Tracheostomy Care

Changes in Medicare payments made in 2010, are leading to an influx of patients with tracheostomies and those who are ventilator dependent into sub-acute skilled nursing facilities. Health care reform will further influence this trend and reimbursement will depend on quality care and positive outcomes. This course is for practitioners and facilities who want to be proactive in being able to meet the demand and support this fragile population.

Tracheostomy and ventilators can make even the most seasoned healthcare practitioners uneasy. For many RN’s, LPN/LVN’s, and CNA’s working in skilled nursing facilities, these patients will provide a new challenge and demand that they develop new skills. This course aims to take the mystery out of tracheostomy care. The latest technological advances for tracheostomy tubes will be reviewed. Through the use of video demonstration and thorough review of industry best practice methodologies, nurses and other healthcare practitioners will gain the knowledge and the confidence they will need to provide quality care.

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Upon completion of this course, the participant will be able to:
  1. Describe basics of airway anatomy.
  2. List 3 indications for tracheostomy.
  3. Describe key points of bedside respiratory assessment.
  4. Identify signs of respiratory distress.
  5. Identify types and sizes of tracheostomy tubes.
  6. Describe MOV technique and  tracheostomy tube inflation.
  7. Recognize why, when and how to suction the tracheostomy tube.
  8. Recognize why, when and how to clean the skin around the tracheostomy tube.
  9. Recognize why, when and how to change the tracheostomy ties.
  10. Recognize why and when to change the tracheostomy tube.
  11. Recognize why, when and how to use respiratory and universal precautions.
  12. Recognize why humidification is important for tracheostomy.
  13. List different modalities for delivering humidification to the tracheotomy.
  14. State the important supplies to have stand-by in the room of the tracheostomy patient.
  15. Identify the management of the tracheostomy patient found in distress.
  16. List the documentation required for tracheostomy and respiratory care provided.


Chapter 1: Basic Airway Anatomy

  • Key Points for Bedside Respiratory Assessment
    • Inspection
    • Palpation
    • Auscultation
  • Medical terminology for breath sounds with wave file demonstrations
  • Documentation

Chapter 2: Respiratory Distress

  • Signs of Respiratory Distress
  • Documentation

Chapter 3: Tracheostomy

  • Medical Justification (Indications) for Tracheostomy
    • Two video demonstrations of the surgical technique for tracheostomy
      • 3-D medical animation
      • Graphic video of the surgery being performed (approximately 11 minutes)
  • Possible complications of tracheostomy

Chapter 4: Tracheostomy Tubes

  • Tracheostomy Tubes
    • Description and diagram of basic functional parts
    • Detailed explanation of the tracheostomy tube cuff
      • Outline of the procedure for inflating and deflating the tracheostomy tube cuff
    • Possible complications
    • Documentation
    • Procedure for MOV Technique
  • Chart outlining innovative new tracheostomy tubes in use today
    • Indications
    • Manufacturers
  • Images and explanations of four other tracheostomy like devices
    • Sleep apnea tube
    • Stoma Button
    • Transtracheal oxygen catheter
    • Laryngectomy tube
    • Open stoma

Chapter 5: Suctioning

  • Suctioning
    • Best practice guidelines for suctioning the patient with a tracheostomy
    • Possible complications
    • Documentation
  • Video demonstration of suctioning the tracheostomy patient

Chapter 6: Humidity, Speaking Valves and Tracheostomy Caps

  • Humidity
    • The importance of supplemental humidity for the tracheostomy patient
      • Options for providing humidity
  • Speaking valves
  • Tracheostomy plugs

Chapter 7: Tracheostomy Care

  • Best practice guidelines for performing tracheostomy care
    • Possible complications
    • Documentation

Chapter 8: Tracheostomy Tube Changes

  • Tracheostomy tube change
    • The first tracheostomy tube change
    • Routine tracheostomy tube change
      • Indications
      • Schedule

Chapter 9: Resources

  • Algorithm for the management of a tracheostomy patient found in respiratory distress
  • Skills Competency Checklists
    • Tracheostomy Care
    • Tracheostomy Suctioning
  • California Bill 241
  • Implicit Bias in Healthcare
  • What is Implicit Bias?
  • Implications of Implicit Bias in Healthcare
  • How to Reduce Implicit Bias

Price: $35.00

Contact Hours: 3.5

Course Author

Theresa McGauley-Keaney

Theresa McGauley-Keaney, Registered Respiratory Therapist, has been a practicing registered respiratory therapist in the city of Worcester, Massachusetts, since 1986, with the bulk of her experience in acute care.  She earned a certificate in web design from Clark Career Institute and holds a BA in Communication from the University of Massachusetts.

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