What is the correct sequence of actions for tracheostomy care?

The correct sequence for tracheostomy care involves first cleaning the area around the stoma and the tracheostomy tube to prevent infection and promote hygiene. Following the cleaning process, the old ties that secure the tube should be removed; however, it's important to stabilize the tube while this is being done, which is typically ensured by the initial cleaning and secured in a way that prevents accidental dislodgement. Once the area is clean, new ties or a securement device can be applied to ensure the tracheostomy tube remains securely in place.

This method prioritizes cleanliness and stability, which are crucial for the safety and comfort of the patient. The procedure ensures that the tracheostomy is maintained properly and minimizes the risk of complications such as infection or accidental decannulation.

The other options differ in the order of actions, which can compromise the safety and effectiveness of the tracheostomy care process. Starting with removal or securing without proper cleaning could lead to patient discomfort or increased risk of infection.