- Explain procedure to patient, engage his co-operation and provide privacy.
- Prepare trolley and send to the bedside.
- Wear disposable gloves and suction the tracheostomy tube.
- Remove the inner tube by turning the lock about 90o counter clockwise with the dominant hand and the non-dominant hand removes the inner cannula by gently pulling it out.
- Soak inner cannula in hydrogen peroxide for five (5) minutes and suction the outer cannula.
- Remove gloves, wash hands and put on sterile gloves.
- Remove inner tube from hydrogen peroxide solution into the sterile bowl with saline solution and brush the lumen and entire cannula thoroughly.
- Rinse the inner tube in a clean saline solution and dry the inner side of cannula with gauze squares twisted together.
- Re-insert inner cannula into outer cannula and turn 90o clockwise to lock.
- Clean the stoma using square on forceps or with sterile cotton buds with saline solution. If there are debris, clean with hydrogen peroxide before saline solution.
- Apply a sterile dressing and change the tie tapes, check tightness of tracheostomy tie.
- Thank patient, discard and decontaminate equipment.
- Wash and dry hands.
- Document procedure and findings in nurses’ notes.