Background: Tracheostomy administration and implantation are becoming more common in intensive care units. Because of this, it's essential that nurses have the information and training required to provide tracheostomy patients with safe and effective care. It's critical to increase nurses' knowledge of potential challenges tracheostomy patients might have and to give nurses guidance on how to best care for and help these patients. It outlines the kind of care that should be provided to tracheostomy patients who are critically ill, including endotracheal suctioning and humidification techniques. Objective: to determine the outcomes of implementing post tracheostomy tube care bundle in critically ill patients Setting: This study was carried out in the General ICUs namely, Casualty unit (unit I), General ICU (unit II, III) at the Alexandria Main University Hospital, Egypt. Subjects: A convenience sample of 70 newly admitted adult patients will be included in this study. patients who had stoma site infection were excluded from the study. The sample was equally assigned into two equal groups: group I, the control group (35 patients) and group II, the intervention group (35 patients) Tool: Two tools were used. Tool one: “Critically ill patients assessment sheet". Tool two: “patient's outcomes assessment sheet". Results: There was a statistically significant difference was observed between the intervention and control groups regarding physiological parameters as (respiratory rate, Spo2 ,Sao2 , mean arterial pressure ,temperature and heart rate),signs of respiratory tract infection ,signs of respiratory distress and need for suctioning Conclusion: Implementation of tracheostomy tube care bundle interventions significantly decreased development of respiratory tract infection, signs of respiratory distress and maintained physiological parameters of critically ill patients within the normal ranges. Recommendations: Critical care nurses should assess for signs of respiratory distress and respiratory tract infection.