A registered nurse must meet the following requirements before delegating the tracheostomy care and suctioning protocol, as provided in § 20:48:04.01:21:

1. (1) Provide instruction to the nursing assistant on:

   1. (a) Airway anatomy;
   2. (b) The purpose and function of a tracheostomy;
   3. (c) The type of tracheostomy tube used by the client;
   4. (d) Inspecting the stoma site;
   5. (e) Infection control procedures;
   6. (f) Cleaning the stoma site;
   7. (g) Changing the dressing;
   8. (h) Changing or cleaning the inner cannula;
   9. (i) Suctioning the client's tracheostomy;
   10. (j) Signs and symptoms of tracheostomy-related complications;
   11. (k) Emergency care; and
   12. (l) When the registered nurse should be contacted;
2. (2) Verify, through the administration of a test or observation, that the nursing assistant knows the content listed in subdivision (1) of this section;
3. (3) Directly observe the nursing assistant perform the procedures and tasks on the client until the nursing assistant demonstrates competency;
4. (4) Document the training provided to the nursing assistant;
5. (5) If the client's tracheostomy medical orders change, evaluate the client to determine if the nursing assistant requires further instruction and observation; and
6. (6) Evaluate the competency of the nursing assistant annually to determine if further instruction and observation is needed.

Source: 52 SDR 24, effective September 8, 2025 .

General Authority: SDCL 36-9-21 .

Law Implemented: SDCL 36-9-3 (7)(8)(11)(13), 36-9-21 (4)(5).