Tracheostomy Care & Suctioning

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School

Herzing University *

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Course

221

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Mechanical Engineering

Date

Feb 20, 2024

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docx

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NSG 125 Nursing Skill Competency: Tracheostomy care & suctioning Name: ________________________________ Date: ____________________ Preparation Comments Yes No Confirm provider order +1 Perform skill over riders -Provide privacy -Hand hygiene, dons clean gloves -Introduce self & explain procedure - Gather equipment +2 Identify patient with two identifiers +1 Assess oxygenation status of patient & need for suctioning +1 Position patient comfortably in semi-fowlers position +1 Tracheostomy suctioning Yes No Turn on suction unit and adjust to appropriate pressure (no more than 150 mmHg for adults) +1 Open sterile suction package or tracheostomy care kit using aseptic technique. You can use the package as your sterile field or set one up. +1 Don Sterile gloves +1 With the dominant gloved hand, pick up the sterile catheter, Pick up the connecting tubing using the non-dominant hand and connect the tubing and suction catheter +1 Moisten the catheter by dipping it into the container of sterile saline and check suction. +1 Using your non-dominant hand, Hyper-oxygenate patient for 30-60 seconds +1 Using the dominant hand and maintaining sterility, insert the suction catheter into the tracheal airway until resistance met (do not apply suction during insertion) +1 Apply continuous suction, slowly withdraw catheter while rotating the catheter in a circular motion (suction for no longer than 20 seconds). +1 Reapply oxygen to patient and hyper-oxygenate for up to 60 seconds +1 Rinse catheter and tubing with normal saline until clear +1 Repeat suctioning process again. DO NOT suction more than 3 times in one episode +2 After completion, remove the catheter from suction and remove gloves. Perform hand hygiene. +1 Don clean gloves and perform oral suctioning as needed +1 Reassess the patient’s respiratory status (RR, effort, oxygen saturation, lung +1 Rev 11/2020

sound) Maintains sterility during procedure, keeping sterile field in view, avoids reaching over sterile field, avoids contaminating dominant hand & supplies +1 Tracheostomy Care Yes No After performing suctioning, assess for the need to provide tracheostomy care after suctioning +1 Open your sterile supplies for tracheostomy cleaning if not previously opened from suctioning. If using a disposable inner cannula open it at this time. +1 Non-disposable cannula care: - Don sterile gloves - Unlock and remove the inner properly and drop the cannula into the saline basin - Reapply tracheostomy make for oxygen source - Use the small brush to scrub off secretions from the inner cannula - Rinse the inner cannula properly and dry thoroughly - Replace the inner cannula and secure the locking mechanism - Hyperventilate if needed +2 Disposable cannula care: - Remove old cannula appropriately and replace it with the new one - Ensure the new cannula is locked into position - Dispose of the contaminated cannula appropriately and apply oxygen +1 Dip the cotton-tipped applicator or gauze in the saline to clean the stoma under the faceplate. Use each applicator or sponge only once, moving from stoma site outward +1 Pat the skin dry with a dry 4x4 gauze sponge +1 Slide the split gauze under the faceplate +1 Change out the tracheostomy holder: - Obtain a second person to assist in the holder change - One nurse holds the faceplate while the other gently removes the collar - Replace with the new collar - Another way is to place the new collar over the old one, not removing the old collar until the new one is fully in place. This ensures the tracheostomy cannula is not dislodged. - Place two fingers under the collar to ensure it is not too tight +1 Remove gloves & PPE, Perform hand hygiene +1 Completion Yes No Assist patient to a comfortable position and assess oxygenation status +1 Discard used supplies +1 Document procedure +1 Student fails the skill if total score is less than 80% (28/35) Student will fail skill if any of the BOLD criteria are not met . Total Score /35 PASS: __________ Remediation: ___________ Practice Faculty Signature: ______________________________________ Date: _________________ Rev 11/2020

Check-Off Faculty Signature: _____________________________________ Date: _________________ Comments: Rev 11/2020

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