Sterilizer Monitoring Program

Weekly sterilization monitoring, using microbiologic methods, has been recommended by the Centers for Disease Control (CDC) and the American Dental Association (ADA).

Using a microbiological monitor is the only way to ensure that sterilization has been achieved. Although thermally sensitive tapes and bag markers indicate exposure to sterilization conditions, they do not verify that sterilization has been achieved. Results of studies of the effectiveness of dental office sterilization have been variable, with 2% to 20% failure rates in monitored sterilization attempts. The majority of sterilization failures have been found to be due to human error, rather than equipment failure.

Do you know if the instruments your office uses are sterile?

• All test failures are telephoned immediately.
• Repeat testing is provided at no charge following a test failure.
• Printed reports are mailed on each test performed.
• Cumulative printed reports are provided on request.
• Certificate of participation, suitable for framing and display, is provided.
• Toll free number 1-800-626-4692 (IOWA) is available for questions and consultation.
• Consultation with faculty and staff is available at no charge .
• Postage-paid business reply envelopes are provided for return of specimens.
• Supplies are bar coded to ensure accurate tracking of expiration date of biologic monitor, specimen, and participant identification.

Doctor's name ___________________________________________

Office name______________________________________________

Address_________________________________________________

City, State, Zip Code_______________________________________

Telephone number_________________________________________

How many and what type of sterilizer(s) will you be testing?

_____Chemical vapor
_____Dry heat
_____Moist heat (Steam)

How frequently will you be testing?

_____Weekly ($260/year* per sterilizer)
_____Monthly ($72/year* per sterilizer)*Prepaid yearly or at six-month intervals

I wish to participate in The University of Iowa College of Dentistry Sterilizer Monitoring Testing Program. I understand that sterilization monitoring supplies will be sent to me along with postage-paid return envelopes. These are to be returned promptly after sterilization for processing. I am also aware that the results of such testing will be confidentially mailed to me for the purpose of maintaining an independent record of sterilizer effectiveness as recommended by CDC and ADA guidelines.

______________________________________________________________________________
Signature

Method of Payment (Please circle one of the following):
Check enclosed
VISA
MC
card #__________/___________/__________/__________ exp ____/____

All orders are subject to credit approval.
Checks should be made payable to:
STERILIZER MONITORING SERVICE

Please mail to: