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 14-12

Providing Tracheostomy Care (Continued)

Comments

10. Put on disposable gloves.


11. Remove the oxygen source if one is present. Stabilize the
    outer cannula and faceplate of the tracheostomy with your
    nondominant hand. Grasp the locking mechanism of the
    inner cannula with your dominant hand. Press the tabs
    and release lock. Gently remove inner cannula and place in
    disposal bag. If not already removed, remove site dressing
    and dispose of it in the trash.


12. Discard gloves and put on sterile gloves. Pick up the new
    inner cannula with your dominant hand, stabilize the face-
    plate with your nondominant hand, and gently insert the
    new inner cannula into the outer cannula. Press the tabs to
    allow the lock to grab the outer cannula. Reapply oxygen
    source, if needed.

Applying Clean Dressing and Holder

(See the Skill Variations in your skills book for steps for an

alternate site dressing if a commercially prepared sponge is not

available and to secure a tracheostomy with a tracheostomy

ties/tape instead of a collar.)

13. Remove oxygen source, if necessary. Dip cotton-tipped
    applicator or gauze sponge in cup or basin with sterile
    saline and clean stoma under faceplate. Use each applica-
    tor or sponge only once, moving from stoma site outward.


14. Pat skin gently with dry 4 4 gauze sponge.


15. Slide commercially prepared tracheostomy dressing or pre-
    folded non-cotton-filled 4 4-inch dressing under the
    faceplate.


16. Change the tracheostomy holder:
    a.Obtain the assistance of a second individual to hold
    the tracheostomy tube in place while the old collar is
    removed and the new collar is placed.
    b. Open the package for the new tracheostomy collar.
    c. Both nurses should put on clean gloves.
    d. One nurse holds the faceplate while the other pulls up
    the Velcro tabs. Gently remove the collar.
    e. The first nurse continues to hold the tracheostomy
    faceplate.
    f. The other nurse places the collar around the patient’s
    neck and inserts first one tab, then the other, into the
    openings on the faceplate and secures the Velcro tabs on
    the tracheostomy holder.

ExcellentSatisfactoryNeeds Practice