Durable Medical Equipment (DME)
Tuesday, February 17, 2026

Subject/Title: Ordering tracheostomy supplies for patients seen in the otolaryngology clinic with established tracheostomy (trach).

Purpose: To facilitate timely ordering and acquisition of durable medical equipment (DME) for patients with a tracheostomy.

Target Population: Established patients who have been seen in the otolaryngology clinic and need trach supplies.

Definitions: None

Criteria: Patients who have a documented tracheostomy and have been seen in the otolaryngology clinic requesting trach supplies.

Clinical Assessment/Screening:

A. Allergies: None

B. Contraindications: Patient has not had a documented face to face or telemedicine visit within 6 months.

Details of the Order: The RN/MA will place an order in the electronic health record (EHR) using the order mode "per protocol" for the following:

A. Name of treatment, test or medication: Homegoing DME supply-Tracheostomy. (8342)

B. All relevant details necessary to complete order: Order a six-month supply of the following:

  1. Type
  2. Quantity
  3. Brand
  4. Style
  5. Size
  6. Comments: include daily trach needs such as trach ties/straps
  7. Additional orders include inner cannula, plug/stop, speaking valve, suction pump, and supplies.

C. Monitoring parameters if indicated: None.

D. Precautions, observations, considerations, and circumstances for contacting provider: Reach out to provider with any questions or need for clarification regarding trach supply orders.

Documentation Requirements:

A. Staff utilizing protocol must document an order to initiate the protocol in EHR per the Protocol Orders clinical protocol.

B. Location of documentation in the medical record: Within the DME order. If a special order or special mailing product, the patient is called, and a Telephone Encounter is entered.

REFERENCES: 

Elsevier on Trach care: Swanson, L. (2025). Chapter 24: Airway management. In A.G. Perry and others (Eds.), Clinical nursing skills & techniques (11th ed., pp. 753-788). St. Louis: Elsevier.

APPROVED BY:

Medical Director

RN Clinic Manager