improper trach.care?

[RASKI]

my mother is 69 and has had a trach for almost a year due to surgical complications.she is rehabbing in a nursing facility.she has been wheened down to a 4mm cuffless trach w/inner canula which was installed in april.she has progressed to the point where her trach is capped(except for cleaning)for the past four to five weeks.there has been talk of removing it completely soon.the doctor wanted her a little sronger before it was done.this past friday is when some trouble began.i found out that the nurse removed her cap before she went for outdoor activities which lasted several hours.this did not sound right to me.after she returned i believe the cap was reinstalled,but shortly thereafter the neck band securing the trach must have lossened.she must have coughed and blew the trach out of her neck.she was taken to the hospital where a new trach was inserted.her doctor was unable to be contacted which is why a new one was inserted.she now has a mask with humidified air air is applied directly over the trach.she sometimes coughs blood and sputtum because of the recent procedure.can someone tell me if her care was managed properly.i have doubts-thank you

[National Jewish]

Removal of the tracheostomy (trach) tube cap wasn

[RASKI]

follow up-this morning she coughed out her trach again.i do not understand this.she was then admitted at the hospital for observation w/o trach to see how she does.so far o2 levels 95-97%