APPLICATION OF RISK ANALYSIS METHODOLOGY IN EPIDEMIOLOGICAL SURVEILLANCE IN ENDOSCOPY (REPORT 2)

Abstract

Background. Diagnostic and therapeutic endoscopy has become a cornerstone of clinical practice due to its high diagnostic value. However, the growing use of endoscopy has been accompanied by an increasing number of adverse events, healthcare-associated infections holding a special place among them. Objective. To assess compliance with sanitary and epidemiological requirements during endoscope reprocessing in healthcare facilities of the Republic of Belarus and to identify infection control strategies in terms of risk-based audit. Material and Methods. The main methodological framework was based on risk assessment and prioritization approaches developed by the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the European Society of Gastrointestinal Endoscopy (ESGE). Results. Analysis of 11 endoscopic units showed that overall technological discipline was generally maintained; however, some typical organizational and control deficiencies were identified. The highest number of nonconformities was recorded during leak testing: most facilities lacked leak testers and clear documentation procedures for test results. At the stage of final cleaning, violations included inappropriate brush selection and the state of brushes, unsuitable wiping materials, and expired reuse life of disinfectants. During high-level disinfection (HLD), there were noted inadequate exposure time, wrong minimum effective concentration of disinfectants or wrong temperature. At the same time, final operations – rinsing, drying and storage – were performed consistently, maintaining strict adherence to protocols. Conclusion. A comprehensive assessment demonstrated that the main risk factors were insufficient standardization of procedures and inadequate internal quality control, rather than direct violations of technological regulations. The introduction of checklists helped to structure both sanitary-epidemiological audit and monitoring procedures, to improve the accuracy of assessment, to ensure uniformity of requirements and to implement targeted corrective actions. The application of a risk-based approach in auditing endoscope reprocessing enhances the epidemiological safety of endoscopic procedures and supports the development of a sustainable internal infection risk surveillance system.