Can the registered nurse change or reposition a tracheostomy tube?

It is within the scope of practice of an appropriately trained and competent registered nurse to perform tracheostomy care under the direction of an authorized health care practitioner, following clinical practice standards, including:

• Changing, repositioning, or reinserting a tracheostomy tube in an established or non-established tract;
• Tracheostomy site care and dressing changes; and
• Inflation and deflation of cuff in a healed and fresh, established or non-established tracheostomy stoma.

The registered nurse should use the Scope of Practice Decision Tree to determine if the activity is within the nurse’s legal and individual scope of practice. Standing orders may be used. See the Nursing Care Quality Assurance Commission’s Neonatal Intubation and Related Procedures Advisory Opinion for additional information.