INTRODUCTION
China
revealed a case of pneumonia where the exact cause of the issue was unknown on
December 31, 2019. Then, on February 11, 2020, the World Health Organization
(WHO) gave the name of this virus as Coronavirus Disease 2019 (COVID-19) (Burhan, 2020).
The COVID-19
pandemic has had a very significant impact on the existing health order in the
world, including Indonesia. No one is unaffected by this pandemic where almost
all components feel the impact, including health workers feeling fatigued,
fear, anxious, even being required to work under pressure. This change in
workflow is due to the pandemic. Hospitals need psychological support and
supplies amid a financial crisis, especially medical equipment, Personal
Protective Equipment (PPE) (Chaudhari & Dhingra, 2020).
Since, this has a negative impact, especially in the decision-making process (accuracy,
vigilance, exchange of information), which can be dangerous for patient safety (Zipperer, 2020).
Globally,
the number of confirmed cases is 186,318,584, and the number of deaths is
4,028,258. In Indonesia, the number of positive confirmed cases that the
ministry of health has released is 2,527,203 people, of which 376,015 active
cases (14.9%), 2,084,724 cases recovered (82.5%), and with a death toll of
66,464 people (2.6%) as of the 12th July 2021. This shows that Indonesia has a
death rate from COVID-19 of 2.6%. The death rate or the so-called Case fatality
rate (CFR) is percentage of deaths number calculated based on overall COVID-19
positive cases that have been reported (Ministry of Health of the Republic of
Indonesia, 2021)
Until May 2021,
72 (17.14%) health workers from 420 health workers at Tengku
Rafi'an Regional Public Hospital were exposed to
Covid-19, as it is known that the World Health Organization (WHO) has set a
limit on the percentage of the positivity rate of 5%. The positivity rate is
comparing the (positive) cases that occur with the number of tests performed.
Furthermore, during the pandemic, infection preventionists
observed that uncertainty and inconsistent directions were important issues (Alsuhaibani et al., 2022).
From the
available data, there are 306 health workers at Tengku
Rafi'an Regional Public Hospital who have attended
the IPC training or 76.25% who have not participated in the training, or
approximately 114 health workers. During the COVID-19 pandemic, the IPC had
only held training seven times, and it was not structured or well-scheduled.
Thus, it will affect the risk of existing health workers. Meanwhile, the level
of compliance Covid-19 Protocol implementation, based on a report from the IPC,
65% have implemented the Covid-19 Protocol compliance. In comparison, 20% still
have health workers who still like to huddle both during work, and during
breaks, 15% are still in-service uses PPE that does not appropriate, this is
due to the non-optimal fulfillment of occupational health equipment and
facilities, including the K3RS program.
Therefore,
risk management is needed to minimize the occurrence of occupational risks for
health workers at Tengku Rafi'an
Regional Public Hospital. The research contribution is shown to develop the
results of K3RS knowledge.
Research Model
������� The following is a
description of the constellation to describe this current research:
Figure 1. Research Constellation
(WHO,
2020b, Minnesota Department of Health,
2014, Braeseke, 2011, World
Health Organization and International Labour Organization, 2021)
Research Hypothesis
Development
Based on the identification
and formulation of the problem, the researcher developed four research
hypotheses, as follows:
H1: There is a positive influence between the
implementation of the Covid-19 health protocol, IPC training implementation,
and the application of occupational health and safety standards to the occupational
risks of health workers simultaneously at Tengku Rafi'an Hospital, Siak Regency
H2: There is a positive influence between the
Covid-19 health protocol implementation on the work risk of health workers at Tengku Rafi'an Hospital, Siak Regency.
H3: There is a positive influence between IPC
training implementation on the work risk of health workers in the Covid-19
pandemic era at Tengku Rafi'an
Hospital, Siak Regency.
H4: There is a positive influence between the
application of occupational health and safety standards on the occupational
risk of health workers at Tengku Rafi'an
Hospital, Siak Regency.
On the other hand, indirect
relationships are the result of the effects of exogenous variables on
endogenous variables mediated by intervening variables. Adding direct and
indirect relationships (Ghozali, 2016).
The data analysis in this
research uses a Structural Equation Modeling (SEM) path analysis model with the
help of the AMOS program. Judging from the research constellation, obtained 2
(two) linear substructures.
The first substructure
analysis is analyzing the implementation of the Covid-19 health protocol (PC)
the implementation of infection prevention and control (IPC) as an exogenous
variable to the application of occupational health and safety (OHS) standards,
both simultaneously and partially.
The second substructure
analysis is analyzing the implementation of the Covid-19 Health Protocol (PC),
the implementation of the IPC, the application of Occupational Health and
Safety (OHS) standards as an exogenous variable to the Occupational Risk of
Health Workers (RK) partially or simultaneously.
Sobel test was conducted to
determine whether the variable of the application of Occupational Safety and
Health Standards had an effect as a mediation (intervening) or not. It is said
to be an intervening variable if the variable influences the relationship
between the independent variable and the dependent variable (Ghozali, 2016).
METHOD
The research method in this study is observational
research, using a quantitative and descriptive causative study design. The population and sample are hospital health workers in the Covid-19 pandemic era as many as 200 respondents. In this study, the questionnaire became a technique in data collection. The
research questionnaire collects primary data obtained from selected
respondents, becoming the research sample.
The preparation of the questionnaire is done by
submitting a closing statement and several
answer choices using a Likert scale which aims
to measure how strongly the
level of agreeing or disagreeing with a statement is (McDaniel & Gates, 2013).
Path analysis is used in data analysis techniques, which use multiple
and bivariate regression analysis in its development. This analysis aims
to test the
regression equation in which several exogenous
and endogenous variables are involved simultaneously, and it is possible
to test the
intervening variables. In addition, this analysis can measure
the relationship directly or indirectly
between variables in the research model. The beta coefficient can be seen to
determine the direct relationship between exogenous variables and endogenous
variables.
Test Instrument
Data
Pearson Product Moment Correlation is used to
test the validity, and the
results are valid if the value of
r count > r table. Data from 30 respondents was taken for
validity testing. The test results show that
all variables r count ≥ r table (two-sided test with sig. 0.05), it can be
concluded that all instruments or statement items
are declared valid to the total score if the correlation
is significant. Questionnaire items that are not valid are not included
in further analysis.
The Cronbach Alpha (α) test was used
to test the
reliability with a value of (α) > 0.6, the results showed
that all of the variables
in this study were reliable.
All variables tested for reliability were found to meet
the requirements.
�
RESULTS
AND DISCUSSION
Deskriptive Analysis Results
The research was
conducted by distributing 200 copies of the questionnaire that make the data
obtained were 200 respondents. From the distribution of research instruments
that are distributed, it produces several characteristics of data samples based
on occupations and work locations as presented in the following:
Table 1
Respondents Demographic Characteristics
Respondents (n=200)
|
No
|
Occupation
|
Frequency
|
Percentage
|
|
1
|
Doctor
|
37
|
18,5%
|
|
Nurse
|
112
|
56,0%
|
|
Midwives
|
43
|
21,5%
|
|
Laboratory Officer
|
3
|
1,5%
|
|
Radiology Officer
|
5
|
2,5%
|
|
2
|
Age
|
|
|
|
20-30 Years Old
|
53
|
26,5%
|
|
31-40 Years Old
|
69
|
34,5%
|
|
> 40 Years Old
|
78
|
39,0%
|
|
3
|
Work Locations
|
|
|
|
Emergency Room (ER)
|
23
|
11,5%
|
|
Outpatient
|
35
|
17,5%
|
|
Non-Covid
Hospitalization and Non-Covid ICU
|
109
|
54,5%
|
|
Covid-19 Hospitalization
and Covid-19 ICU
|
25
|
12,5%
|
|
Laboratory
|
3
|
1,5%
|
|
Radiology
|
5
|
2,5%
|
|
4
|
Length of Work
|
|
|
|
0-5
Years
|
50
|
25,0%
|
|
6-10
Years
|
68
|
34,0%
|
|
>10
Years
|
82
|
41,0%
|
Processed Primary Data, 2021
From the
study results in table 1, the research subjects used were based on the
occupation, which showed the highest was dominated by nurses, include 112
(56.0%) while the lowest was laboratory workers, include 3 (1.5%). Then the
highest age range was 78 (39.0%) and the age range between 20-30 years was 53
(26.5%) the lowest.
The data
obtained at the work location, include Non-Covid
Inpatient and Non-Covid ICU as much as 109 (58.9%) is
the highest in this study and the work location in the Laboratory section is 1
(0.5%) the lowest.
The data
obtained also shows that work experience >10 years dominates the subjects in
this study, include 82 (41.0%) and subjects who have low work experience are
subjects who have a score range of 0-5 years of 50 (25.0%).
The goodness of fit test
After testing the influence between exogenous
and endogenous variables to produce a good model, the next step is to analyze
the suitability of the data thoroughly. This test determines whether the
obtained model is a fit model or not if the test results in an invalid
modification or specification of the model is needed.
Table 2
Results of Goodness of Fit
|
No
|
Goodness of Fit
|
Cut off value
|
Results
|
Model
evaluation
|
|
1.
|
Probabilitas Chi Square
|
≥ 0,05
|
0,186
|
Good Fit
|
|
2.
|
CMIN/DF
|
≤ 2,00
|
1.74
|
Good Fit
|
|
3.
|
GFI
|
≥ 0,90
|
0.99
|
Good Fit
|
|
4.
|
AGFI
|
≥ 0,90
|
0.95
|
Good Fit
|
|
5.
|
CFI
|
≥ 0,90
|
0.99
|
Good Fit
|
|
6.
|
TLI
|
≥ 0,90
|
0.95
|
Good Fit
|
|
7.
|
NFI
|
≥ 0,90
|
0.98
|
Good Fit
|
|
8.
|
IFI
|
≥ 0,90
|
0.99
|
Good Fit
|
|
9.
|
RMSEA
|
≤ 0,08
|
0.06
|
Good Fit
|
Processed primary data,
2021
According to (Ghozali, 2016)
overall Goodness of fit can be assessed based on at least five criteria.
Based on the table
above, in this study, it can be seen there are at least 5 GOF indicators that
show a good fit, thus it can be concluded that the overall model is fit and
appropriate. In other words, these three variables make up the Covid-19
Protocol (PC) variable, IPC Training (IPC), Implementation of OHS standards as
intervening (OHS) and the work risk of health workers (RK).
Path Analysis Results
This analysis aims to
analyze the implementation of the Covid-19 health protocol (PC), the
implementation of infection prevention and control (IPC), the application of
occupational health and safety standards (OHS) as an intervening variable for
the occupational risk of health workers (RK) partially or simultaneously.
Following are the results of calculations using SEM AMOS V.23, visualized in
the following path diagram:
Figure 1. Path
Diagram Calculation Results
Correlation Analysis
The correlation
between the Implementation of the Covid-19 Health Protocol (PC) and the
Implementation of Infection Prevention and Control (IPC) can be seen in the
following table and figure:
Table 3
Covid-19 Health (PC) and Implementation of
Infection Prevention and Control (IPC)
|
Correlation Between
Variables
|
Estimate
|
P-Value
|
|
Covid19 Protocol
<--> IPC training
|
0.454
|
0.000
|
Processed primary data,
2021
Figure 3. Calculation
Results of Correlation Diagram
Based on these
results, the correlation between the Implementation of the Covid-19 Health
Protocol (PC) and the Implementation of Infection Prevention and Control (IPC)
is 0.454 (p = 0.000 0.050), thus it can be concluded that the correlation is
quite strong.
Path Analysis of the Implementation of the
Covid-19 Health Protocol (PC), Implementation of Infection Prevention and
Control (IPC) as an exogenous variable to the Implementation of Occupational
Health and Safety (OHS) Standards
Figure 4. Substructure
Diagram 1
Table 4
Implementation of the Covid-19 Health Protocol
(PC), Implementation of Infection Prevention and Control (IPC) on the
Implementation of Occupational Health and Safety (OHS) Standards
|
Variables Effect
|
Estimate
|
P-Value
|
R Square
|
|
OHS <-- IPC Training
|
-0.315
|
0.000
|
0.290
|
|
OHS <-- Covid 19
Protocol
|
0.389
|
0.000
|
Processed primary
data, 2021
The result of the
Coefficient of Determination obtained is 0.290 or 29.0%, which means the effect
of the Covid-19 Health Protocol (PC), the Implementation of Infection
Prevention and Control (IPC) on the Implementation of Occupational Health and
Safety (OHS) Standards simultaneously is 29.0%, as for the rest is influenced
by other factors that are equal to 71.0% (100%-29.0%).
Path Analysis for Implementation of
Covid-19 Health Protocol (PC), Implementation of Infection Prevention and Control
(IPC), Implementation of Occupational Health and Safety Standards (OHS) on
Health Workers Risk (RK)
Figure 5. Substructure Diagram 2
Table 5
Implementation of
Covid-19 Health Protocol (PC), Implementation of Infection Prevention and
Control (IPC), Implementation of Occupational Health and Safety Standards (OHS)
on Occupational Risks of Health Workers (RK)
|
Variables Effect
|
Estimate
|
P-Value
|
R Square
|
|
Work Risk <-- IPC Training
|
0.256
|
0.000
|
0.315
|
|
Work Risk <-- Covid 19 Protocol
|
0.507
|
0.000
|
|
Work Risk <-- OHS
|
0.179
|
0.000
|
Processed primary
data, 2021
From
table 5, the R-square (r2) number is 0.315, the magnitude of this number is the
magnitude of the influence of the Covid-19 Health Protocol (PC), Implementation
of Infection Prevention and Control (IPC), Implementation of Occupational Health and Safety
(OHS) �Standards on Workforce Risk Health (RK)
simultaneously is 31.5% (0.315 x 100%). In contrast, other factors influence
the rest, include 68.5% (100%-31.5%).
Table 6 summarizes the tests carried out
between exogenous and endogenous variables
Table 6
The effect of exogenous
variables with endogenous variables test
|
Variables Effect
|
Estimate
|
P-Value
|
Conclusion
|
|
OHS <-- IPC Training
|
-0.315
|
0.000
|
Significant
|
|
OHS <-- Covid19 Protocol
|
0.389
|
0.000
|
Significant
|
|
Work Risk <-- IPC Training
|
0.256
|
0.000
|
Significant
|
|
Work Risk <-- Covid
19 Protocol
|
0.507
|
0.000
|
Significant
|
|
Work Risk <-- OHS
|
0.179
|
0.000
|
Significant
|
Processed primary
data, 2021
Direct and Indirect Effect
Table 7
Direct and Indirect
Effects
|
Standardized Total Effects
|
|
IPC Training
|
Covid19 Protocol
|
OHS
|
Work Risk
|
|
OHS
|
-.223
|
.244
|
.000
|
.000
|
|
Work Risk
|
.186
|
.478
|
.236
|
.000
|
|
Standardized Direct Effects
|
|
IPC Training
|
Covid19 Protocol
|
OHS
|
Work Risk
|
|
OHS
|
-.223
|
.244
|
.000
|
.000
|
|
Work Risk
|
.239
|
.420
|
.236
|
.000
|
|
Standardized Indirect Effects
|
|
IPC Training
|
Covid19 Protocol
|
OHS
|
Work Risk
|
|
OHS
|
.000
|
.000
|
.000
|
.000
|
|
Work Risk
|
-.053
|
.058
|
.000
|
.000
|
Processed primary data, 2021
Based on table 7, the
data obtained is used to determine the relationship between the effect of the
IPC Training and the Covid Protocol mediated by OHS on Occupational Risk. It can be said that
the indirect relationship between the IPC variable and the Covid-19 Protocol on
Occupational Risk is significant. Therefore OHS can mediate the influence of the
relationship.
Sobel Test
The Effect of Covid-19
Health Protocol Implementation on the Risk of Health Workers through the
Implementation of Occupational Safety and Health Standards
|
![]() 
|
|
=
|
![]() ��� (0.1790)2 (0.1070)2
+ (0.3890)2 (0.0460)2 + (0.1070)2 (0.0460)2
|
|
=
|
��� 0.0007112587
|
|
=
|
0.0266694344
|
Thus,
the value of t, obtained from the tests carried out as follows:
|
t=
|
ab
|
=
|
0.069631
|
=
|
2.610891520
|
|
sab
|
0.0266694344
|
Based on the calculation of the t-test above, the t
count = 2.610891520 is greater than the t table with a significance level of
0.05, which is 1.97. it is concluded that the value of 2.610891520 can mediate,
or the coefficient is significant.
The Influence of the
Infection Prevention and Control (IPC) Implementation on the Risks of Health
Workers through the Implementation of Occupational Safety and Health Standards
|
![]() 
|
|
|
� =
|
![]() � (0.1790)2 (0.0950)2 +
(-0.3150)2 (0.0460)2 + (0.0950)2 (0.0460)2
|
|
=
|
�� 0.0005182270
|
|
=
|
0.0227646003
|
|
|
|
|
Thus,
the value of t, obtained from the tests carried out as follows:
|
t=
|
ab
|
=
|
-0.056385
|
=
|
-2.476871957
|
|
sab
|
0.0227646003
|
Based on the t-test calculation above, the t-count =
-2.476871957 is greater than the t-table with a significance level of 0.05,
-1.97. it is concluded that the value of -2.476871957 can mediate or the
coefficient is significant
DISCUSSION
The effect of the Covid-19
health protocol implementation, IPC training implementation, and the
application of occupational safety and health standards on the work risk of
health workers in the Covid-19 pandemic era simultaneously
To minimize the risk of health workers to COVID-19,
the risk management process must be an integral part of the management of Tengku Rafi'an Regional Public
Hospital in decision making and integrated into the structure. The OHS policy
must be established starting from the director level to below the ranks or all
health workers, which includes prevention of occupational risks (Risk
Identification, Risk Assessment), providing information and training, as well
as providing the necessary organization and facilities. It aims both to carry
out prevention and protection, especially primary prevention, and assist in the
decision-making process based on risk analysis at Tengku
Rafi'an Regional Public Hospital.
This is in line with the average index results
obtained where the Covid-19 Health Protocol implementation, IPC Training
implementation, and Implementation of Occupational Safety and Health Standards
are at high intensity, and the work risk of health workers is at low power, which
means that the three exogenous variables have a significant effect. To reduce
the risk of health workers work.
The results of this study confirm the research
conducted (Hertzberg, Wang, Elon, & Lowery-North, 2018)
with the results that the risk of cross-infection between health workers is
greater than between patients or between patients and health workers. Service
providers had the least risk, followed by nurses, and non-patient care staff
had the greater risk. Moreover (Pedrosa et al., 2020)
with the results of a risk assessment of members in the radiology department
using the CDC risk factors for Covid-19 infection.
The effect of
implementing Covid-19 health protocol on the work risk of health workers
Applying aspects of
administrative control, Environmental Control and Compliance Engineering,
Behavior, binding regulations in implementing the covid-19 health protocol will
minimize the risk of health workers working at Tengku
Rafi'an Regional Public Hospital against Covid-19,
this is in line with the average results the index of the application of the
covid-19 protocol which shows high intensity. In contrast, the average risk
index of health workers shows low intensity. This means that the higher the
implementation of the Covid-19 protocol, the lower the risk level of health
workers against Covid-19.
The results of this study
confirm the research conducted (Tarfaoui, Nachtane, & Goda, 2020), namely the use of additive manufacturing (face masks and
ventilator ambu bags), known as 3D printing, can be
used to overcome the limitations of PPE for health workers and has an essential
function to support conventional production supply. Then, (Calderwood et al., 2020)
with the results that the use of PPE (N95 respirators, powered
air-purifying respirators (PAPRs), or half-mask respirators, face shields) is
recommended for health workers who take nasopharyngeal swab specimens, perform
intubation, extubate, or bronchoscopy, ENT procedures, surgery, and chest tube
placement in patients with suspected or confirmed Covid-19.
The effect of
implementing IPC training on the work risk of health workers
This IPC training is
important to be carried out comprehensively and intensively since IPC
practitioners helped with emergency preparedness and response (e.g.,
fever-triage tactics, screening procedures, and quarantine practices for sick
or suspected patients) to stop the virus from spreading, particularly from
patients to health workers (Wang, Liu, Zhou, & Lee, 2020).
Especially at Tengku Rafi'an
Regional Public Hospital to minimize the risk of health workers during the
COVID-19 pandemic, such as implementing 5 Moments of Hand Hygiene, Cough
Ethics, procedures for using PPE correctly and others, as well as implementing
standard precautions. As part of the infection prevention and control process
that must continue to be carried out by both patients and related staff
throughout the Tengku Rafi'an
Hospital area. The infection prevention and control program at Tengku Rafi'an Hospital and
building a monitoring and evaluation system in its implementation need to be
supported in its implementation both by health workers in providing services,
even individuals (including patients and visitors). In line with the average
index according to the three-box method of implementing the PPI training, it is
at a high score level, which means the influence of this PPI training reduces
the risk of health workers during the COVID-19 pandemic.
The results of this study
confirm the research conducted (Piche-Renaud et al., 2020)
that is, only 86 respondents (50%) know the steps for using PPE
correctly; 60 (35%) respondents know the correct steps for removing PPE; and
most (n = 113, 70%) understood the need to wash hands immediately before
removing masks and eye protection.
The effect of
implementing occupational safety and health standards on labor
risk
As recommended, implementing occupational safety and health standards
will create a healthy work environment without endangering health workers and
patients, and the surrounding community. This is also in line with the average
results of the index. The effect of applying occupational health and safety
(OHS) standards is at a high intensity and affects the risk of health workers
at a low intensity.
The OHS policy must be established starting from the director's level to
below its ranks or all health workers, including prevention of occupational
risks, provision of information and training, and provision of the necessary
organization and facilities. This has a good aim to be able to carry out
prevention and protection, especially primary prevention at Tengku
Rafi'an Regional Public Hospital.
The results of this study confirm the research conducted (Kim et al., 2021), namely, to prevent
nosocomial transmission, all patients with suspected symptoms, relevant
radiological features, or leading epidemiology are isolated. Then, (Pedrosa et al., 2020)
with the results of a risk assessment of members in the radiology department
using the CDC risk factors for COVID-19 infection.
conclusion
The implementation of the Covid-19 Health Protocol, IPC Training, and the
Implementation of Occupational Safety and Health Standards together have a
significant effect on the Occupational Risks of Health Workers simultaneously
and partially at Tengku Rafi'an
Regional Public Hospital Siak Regency.
Implication
Theoretical Implications
Occupational risks of health workers are
occupational hazards that place them at risk of illness, injury, and even death
in the context of the COVID-19 response. These occupational risks include
occupational infection with COVID-19, skin disorders and heat stress due to
prolonged use of PPE, exposure to toxins due to increased disinfectants,
psychological stress, chronic fatigue, stigma, discrimination, physical and
mental violence, and abuse. Then, the risk assessment should lead to preventive
and mitigating actions to avoid exposure based on the level of risk,
considering the local epidemiological situation, the specifics of work
arrangements and assignments, control hierarchy, and compliance with IPC
measures. The workplace risk levels mentioned above can also help identify
priority groups when the deployment of a COVID-19 vaccine is planned (WHO, 2021).
Implementing the COVID-19 health protocol is an
essential part of the strategy to prevent the risk of health workers being
exposed to the Covid-19 virus. Changes in behavior in IMR in the hospital
environment can be implemented with several guidelines such as maintaining
distance, using masks, maintaining hand hygiene, using PPE at work, and others (WHO, 2020).
Infection Prevention and Control (IPC) is a
series of ways to prevent disease transmission in all areas in the health
facilities (Minnesota, 2014).
Health protection in the workplace aims to
promote and maintain the highest physical, mental, and social safety for the
entire profession. Avoid workers' health problems as a result of the work
situation. Protect workers in the workplace from the harm posed by factors
harmful to their health. The placement and training of workers in the work area
need to be adjusted to their physiological and psychological abilities. In
short, "Adaptation of work to people, and adaptation of everyone to their
work" (Braeseke, 2011).
Managerial Implications
To minimize the risk of health workers to
covid-19 The risk management process must be an integral part of the management
of Tengku Rafi'an Hospital
in decision making and integrated into the structure. The OHS policy must be
established starting from the director level to below the ranks or all health
workers, including prevention of occupational risks (Risk Identification, Risk
Assessment), providing information and training, and providing the necessary
organization and facilities. In addition, planning and budgets need to be
prepared by both hospital management and the government to implement the risk
management system built by the hospital properly.
The management of Tengku
Rafi'an Regional Public Hospital applies aspects of
administrative control, Environmental Control, and Compliance Techniques,
Behavior, Binding regulations in implementing the Covid-19 health protocol so
that it will minimize the work risk of health workers at Tengku
Rafi'an Hospital against Covid-19
Create a program/strategy for infection
prevention and control and build a Monev (Monitoring
and Evaluation) system in its implementation
OHS policy must be established starting from the
director level to below the ranks or all health workers, which includes
prevention of occupational risks (Risk Identification, Risk Assessment),
providing information and training, and providing the necessary organization
and facilities. It aims both to carry out prevention and protection, especially
primary prevention, and assist in the decision-making process based on risk
analysis at Tengku Rafi'an
Regional Public Hospital.
Research
Limitations
There
are several limitations of the research conducted, namely that the research
respondents consisted of various health professional professions, with varying
shift hours, making it somewhat difficult for researchers to meet to clarify
the contents of the questionnaire. The results obtained only apply to the
population of health workers, do not generalize like other hospital employees
Suggestion
Based on the results and discussion of
hypothesis testing and research findings, suggestions for recommendations:
The risk management process must be an integral
part of the Tengku Rafi'an
Regional Public Hospital management in decision making and integrated into the
structure. The OHS policy must be established starting from the director level
to below the ranks or all health workers, including prevention of occupational
risks (Risk Identification, Risk Assessment), providing information and
training, and providing the necessary organization and facilities. It aims both
to carry out prevention and protection, especially primary prevention, and
assist in the decision-making process based on risk analysis at Tengku Rafi'an Regional Public
Hospital.
Implementing aspects of administrative control,
Environmental Control and Compliance Engineering, Behavior, binding regulations
in implementing the COVID-19 health protocol will minimize the work risk of
health workers at Tengku Rafi'an
Regional Public Hospital against Covid-19.
The management of Tengku
Rafi'an Regional Public Hospital through the IPC
Committee needs to provide comprehensive and intensive training for all health
workers such as applying 5 Moments of Hand Hygiene, Cough Ethics, procedures
for using PPE correctly and others, as well as applying standard precautions as
part of the prevention and treatment process. Infection control must continue
to be carried out by both patients and related officers in all areas of Tengku Rafi'an Regional Public
Hospital.
REFERENCES
Alsuhaibani,
Mohammed, Kobayashi, Takaaki, McPherson, Chad, Holley, Stephanie, Marra,
Alexandre R., Trannel, Alexandra, Dains, Angelique, Abosi, Oluchi J., Jenn,
Kyle E., & Meacham, Holly. (2022). Impact of COVID-19 on an infection
prevention and control program, Iowa 2020-2021. American Journal of
Infection Control. Scopus
Braeseke, G. (2011). Occupational Health and Safety Risks In The
Healthcare Sector. Luxembourg: European Union. Google Scholar
Burhan, Erlina. (2020). Pedoman
tatalaksana COVID-19.
Jakarta: Perhimpunan Dokter
Paru Indonesia.
Calderwood, MS, Deloney, VM, Anderson, DJ, Cheng, VCC, Gohil, S., & JH
Kwon. (2020). Policies and practices of SHEA reasach network hospitals during
the COVID-19 pandemic. Infection Control & Hospital Epidemiology,
1�9. Google Scholar
Chaudhari, Prabhat Kumar, & Dhingra, Kunaal. (2020). Full digital
workflow of nasoalveolar molding treatment in infants with cleft lip and
palate: comment. Journal of Craniofacial Surgery, 31(7),
2067�2068. Google Scholar
Ghozali, Imam. (2016). Desain Penelitian Kuantitatif & Kualitatif
untuk Akuntansi. Bisnis Dan Ilmu. Semarang: Yoga Pratama. Google Scholar
Hertzberg, Vicki Stover, Wang, Yuke A., Elon, Lisa K., & Lowery-North,
Douglas W. (2018). The risk of cross infection in the emergency department: a
simulation study. Infection Control & Hospital Epidemiology, 39(6),
688�693. Google Scholar
Kim, Yun Jeong, Choe, Jae Young, Kwon, Ki Tae, Hwang, Soyoon, Choi, Gyu
Seog, Sohn, Jin Ho, Kim, Jong Kun, Yeo, In Hwan, Cho, Yeon Joo, & Ham, Ji
Yeon. (2021). How to keep patients and staff safe from accidental SARS-CoV-2
exposure in the emergency room: Lessons from South Korea�s explosive COVID-19
outbreak. Infection Control & Hospital Epidemiology, 42(1),
18�24. Google Scholar
McDaniel, C., & Gates, R. (2013). Riset Pemasaran Kontemporer
(Sumiyarto dan Rambat Lupiyoadi, Penerjamah). Jakarta: Salemba Empat. Google Scholar
Minnesota, ClearWay. (2014). Minnesota Department of Health. Minnesota
Adult Tobacco Survey.
Pedrosa, Ivan, Browning, Travis, Kwon, Jeannie K., Morriss, Michael,
Matsler, Lacy, Pinho, Marco C., Lamus, Daniel, Pillai, Anil, Karow, Sweta
Patel, & Garinn, Jon. (2020). Response to COVID-19: Minimizing Risks,
Addressing Challenges and Maintaining Operations in a Complex Academic
Radiology Department. Journal of Computer Assisted Tomography, 44(4),
479. Google Scholar
Piche-Renaud, PP, Groves, HE, Kitano, T., Arnold, C., Thomas, A., &
Streitenberger, L. (2020). Healthcare worker perception of a global outbreak of
novel coronavirus (COVID-19) and personal protective equipment: survey of a
pediatric tertiary-care hospital. Infection Control & Hospital
Epidemiology, 1�7. Google Scholar
Tarfaoui, M., Nachtane, M., & Goda, I. (2020). Additive manufacturing
in fighting against novel coronavirus COVID-19. The International Journal of
Advanced Manufacturing Technology, 1�15. Google Scholar
Wang, Jiancong, Liu, Fangfei, Zhou, Mouqing, & Lee, Yew Fong. (2020).
Will the status of infection prevention and control (IPC) professionals be
improved in the context of COVID-19? American Journal of Infection Control,
48(6), 729�730. Scopus
World Health Organization. (2020). Novel Coronavirus
(2019-nCoV): situation report, 11. Geneva. Google Scholar
World Health Organization. (2021). COVID-19: occupational health and
safety for health workers: interim guidance, 2 February 2021. World Health
Organization. Google Scholar
World Health Organization and International Labour Organization. (2021).
COVID-19 : Occupational health and safety for health workers. COVID-19:
Occupational Health and Safety for Health Workers, (February), 1�16. Google Scholar
Zipperer, L. (2020). COVID-19: Team and Human Factors to Improve Safety.
Compliance with The Implementation of Covid-19 Health
Protocol Infection Prevention and Control (IPC) Training and Occupational
Safety and Health (OSH) as Mediation on Occupational Risks of Health Workers at
Tengku Rafi'an Hospital