trach changes- how often??

Hello, there are a few nurses and speech therapists at the hospital that I work that are extremely interested in finding out how frequently other hospitals change the trachs on patients. Per the Shiley insert, they should be changed every 29 days....however, our hospital policy states "prn". We are a large teaching hospital that has had patients that required going back to the operating room to have trach changes because of granulation tissue growing thru the fenestration holes. Part of the problem at our hospital is because we are a large teaching/trauma hospital. The patients get the trachs placed in Truama ICU, however, by the time the patients get to the stepdown units and med/tele units the trach may have been in too long and no one seems to know who and when should change them.


I'd love to have feedback, information, etc from other nurses and speech therapists.

Thanks for responding. Yes, I did mean the entire trach. Changing the
inner cannulas is part of our daily trach care. The problem is the entire
trach change and downsizing trachs from 8's to 6's, etc. Speech often
requests a smaller size trach when working with PMV's.