Introduction
Hearing aids are a miniature amplifier which is designed specially to enhance hearing.
Definition
Hearing aid is an electroacoustic device which typically fits in or behind the wearer’s ear and is designed to amplify and modulate sound for the wearer.
Purposes
- To improve the ability to differentiate between sounds.
- To make listening easier.
- To maintain proper hearing aid function.
Types
- Behind-the-ear (BTE) aid: It is a small plastic case that rests behind the ear.
- “Mini” BTE (or “on-the-ear”) aid: It also fits behind/on the ear but is smaller.
- In-the-ear (ITE) aid: All parts of the hearing aid are contained in a shell that fills in the outer part of the ear.
- In-the-canal (ITC) aids and completely-in-the-canal (CIC) aid: These hearing aids are contained in tiny cases that fit partly or completely into the ear canal.
- Eyeglasses aid: Similar to the behind-the-ear aid, but the components are housed in the temple of the eyeglasses. It can be in one or both temples of the glasses.
- Body hearing aid: It is a pocket-sized aid, used for more severe hearing losses, and clips onto an undergarment, shirt pocket, or harness carrier supplied by the manufacturer.
Indications
- Adults
- Severe-to-profound, bilateral sensorineural hearing loss (>70 dB).
- Children
- Profound, bilateral sensorineural deafness (>90 dB).
- Little or no benefit from appropriately fitted hearing aids.
Contraindications
- Deafness due to lesions of the acoustic nerve or central auditory pathway.
- Active external or middle ear infections.
- Cochlear ossification that prevents electrode insertion.
- Absence of cochlear development.
- Perforated tympanic membrane.
Articles
| Articles | Purpose |
| Bath towels (2) | To hold the hearing aid.To protect the bed from soiling. |
| Facial tissue | To wipe and remove the cerumen from the outer part of hearing aid. |
| Wax loop | To wipe and remove the cerumen. |
| Storage case | To store hearing aid and batteries. |
| Wash cloth | To wash the ear canal. |
| Warm water and soap | To wash the ear canal. |
| Clean gloves if drainage is present | To protect hand and reduce cross-infection. |
| Spare battery size depending on aid (if necessary) | For replacement. |
| Dryer (optional) | To dry the moisture. |
Procedure
| Nursing Action | Rationale | |
| Removal and cleaning of hearing aid | ||
| 1. | Perform hand hygiene and apply clean gloves, if drainage present. | Reduces transmission of microorganisms. |
| 2. | Turn hearing aid off and lower the volume. Grasp the aid securely and gently remove the device. | Prevents feedback (whistling) during removal, prevents dropping of hearing aid, and prevents injury to ear. The batteries continue to run if the aid is not turned off. |
| 3. | Hold aid over towel and wipe exterior with tissue to remove cerumen. | Prevents breakage if dropped. |
| 4. | Carefully inspect the aid and remove the accumulated cerumen with wax loop. | Cerumen may block sound from receiver. |
| 5. | Inspect the ear mold for rough edges. | May irritate ear canal. |
| 6. | Open battery door and place hearing aid in labeled storage container. | Allows drying of internal compartments and prevents breakage. |
| 7. | Place towel beneath the patient’s ear. Wash ear canal with wash cloth moistened in soap and water. Rinse and dry. | Absorbs excess water. Removes cerumen from ear canal. |
| 8. | Remove gloves and perform hand hygiene. | Reduces transmission of microorganisms. |
| Inserting hearing aid | ||
| 9. | Perform hand hygiene and apply gloves if drainage is present. | Reduces transmission of microorganisms. |
| 10. | Remove hearing aid from storage case and check battery. | To know the condition of the battery. |
| 11. | Close battery door. | Door must be closed to turn on hearing aid. |
| 12. | Turn volume slowly to high. | Prevents damage to hearing aid. |
| 13. | Cup hand over the hearing aid. Listen for feedback (whistle or squeal). | Feedback occurs when hearing aid is working. |
| 14. | Turn hearing aid volume off. | Prevents feedback during insertion (whistling). |
| 15. | Identify hearing aid as either right (marked R or red color coded) or left (marked L or blue color coded). | Prevents damage and injury. |
| 16. | Hold hearing aid with thumb and index finger of dominant hand. Insert pointed end of the ear mold into the ear canal. | Prevents dropping and proper positioning, prevents injury. |
| 17. | Slowly turn on the volume to comfortable level for the patient. | Prevents discomfort and injury to the ear. |
| 18. | Close and store the case and perform hand hygiene. | Prevents loss and reduces transmission of microorganisms. |
| 19. | Inform the patient to follow manufacturer’s instructions for cleaning the ear mold. | To prevent damage or malfunction. |
| Documentation | ||
| 20. | Record removal of hearing aid, storage and location, and any sign or symptom of infection or injury or sudden decrease in hearing acuity. | For further planning of care. |
Special Considerations
- Monitor for frustration or withdrawal due to communication barriers.
- May struggle with dexterity—offer tools like battery loaders or larger controls
- Help patients build confidence by wearing aids gradually and consistently, especially with new devices.
- Store in a dry, protective case when not in use. Consider using a dehumidifier designed for hearing aids.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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