1) Identify patient using name and explain what is about to occur

2) Auscultate bronchial breath sounds

3) Perform hand hygiene before donning personal protective equipment (PPE)

4) Don PPE in the correct order (disposable apron, mask with face shield and disposable gloves)

5) Set suction pressure accurately (between 13 and 20 kPa)

6) Connect the suction catheter to the connecting tubing

7) Remove cap from sterile water and don sterile gloves (dominant hand)

8) Pick up the sterile suction catheter without touching any non-sterile surfaces

9) Pick up the suction catheter (sterile portion) with sterile (dominant) hand

10) Turn on suction machine and aspirate sterile water

11) Explain to patient that you are about to suction tracheostomy

12) Remove artificial nose with the non-sterile (non-dominant) hand

13) Position artificial nose on package of sterile gloves (sterile place)

14) Explain to patient that you are about to insert catheter

15) Insert catheter into tracheostomy until resistance is met

16) Suction patient for 10 to 15 seconds while you roll the catheter between your thumb and forefinger

17) Set artificial nose accurately after suctioning

18) Rinse catheter with water

19) Turn off suction machine and remove the catheter from the connecting tubing

20) Dispose of catheter while maintaining sterility of dominant hand

21) Doff PPE in the correct order (i.e. gloves, apron and mask)

22) Perform hand hygiene

23) Auscultate bronchial breath sounds

24) Explain that suctioning was finished