Ooh...oral care pet peeve: Oral care done without suctioning above the ETT/trach cuff afterward!!! All that crap builds up and breeds nasties...or if the cuff leaks they're aspirating!!
We use the Sage Qcare Q4 hours, but you know it never gets done that often by everyone. Check it out:
http://www.sageproducts.com/products/qCare.asp
~Lauren