Evaluation
When evaluating the patient after suctioning, assess and document physiologic and psychological responses to the procedure. Convey your findings verbally during nurse-to-nurse shift report and to the interdisciplinary team during daily rounds.
Trach site care and dressing changes
Tracheostomy dressing changes promote skin integrity and help prevent infection at the stoma site and in the respiratory system. Typically, healthcare facilities have both formal and informal policies that address dressing changes, although no evidence suggests a particular schedule of dressing changes or specific supplies for secretion absorption must be used. On the other hand, the evidence does show that:
secretions can cause maceration and excoriation at the site
the site should be cleaned with NSS
a skin barrier should be applied to the site after cleaning
loose fibers increase the infection risk
the trach tube should be secured at all times to prevent accidental dislodgment, using the two-person securing technique described below under “Securing the trach tube.”