Nursing Performance Checklist

Tracheostomy care and suctioning

_________________________: Student Name
: Purpose
.To bypass upper airway obstruction -1
.To allow removal of tracheobronical secretions -2
.To allow long term use of mechanical ventilation -3
.To prevent aspiration of oral or gastric secretions in paralyzed patient-4
.To replaced endotracheal tube -5
Equipment: for care
Tracheostomy care kit :
Sterile towel
Sterile gauze sponges (12)
Track sparks (2)
Face shield
Sterile cotton swabs
Sterile gloves

Hydrogen peroxide
Sterile water
Antiseptic solution
Tracheostomy tie tape

: Steps of procedure
Tracheostomy care
. Assess condition of stoma -1
.Examine neck for subcutaneous emphysema -2
. Explain procedure for patient -3
.Wash hands -4
.Suctioning of the trachea -5
Assembling and preparing equipment to maintaining-6
.sterile filed
.Wear sterile gloves and face shield -7
Cleanse stoma area and the plate of the tracheostomy -8
tube with sterile cotton tipped applicator or gauze saturated
.with H2O2
Repeat steps 6 using the sterile water-soaked gauze -9
.sponges
.Repeat steps 6 using dry sponges -10
Removing inner cannula by rotating it while stabilizing -11
outer cannula for cleaning with H2O2 and replacing
.new disposable inner cannula
.Change tracheostomy tie -12
.Place a gauze pad between the stoma and tracheostomy -13

Done
complete incomplete

Not
done

Steps of procedure : cont

Done
complete incomplete

Not done

Document procedure -14

, observation of stoma [ irritation , reddness
edema, subcutaneous air] and character
.of secretion [ color ,consistency]
Clean the stoma q8hrs or more and tie should be -15
.changed every 24 hrs or more if soiled or wet

Equipment : for suctioning

. sterile suction catheter.
. sterile gloves.
.sterile towel .
.suction sources .
.sterile water.

resuscitation bag connect to 100 O2 source normal saline 2 sterile cup of water sterile water soluble lubricant face shield Done
: Steps of procedure
complete incomplete
For sterile tracheobronchial suction
.Monitor heart rate and auscultate breath sound -1
.Explain procedure to the client-2
.Assemble equipment -3
.Wash hands -4
Open sterile towel and place it -5
Under client chest. Open alcohol
Wipes on corner of towel. Place small
Amount of sterile water soluble jelly
.On towel
.Open sterile gloves -6
.Open suction catheter package -7
Use the sterile hand to remove -8
,The suction catheter from package
.curling the catheter around the gloved fingers
.Connect suction catheter to suction sources -9
.Disconnect the patient from ventilator -10
Ventilate and oxygenate the patient with -11
.resuscitator bag (4 to 5 times)
.Gentle insert suction catheter -12
Inserted suction catheter while withdrawing and gentle rotating the catheter no longer than 10 to 15
.second

Not done

Steps of procedure : cont

Done
complete incomplete

Bag the patient between -14

.suction
Instill 3-5 ml normal saline and bag then suction.
16- Rinse the catheter in the basin that contain sterile
.water
. Continue making suction passes -17
.Give patient 4 to 5 breath with bag-18
.Return patient to ventilator -19
Suction oropharyngeal cavity after -20
.completing tracheal suctioning
.Clean fitting of bag with alcohol swab -21
.Assess vital signs -23
Record amount and consistency -24
.of secretion
.Assess need for suction at least every 2 hrs -25

______________________________ : Supervised by
_________________________________ : Comments
.steps done by physician *

Not done