Question

The nurse is going to perform inline tracheostomy suctioning followed by tracheostomy tube care (using a disposable inner cannula). Which of the following is an incorrect step in the sequence for these procedures?

A) Perform hand hygiene. Connect the suctioning tubing to the suction machine. Set on low. Hyperoxygenate the patient. Unlock the suction catheter. Insert the catheter during inspiration.
B) Apply suction. Withdraw the catheter to the point indicated. Lock the suction catheter. Turn off the suction machine. Provide oral care.
C) Remove existing tracheostomy dressing. Using sterile technique, open the tracheostomy kit. Prepare the supplies: open 4-by-4 gauze, saline, and hydrogen peroxide. Place cotton swabs in saline solution.
D) Apply clean gloves. Remove the existing inner cannula. Insert the new inner cannula. Clean around the stoma and flange. Have another family member hold the tracheostomy tube.
E) Cut the existing tracheostomy ties and remove them. Install new tracheostomy ties. Insert new tracheostomy dressing. Discard the used equipment and supplies. Reposition the patient.

Answer 1

The error in the sequence for tracheostomy care is the suggestion to have a family member hold the tracheostomy tube, which should instead be done by a healthcare professional to maintain sterile technique.

Step-by-step explanation:

The incorrect step in the sequence for performing inline tracheostomy suctioning followed by tracheostomy tube care (using a disposable inner cannula) is found in choice D: Apply clean gloves. Remove the existing inner cannula. Insert the new inner cannula. Clean around the stoma and flange. Have another family member hold the tracheostomy tube.

The family member should not be advised to hold the tracheostomy tube as this task requires a professional with sterile technique to prevent infection. Instead, a trained member of the healthcare team should hold the tube securely in place during this care process.