see also: Tracheotomy, Tracheostomy & Modifications

Tracheostomy Home Care Booklet

ROUTINE PREOPERATIVE TEACHING OF THE ADULT PATIENT

1. Objective:
   1. Patient/family will verbalize understanding of routine preoperative instructions.
2. Content:
   1. Refer to clinic policy Routine Preoperative Teaching for the Adult Patient.

ALTERED AIRWAY

1. Objective:
   1. Patient/family will verbalize understanding of implications and care of altered airway.
2. Content:
   1. Provide diagram and discuss how normal upper airway filtering, moistening, and warming functions are bypassed.
   2. Demonstrate tracheostomy tubes (Shiley and Jackson).
   3. Discuss purpose of pulmonary cares: to provide humidity and assist in keeping airway clear.
   4. Describe instillation of saline solution, suctioning, heated nebulizer with mask, and frequency of cares determined by secretions and pulmonary status.

ALTERED COMMUNICATION

1. Objective:
   1. Patient/family will verbalize understanding of altered communication following a tracheostomy.
2. Content:
   1. Discuss inability to speak with a cuffed tracheostomy tube. Emphasize potential to speak with an uncuffed tube.
   2. Determine ability to read and write and discuss appropriate communication methods (ie, writing materials, picture board).
   3. Explain that the call light system/intercom at nurses' desk is labeled to indicate patient cannot speak; call light will be answered promptly.

PHYSICAL/SENSATION CHANGES

1. Objective:
   1. Patient/family will verbalize understanding of physical/sensory changes following a tracheostomy.
2. Content:
   1. Describe air exchange: secretions expelled through tracheostomy tube instead of mouth and nose; cover tube when coughing.
   2. Explain ability to taste and smell will be diminished because upper airway is bypassed.

HOME CARE INSTRUCTIONS

1. Objective:
   1. Patient/family will verbalize understanding/demonstrate home care instructions.
2. Content:
   1. Refer to teaching booklet Tracheostomy Home Care Booklet.
      1. Clean technique
      2. Humidity
      3. Making saline solution
      4. Instilling saline solution
      5. Cleaning humidifier
      6. Suctioning
      7. Cleaning inner cannula
      8. Skin care
      9. Changing ties
      10. Changing tracheostomy tube
      11. Cleaning equipment
      12. Precautions
      13. Adverse signs