Trach Care Procedure

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Nursing 130 Testable Skill

Tracheostomy Care

Procedure Rationale S/U


1. Gather equipment, PPEs, perform hand hygiene, Provides patient reassurance and decrease
identify and explain to patient purpose hand microorganisms
2. If patient needs suctioning, following suction Suctioning first prevents contamination of
procedure prior to tracheostomy care cleaned tracheostomy area
3. Prepare tracheostomy cleaning tray and supplies Proper preparations helps to increase
(Q-tips, cleaning solution—pour into basin, open efficiency.
packaging of new inner cannula—if applicable),
4. Apply clean gloves, goggles. PPEs for the caregiver. Proper disposal of
a. For a disposable inner cannula, gently soiled dressings and inner cannula prevents
remove by stabilizing the faceplate with contamination of sterile supplies
nondominate hand and dispose.
b. For non-disposable inner cannula, gently
remove by stabilizing the faceplate with
nondominate hand place in basin of
cleaning solution
c. Remove soiled dressing
5. Remove soiled gloves. Prevents contamination of new sterile supplies
6. Apply sterile gloves New tracheosomy care should be done with
sterile technique. Clean technique may be
used in the home.
7. Using Q-tips, cleanse tracheostomy wound and 3% H2O2 is effective in loosening dried
plate of tracheostomy tube moistened with secretions
cleaning solution. (Use each Q-tip once and
dispose). Pat dry with sterile 4x4 or Q-tip
8. Replace inner cannula: Replacement or cleansing of inner cannula
a. For disposable inner cannula: replace removes dry secretions which can block
with new cannula airway
b. For non-disposable inner cannula: Clean
inner cannula with tube brush (if available
in kit and according to manufacturer’s
instructions.) Dry with sterile 4x4 and
insert cannula, locking into place.
9. Change trach ties. Secure new trach ties (or Important to maintain stabilization of trach
Velcro ties) into flange before removing old ties. tube to prevent dislodgement
10. Replace tracheostomy dressing or prefolded non- Special dressings are used to prevent threads
cotton-filled 4x4 dressing under faceplate. Ensure from entering tracheostomy causing airway
ties not too loose or too tight. (the nurse should obstruction or abscess formation.
be able to fit one finger between neck and collar.
11. Reassess patient’s respiratory status and need for Evaluation of nursing interventions is
oxygen. Document procedure important to note patient progress.

Pp, Spring, 2013

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