Aaron's tracheostomy website has a fountain of info re trach care.
Trach change procedure:
If needed, I always suction patient first to prevent splatters/minimize cough reflex when doing tie change then clean stoma and inner canula. Ties changed last
With the Dale velcro holder, I place the large side under the neck and guesstimate when to attach small side, remove and place together. Always attach velcro large side of holder first above old holder, then place new one under neck. Check to see if I need to make any adjustment. Then detach short side old tie, attach new
short side, detach old long side tie, remove old tie entirely; make sure one fingerwidth is able to fit under holder to allow for neck swelling/ movement.
In homecare we would wash in laundry bag or handwash in soap then soak in 1:10 bleach solution and reuse especially if payment an issue.
Practice does make perfect! You'll get the feel for it.