Speed is a militant force against sterilization," writes John Perkins in Principles and Methods of Sterilization in Health Sciences. Speed reduces the overall factor of safety. It becomes the accomplice of trapped air and dried-on debris. Speed requires a high degree of reliability in functional and mechanical control of all the variables so as to affect a minimum margin of doubt in the end result.

Perhaps nowhere else is speed more of an enemy than in endoscope reprocessing. This is partly because few rigid and even fewer flexible endoscopes can be steam sterilized. Instead, they need to be sterilized or high-level disinfected by various low-temperature chemical processes. Even if you can overnight sterilize by an EtO or plasma system, because instruments may be used four or more times per day, they often must be cleaned and disinfected between patients. Because there is often pressure to speed up the process, facilities may take risky shortcuts.

Contact Dan Mayworm at 'danmayworm@wans.net').