose, time, expiry, allergies and the correct ear; inspect the order and preparation.
  • Assess pain, discharge, dizziness, hearing symptoms and the external ear; report unexpected findings.
  • Bring the drops to room temperature when appropriate, explain the procedure and obtain consent.
  • Perform hand hygiene, position the patient with the affected ear uppermost and support the head.
  • For an adult, gently pull the auricle upward and backward; for a young child, pull it downward and backward according to age and policy.
  • Clean only visible external discharge with a clean sterile swab; do not probe deeply into the canal.
  • Hold the dropper above the ear without touching the auricle or canal and instil the prescribed number of drops.
  • Ask the patient to remain with the ear uppermost for the prescribed time, commonly several minutes, unless contraindicated.
  • Observe for dizziness, nausea, pain, hearing change, rash or other reaction; assist the patient slowly when sitting or standing.
  • Dispose of waste, perform hand hygiene and document the ear treated, medication, response, teaching and abnormalities.

Precautions

  • Do not use a preparation with uncertain label, expiry, contamination or unsuitable storage.
  • Use additional clinical direction when tympanic membrane perforation, ear surgery, severe pain or heavy discharge is suspected.
  • Keep the dropper from touching the ear and never insert cotton buds or instruments deeply.
  • Escalate severe dizziness, persistent pain, bleeding, facial weakness or acute hearing deterioration.

Aftercare

  • Keep the patient safe until any dizziness has settled and provide the call bell within reach.
  • Store the medication as directed and ensure the cap is replaced without contaminating the dropper.

Nursing considerations

  • Use age-appropriate communication and auricle manipulation.
  • Follow the product and institutional policy for warming, position and contact time.

Possible complications

  • Dizziness, nausea or falls
  • Canal or tympanic membrane trauma
  • Local irritation, infection or allergic reaction
  • Medication error involving the wrong ear or preparation

Patient education

  • Tell the patient to keep the ear dry or follow the prescribed care plan and report pain, dizziness or hearing change.
  • Explain how and when to use the drops at home without touching the dropper tip.

Documentation

  • Record medication, dose, time, ear treated, assessment, position, tolerance, response and any reaction.
  • Document teaching, refusal, abnormal findings and referral or escalation.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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