"Please sterilize twice". This instruction must have been received by most of all my colleagues from doctors atleast once in your life. Although we try to convince them, there are only two sides, "sterile" or "unsterile", very few of them are not ready to accept the 'risk'. Being managers of the service we provide, we are expected to be confident that the material going out of CSSD is sterile and should challenge a random culture test if it was felt necessary. Any opinion from my expert colleagues on this issue?

Hi

Here you can see the advantage of a Quality System. It does not have to be called "ISO 9000".
Establish "Working Procedures" based on appropriate litrature, Standards, Manufacturers Instructions, etc. Define clearly authorisation and responsibilities. Follow them consistantly!
Now, If anyone, in a higher position instruct or demands to over-rule the procedure, ask him to sign by his signature (not verbaly) the order.
You will be surprised.

miki

An addition to mik's answer - which I fully support.
I am sure the doctor demanding double sterilization wants the best for his patients. But he most likely hasn't got a clue of modern Sterilization-Processes. Double sterilization is a waste of time, material and money - and does in no way increase the safety of the sterile goods. In the opposite, negative effects can occur like e.g. superheated linen drapes and possible steam deposites on the instrument (linen has to be laundered and instrument cleaned before resterilization). I also would point out that double sterilization of paper wrappers can compromise the sterile barrier of the wrapper i.e. the devices have to be unloaded and repacked before starting a new sterilization cycle.

Josy Holdener