:up:in the pennsylvania code under the regs for nursing scope of practice, subchapter d. interpretations subheading 21.414. interpretations regarding the functions of licensed practical nurses, t does state that (if there has been adequate education and training) that it is within the lpn scope of practice to change an outer tracheostomy tube after the stoma is healed. web reference http://www.pacode.com/secure/data/049/chapter21/subchapdtoc.html hope this helped!