Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 14-12

Providing Tracheostomy Care

Goal:The patient exhibits a tracheostomy tube and site free

from drainage, secretions, and skin irritation or breakdown. Comments

1. Bring necessary equipment to the bedside stand or overbed
   table.


2. Perform hand hygiene and put on PPE, if indicated.


3. Identify the patient.


4. Close curtains around bed and close the door to the room,
   if possible.


5. Determine the need for tracheostomy care. Assess patient’s
   pain and administer pain medication, if indicated.


6. Explain what you are going to do and the reason to the
   patient, even if the patient does not appear to be alert.
   Reassure the patient you will interrupt procedure if he or
   she indicates respiratory difficulty.


7. Adjust bed to comfortable working position, usually elbow
   height of the caregiver (VISN 8 Patient Safety Center, 2009).
   Lower side rail closest to you. If the patient is conscious,
   place him or her in a semi-Fowler’s position. If patient is
   unconscious, place him or her in the lateral position, facing
   you.Move the overbed table close to your work area and
   raise to waist height. Place a trash receptacle within easy
   reach of work area.


8. Put on face shield or goggles and mask. Suction
   tracheostomy, if necessary. If tracheostomy has just been
   suctioned, remove soiled site dressing and discard before
   removal of gloves used to perform suctioning.

Cleaning the Tracheostomy: Disposable Inner Cannula

(See the Skill Variation in your skills book for steps for clean-

ing a nondisposable inner cannula.)

9. Carefully open the package with the new disposable inner
   cannula, taking care not to contaminate the cannula or the
   inside of the package. Carefully open the package with the
   sterile cotton-tipped applicators, taking care not to contam-
   inate them. Open sterile cup or basin and fill 0.5 inch deep
   with saline. Open the plastic disposable bag and place
   within reach on work surface.

ExcellentSatisfactoryNeeds Practice