Policy Manual sample

MDT Home Health Care Agency, Inc. 129 TRACHEOSTOMY SUCTIONING PURPOSE: Suctioning to remove secretions and maintain the patient's airway for patients with a tracheostomy is provided in accordance with physician's orders. Careful assessment of all medications, especially analgesics and sedatives, as well as assessment of the lungs, will be completed prior to initiating the procedure. Untoward symptoms will be reported to the physician. Education to the patient or caregiver will include technique of suctioning, assessment of need for suctioning, care of equipment, and symptoms of distress or infection to report. RESPONSIBLE PERSONNEL: RN, LPN, RT, CRTT EQUIPMENT: Suction kit, sterile water or saline solution, sterile gloves, suction machine, sterile saline for irrigation PROCEDURE: 1. Wash hands. 2. Explain procedure to patient. Pre-oxygenate patient if source is available. 3. Assemble equipment. Open suction kit carefully. Remove solution container. Pour sterile normal saline into container. 4. Put on sterile gloves. 5. Pick up catheter with dominant hand. 6. Insert catheter into tracheostomy tube. 7. Quickly pass the suction catheter as far as possible into the tube, apply thumb of non- dominant hand to suction vent of tube and gently rotate the catheter between the thumb and forefinger as it is withdrawn 8. Limit suction time to 15 seconds or less. 9. If ordered, 3-5 ml of sterile normal saline solution may be introduced into the tube. 10. Allow time for the patient to rest between suctioning attempts. If the patient is on supplemental oxygen, it should be replaced between attempts. 11. Discard disposable equipment. Clean and store reusable equipment and solutions. 12. Teach family members the signs and symptoms of infection (i.e., fever, labored breathing, increase in secretions, change in color of secretions). These signs should be reported to the physician. 13. Wash hands. DOCUMENTATION: Document procedure, type of secretions including amount and color, patient tolerance to procedure and any patient or caregiver teaching on the Clinical Visit Note. If untoward symptoms are noted, document follow-up/notification of Clinical Manager and/or physician.