NHS Grampian Ear Irrigation Observation ChecklistThe Assessor when supervising the irrigation of ears using the Propulse II or Propulse III Universal should complete the following checklist. A minimum of six supervised practices are recommended, but the final total will depend on when the Learner feels Confident, Competent and Comfortable using the Propulse II or Propulse III Universal unsupervised.Assessors when completing the form should detail what is seen in the relevant boxes.SummaryThis checklist is concerned with the use of the Propulse II and Propulse III Universal electric irrigator. It includes irrigating the ear to facilitate the removal of cerumen and foreign bodies from the external auditory meatus and the removal of discharge, keratin or debris from the external auditory meatus. Chrome/ plastic syringes and the Propulse I should not be used in NHS Grampian. Who is this checklist aimed at?This checklist is designed to be applicable to all staff who are undertaking ear irrigation whether in a hospital, health centre or the patients home. While being supervised, instruction and supervision must be given by a competent doctor, registered nurse or audiologist, who has the knowledge and skills to perform this procedure competently. At the end of the supervised practice, the Supervisor will certify that the assessment has been given, using the 3C Checklist as a guidance framework. Relationship to SVQ unitsThere are direct links to unit: CU7 - Develop Ones Own Knowledge and Practice CL1 - Promote Effective Communication and Relationships CU2 - Prepare and Maintain Environments for Clinical Procedures X12 - Support Clients During Clinical ActivitiesAnd links to the following units depending on where the ear irrigation takes place: X13 - Undertake Agreed Clinical Activities with Clients Whose Health is Stable in Non-acute Care Settings X19 - Prepare and Undertake Agreed Clinical Activities with Clients in Acute Care Settings ProcedureAssessor to record details of Learners actionsBefore taking any action, the clients identity is positively confirmed with the relevant records and once the procedure has been explained, consent to the procedure is gained.The reason and source of referral is checked with the patient and any previous irrigation history or contraindications are identified.Questions from the client are answered correctly in an appropriate manner, level and pace or referred to the appropriate person if they are beyond the Learners responsibility.Hand hygiene is carried out prior to any physical treatment. Both ears are examined with the auriscope and the findings are recorded and discussed with the patient. The course of action decided upon is verified by the Supervisor as correct and is appropriate for the patient. The correct materials and equipment are prepared for use before starting the procedure.The Propulse II or Propulse III Universal is checked and prepared for use. The procedure is carried out using the Propulse II or Propulse III Universal in a manner likely to cause minimum discomfort. The Learner periodically inspects the meatus with the auriscope and inspects the solution running into the receiver. ProcedureAssessor to record details of Learners actionsThe client is given appropriate information, support and reassurance throughout the procedure in a manner which is sensitive to their needs and concerns.After the removal of wax or debris, the excess water in the ear is dry mopped and the Learner examines both the meatus and the tympanic membrane. Any further issues should be treated as required or referred to doctor if necessary. Appropriate hand hygiene is once again carried out.Give advice regarding subsequent ear care and any relevant information,Record all findings and treatments according to Professional and local protocols.Any spills or splashes are cleaned up safely and effectively in line with NHS Grampian Health and Safety requirements.After use, all re-usable equipment is cleaned effectively using appropriate methods and returned to the correct place for re-use. Waste is disposed of safely in the appropriate manner in line with NHS Grampian Health and Safety requirements. Where was the activity undertaken e.g. hospital, Health Centre or in the patients home? If the patient did not give consent for the procedure to take place, please detail below any actions taken. Similarly, if there were any contra-indications prior to commencing the activity, what actions were taken? Please detail below any problems encountered or any indication that the client suffered adverse reactions to the procedure. Include what actions were taken.Supervisor confirms competent performance on