TRACHEOSTOMY CARE

Name: ____________________________________Group:_______________Score:__________
Section: __________________________________ Date:___________
Clinical Instructor: _________________________

PERFOMANCE POINTS 5 4 3 2 1 REMARKS

KNOWLEDGE
1 State the purposes of tracheostomy care.
2 Enumerate the special considerations in
tracheostomy care.
3 Explain the rationale of each suggested
action.
4 Enumerate the equipment’s used.
SKILLS
1 Observe for signs and symptoms of need to
perform tracheostomy care: excess
peristomal secretions, soiled tracheostomy
ties, soiled dressing diminished airflow, or
signs and symptoms of airway obstruction.
2 Check when tracheostomy care was last
performed.
3 Explain procedure to client; have another
nurse or family member to assist in the
procedure.
4 Assist in comfortable position usually supine
or semi-fowler.
5 Place towel across chest.
6 Wash hands, apply gloves, and face shield if
applicable.
7 Suction tracheostomy. Before removing
gloves, remove tracheostomy soiled dressing;
discard in glove with coiled catheter.
8 Open sterile tracheostomy kit. Open gauze
packages aseptically and pour normal saline
on one package and hydrogen peroxide on
another. Leave third package dry. Open two
cotton- tipped swab packages, and pour
normal saline on one package and hydrogen
peroxide on another. Open sterile
tracheostomy dressing package. Unwrap
sterile basin and pour ½ inch hydrogen
peroxide into it. Open sterile brush package
and place into sterile basin. Cut tape and lay
aside in dry area.
9 Apply gloves. Keep dominant hand sterile
throughout the procedure.
10 Remove oxygen source and inner cannula
with non-dominant hand. Drop into
hydrogen peroxide basin.
11 Place tracheostomy collar, T tube or
ventilator oxygen source over cannula.
12 Quickly pick up inner cannula and use small
brush to remove secretions inside and
outside inner cannula.
13 Hold inner cannula over basin and rinse with
normal saline.
14 Replace inner cannula and secure locking
mechanism, if applicable. Reapply trach
collar, T tube, or ventilator oxygen source.
TRACHEOSTOMY STOMA
15 With hydrogen peroxide saturated cotton-
tipped swabs and gauze, clean exposed outer
cannula surfaces and stoma under faceplate
extending 2 to 4 inches in all directions from
the stoma. Clean in circular motion from
stoma outside.
16 With normal saline saturated cotton-tipped
swabs and gauze, rinse hydrogen peroxide
from trach tube and skin surfaces.
17 With 4x4 inch gauze, pat lightly at skin and
exposed outer cannula surfaces.
TRACHEOSTOMY TIES AND DRESSING
CHANGE
18 Ask assistant to hold tube in place. Cut ties.
19 Cut will tape long enough to go around
client’s neck twice (24 to 30 inches). Cut ends
on diagonal.
20 Insert one end of tie through faceplate eyelet
and pull ends even.
21 Slide both ends of tie behind the head and
around neck to other eyelet and insert one
tie through second eyelet.
22 Pull snugly.
23 Tie ends securely in double square knot,
allowing space for only one loose or two
snug fingers in tie.
24 Insert fresh tracheostomy dressing under
clean ties and faceplate.
25 Position client comfortably and assess
respiratory status.
26 Remove gloves and face shield and discard.
27 Wash hands.
ATTITUDE
1 Answers the questions politely.
2 Shows effort to improve performance.
3 Works harmoniously with the clinical
instructor and group mates.
4 Reports in clean uniform, well groomed and
neat.

GRADING:_____TOTAL SCORE______ x 75 + 25 =

COMPUTATION:

CLINICAL INSTRUCTORS SIGNATURE:

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