Published Feb 19, 2005
I was taught trach care and suctioning should be done with sterile tech. A nurse at work says it isn't sterile but clean. Which is right?
Sterile technique always!
In the hospital, we always do it sterile tech... However, when I did home health, pts families were taught clean tech. The theory being that - teaching sterile tech for pts at home - just isnt feasible.
It's a clean procedure for us. BUT when suctioning, the catheter inside it's sleeve stays sterile and when changing the inner cannula we don't touch the portion that actually goes into the trach. Some wear sterile gloves while changing the inner cannula, some don't. Nobody wears sterile gloves when suctioning, changing sponges, or cleaning around the area with peroxide and sterile h20.
I have been working on a respiratory floor for 20 years. Suctioning down the trach, changing and/or cleaning the inner cannula is always done as sterile technique. Cleaning around the outside of the trach can be done with clean technique.
In the hospital, we always do it sterile tech... However, when I did home health, pts families were taught clean tech.
Correct, when working in home health we (families and nursing) use clean technique, sterile in hospital.
Not in home health. :)
mandykal, ADN, RN
I think it depends on exactly what type of trach care and suctioning you're doing. There is a close suctioning and an open suctioning.
The close suctioning, the tube is inside a sleeve therefore does not require sterile technique. The open does require sterile technique b/c it's open and exposed. A greater risk for contamination. As for the inner cannula, lots of hospitals out there are using disposable cannula.
Kitty wrote "when working in home health we (families and nursing) use clean technique, sterile in hospital."
The only thing I can say about home health not using sterile technique is that....at home, they might not have the resources available at hand or cha-ching ($). If you're a nurse assigned to a pt at home, educate the family on importance of sterility. Esp when the pt has a compromised immune sys.
Many different ways to get things done. As long as you know the principles of safety and your scope, any nurse performing a task should have the same goal.
I was taught that trach care in the hospital setting should always be done using sterile technique. Same with suctioning.
We did clean technique in home care, and in some LTC's. In home care you are sometimes lucky if you get one suction cath/day. It takes a docs order and letter of medical necessity to get enough for every time you suction.
We ALWAYS do sterile technique in my particular facility, we use Portex trachs without an inner cannula. But taking what I've learned in my six short years as an RN, if another nurse tells you something that doesn't agree with what you've been taught or what your practice has been, go to your unit's policy and procedure. You can't go wrong, and many times it clears up conflicting practices.
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