Policy Manual sample

MDT Home Health Care Agency, Inc. 128 15 . Dispose of trash; remove gloves. 16. Store equipment. 17. Wash hands vigorously with soap and water. Alternate Procedure - This allows a person to change the tracheostomy ties without assistance. The patient and/or caregivers should be instructed to: 1. Assemble equipment. 2. Wash hands vigorously with soap and water. 3. Sit comfortably in front of a mirror in a well-lighted area. 4. Cut a piece of twill tape more than twice the size of the patient's neck circumference. 5. Using the tweezers, insert one end of the tape through the slot on one side of the tracheostomy tube flange. 6. Gently pull the tape across the top or bottom of the flange and through the slot on the other side. 7. Bring the rest of the tape around the back of the neck and tie in a square knot at side of neck. DO NOT tie a bow. 8. Check tightness of the tape by inserting two fingers between the tape and the neck. Two fingers under the tape usually indicates a proper fit. 9. Make sure the knot is secure, but not too tight. 10. Carefully cut soiled tape and remove. 11. Place pre-cut bib sponge gauze under both sides of the flange, pulling ends up under tape. 12. Dispose of trash; remove gloves. 13. Wash hands vigorously with soap and water. 14. Store equipment. DOCUMENTATION: Document the procedure, including any noted drainage and the patient's tolerance of procedure on the Clinical Visit Note. Document all teaching and the patient's or caregiver's response to teaching. If further action is indicated, document follow-up/notification of Clinical Manager and/or physician. ____________________________________________________