1.Get your supplies ready and within reach.
2.Provide privacy.
3.Wash your hands.
4.Open your Sterile gloves and ready for use.
5.Prepare the area to be used for procedure.(Sterile)
6.Light adjusted for good visualization of the stoma site.
7.Place patient in comfortable position.
8.Neck slightly extended to allow proper care.
9.Have assistant to help you to prevent accidental expulsion.
10.Remove the old security device making sure that the tracheostomy is secured. 11.Thoroughly wash patient neck well.
12.Dry patient neck well.
13.If alone you will secure tube in one hand while keeping the other hand sterile. You use the sterile hand to clean skin around the stoma with normal saline. Making sure that the liquid is not dripping to avoid accidental aspiration.
14.Position sterile pre-cut guaze pad under the flanges of the tracheostomy.
15.Place the new secure device.
16. Auscultation of patient lung fields.
17.Reposition patient for comfort. 18.Thoroughly wash your hands.
19.Thank patient and leave the room. 20.Document your findings and what you did for the patient.
NB: Tracheostomy tube have an inner cannula. It is a tube within the outer tube. Inner cannula can be easily removed and cleaned without changing the whole tracheostomy tube.

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