38 Application of Medicated Topical Creams, Ointments and Drops Performance Checklist

Skill Application of Medicated Topical Creams, Ointments and Drops

• Check care plan and/or refer to nurse for direction.
• Understands the intent of the medication and the outcomes to be achieved.
• CCA only applies topical medications approved by the employer/supervisor.

Demonstrates knowledge of ten rights of medication administration:

• the right medication
• the right person
• the right dose
• the right route
• the right time
• the right day
• the right reason
• the right expiry date
• the right documentation
• and the right education

Steps

1. Check the medication administration record for client’s name, medication name, dose, route and instructions for the medication to be applied.
   • Check the time and date it was last given.
   • Perform hand hygiene.
   • Gather equipment: medication, gloves, tissues (cotton balls for ears), and tongue blade if used for skin creams or ointments; basin with warm water, washcloth, towel, and other supplies as needed.
2. Identify client and explain the procedure.
   • Ensure the client understands the purpose of the medicated creams, ointments, or drops. Provide for privacy.
   • Perform hand hygiene and apply gloves.
3. Check expiry dates on medication.
   • Apply the medication as prescribed.
   • Wash and dry skin before applying medication.
   • Wash debris from eyes, or ears if present. Perform hand hygiene and apply clean gloves.

Creams, ointments or lotions

• Squeeze medication from tube or use tongue blade to take cream/ointment from container.
• Spread small quantity smoothly and evenly with gloved hand over affected area.

Eye drops or ointments

• Ensure correct eye for medication.
  • Tilt client’s head slightly backward.
  • Pull lower lid down with non-dominant hand, instruct client to look up.
  • Ensure dropper or tube does not touch the eye or skin.
• Drop prescribed number of drops onto inside of lower eyelid. A
  • pply pressure to inner corner of the eye for a few seconds.
• For ointment, pull lower lid down, instruct client to look up, squeeze ribbon of ointment along middle third of lower lid.
• Instruct client to close eyelids.
• Give client tissue to remove excess medication from eyes.

Ear drops or ointments

• Ensure correct ear for medication.
  • Position client on side. Lift ear (pinna) upward and outward for adult (downward and back for small child).
  • Ensure dropper does not touch the ear.
• Drop the prescribed number of drops into the ear canal.
• Gently massage the tragus.
• Place cotton ball in the ear.

Finishing Up

1. Return medication to storage location.
   • Provide for safety and comfort.
   • Remove gloves.
   • Perform hand hygiene.
2. Observe the client’s response to the medicated creams, ointments, or drops. Report to the nurse when responses are new or different from expected.
3. Document in the medication administration record; date and time of application.

• • Document on client’s record: observations of the client’s response, and communication with client, family, other care providers or employer.