After tracheostomy placement, preparing patients for discharge can be challenging for medical providers. Patients and families are often learning these skills for the first time as medical teams aim to ensure they feel confident at discharge. The lack of a standardized teaching approach allows for individualized education but can also increase provider burden and contribute to insufficient tracheostomy training. Additionally, factors such as length of stay and discharge disposition can impact both the teaching process and timeline.
Patients typically remain hospitalized for recovery following tracheostomy placement; however, length of stay varies widely. One study reported an average post-tracheostomy stay of approximately 60 days (Ramanthan et al., 2023), though some patients may be discharged within one to two days or stay even longer than the average 60 days. Length of stay has increased for both ventilator-dependent and non–ventilator-dependent patients since the COVID-19 pandemic (Burr et al., 2024). While longer stays may allow more time for tracheostomy training, it can also present challenges for patients. Given the medical complexity of patients with tracheostomies and the influence of comorbidities, an individualized approach is essential to guide discharge timing and education planning.
Approximately 20% of patients undergoing tracheostomy are discharged with the tracheostomy still in place (Stewart et al., 2022). There are a variety of places that patients could be discharged to after hospitalization, including long- or short-term care facilities, rehabilitation, skilled nursing facilities, or home with or without support (Ramanthan et al., 2023). The variety of options can be difficult for providers when it comes to determining teaching plans, as each discharge location requires varying levels of education prior to discharge. Factors such as age, hospital location, and mechanical ventilation requirements also impact disposition. As discharge patterns continue to evolve, teaching approaches must remain adaptable (Duggal et al., 2025).
There is no universally accepted approach to discharge teaching following tracheostomy, though many institutions implement protocols to support standardized education. Much of the literature focuses on pediatric populations, where teaching plans often span 8–13 weeks and involve intensive caregiver training, typically with two designated caregivers (Burr et al., 2024). These programs commonly incorporate a combination of didactic, hands-on, and simulation-based learning. Collaborative, standardized discharge education processes have been associated with reduced length of stay (Amin et al., 2025). While pediatric centers frequently have well-established protocols, similarly structured approaches are less common in adult settings.
When a patient is discharged home, thorough tracheostomy education is especially critical. Prior to discharge, the medical team should review key tracheostomy care topics to ensure patients and caregivers can safely and effectively manage the tracheostomy at home.
Key teaching points include:
- Inner cannula care: Proper techniques for changing and cleaning
- Tracheostomy tube care: Changing and cleaning the tube (particularly important in pediatric patients)
- Tracheostomy tie (neckband) management: Safe tie (neckband) changes and routine skin assessment
- Stoma assessment: Understanding cleaning as well as what the stoma should and shouldn’t look like
- Suctioning: Appropriate technique, frequency, and depth
- Emergency management: Recognition and response to decannulation, mucus plugging, and cardiac arrest
- Emergency preparedness: Set-up and maintenance of a tracheostomy emergency bag
- Medication management: Identification, administration, and understanding of intended outcome of medication as well as potential side effects
- Provider communication: When and how to contact the healthcare team for questions or concerns
Learn more
Understanding practices across institutions can help inform and strengthen local education efforts. Atos Medical is offering a webinar that explores the current state of post-tracheostomy care, including discharge teaching and disposition, and will feature Cassandra Zavala, RN, pediatric case manager for complex care at the Medical College of Wisconsin. She will share insights into team-based care and discharge practices. Whether you work in adult or pediatric settings, have a well-established or developing education pathway, or are seeking to enhance discharge safety, this webinar offers valuable perspectives.
Webinar title: It Takes a Team: Promoting Safe Discharge After Tracheostomy
Date: Tuesday, August 18, 2026
Time: 12:00pm - 1:00pm CT
CEUs offered: AHSA CEUs - 0.1
References
1. Amin R, Agarwal A, Chiang J, Collaco JM, Cristea AI, Propst EJ, et al. Care of infants and children with tracheostomies: an official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2025;211(11):2001–2020. doi:10.1164/rccm.202508-2055ST.
2. Burr KL, Nilson-Italia E, Treut M, McMahon K, Massa K. Review of pediatric tracheostomy training program for home discharge patients. Delaware J Public Health. 2024;10(1):112–114. doi:10.32481/djph.2024.03.15
3. Duggal R, Benyo S, Dewey EN, Nelson RC, Bryson PC, Benninger MS, Hopkins B, Tierney WS. Disparities in posthospitalization disposition following tracheotomy: a national analysis. OTO Open. 2025;9(2):e70129. doi:10.1002/oto2.70129.
4. Ramanathan D, Bruckman D, Appachi S, Hopkins B. Association of discharge location following pediatric tracheostomy with social determinants of health: a national analysis. Otolaryngology–Head and Neck Surgery. 2024;170(2):522–534. doi:10.1002/ohn.516
5. Stewart JM, Snowden V, Charles CE, Farmer EA, Flanagan CE. Barriers to discharge patients with a tracheostomy: a qualitative analysis. J Nurse Pract. 2022;18:547–552.