Mitigasi Risiko Tenaga Kesehatan Terhadap Infeksi SARS-CoV-2 di Rumah Sakit Umum Harapan Bersama Singkawang

RIZKI RAHIM, Dr. dr. Andreasta Meliala, DPH., M.Kes., M.AS

2021 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar belakang: Tenaga kesehatan merupakan kelompok risiko tinggi terinfeksi SARS-CoV-2. Berbagai faktor risiko menyebabkan Covid-19 pada tenaga kesehatan. Mitigasi risiko menggunakan hierarki pengendalian transmisi infeksi perlu diupayakan guna mencegah Covid-19 pada tenaga kesehatan di RS. Tujuan: Menerapkan mitigasi risiko infeksi SARS-CoV-2 pada tenaga kesehatan di RSU Harapan Bersama dengan pendekatan hierarki pengendalian transmisi infeksi. Metode: Rancangan Action Research dilakukan melalui empat tahap yaitu diagnosing action, planning action, taking action dan evaluating action. Identifikasi faktor risiko Covid-19 dilakukan terhadap tenaga kesehatan kontak pasien Covid-19 dari Oktober 2020 hingga Februari 2021. Evaluasi mitigasi risiko yang telah diterapkan sebelumnya menggunakan ceklis kesiapan RS di masa pandemi. FGD dilakukan dalam mengimplementasikan mitigasi risiko berdasarkan hierarki pengendalian transmisi infeksi. Analisis statistik menggunakan uji chi kuadrat dan regresi logistik. Hasil: Sebanyak 81 tenaga kesehatan terdiri dari 26 subjek dengan RT-PCR Covid-19 positif dan 55 subjek negatif diikutkan dalam penelitian. Faktor risiko Covid-19 pada tenaga kesehatan diantaranya kontak erat (OR 3,13; 95% CI 1,16-8,43, p=0,021), APD inadekuat (OR 4,26; 95% CI 1,57-11,60, p=0,003) dan ventilasi inadekuat (OR 4,74; 95% CI 1,26-17,73, p=0,014). Berdasarkan penilaian kesiapan RS di masa pandemi, hanya 3 dari 12 komponen yang mencapai 80%. Mitigasi risiko dengan vaksinasi, zonasi RS, pengaturan ventilasi, jaga jarak, skrining dan triase, sosialiasi PPI, pengaturan jam kerja dan penggunaan APD telah diimplementasikan. Kesimpulan: Kontak erat, APD inadekuat dan ventilasi inadekuat meningkatkan risiko Covid-19 pada tenaga kesehatan. Evaluasi kesiapan RS di masa pandemi belum optimal. Mitigasi risiko dengan pendekatan hierarki pengendalian transmisi infeksi telah diimplementasikan di RSU Harapan Bersama.

Background: Healthcare workers fall into high risk categories for contracting SARS-CoV-2 infection. Several risk factors for Covid-19 in healthcare workers have been identified. Risk mitigation strategy using hierarchy of control against infection transmission is required to prevent Covid-19 among healthcare workers at the hospital. Objective: To implement risk mitigation strategies against SARS-CoV-2 infection among healthcare workers at Harapan Bersama General Hospital (RSU) using hierarchy of control against infection transmission. Method: Action Research design was performed through four stages, namely diagnosing action, planning action, taking action and evaluating action. Covid-19 risk factor identification was carried out among healthcare workers who came in contact with Covid-19 patients between October 2020 and February 2021. Risk mitigation strategies were evaluated using Hospital Readiness Checklist for Covid-19. FGD was performed in the implementation of risk mitigation strategies using hierarchy of control against infection transmission. Statistical analysis was carried out using chi square test and logistic regression. Result: A total number of 81 healthcare workers comprised of 26 Covid-19 RT-PCR positive subjects and 55 negative subjects were included in the study. Risk factors of Covid-19 among healthcare workers were determined as close contact (OR 3,13; 95% CI 1,16-8,43, p=0,021), inadequate PPE (OR 4,26; 95% CI 1,57-11,60, p=0,003) and inadequate ventilation (OR 4,74; 95% CI 1,26-17,73, p=0,014). Only three out of twelve components of Hospital Readiness Checklist for Covid-19 met 80% requirements. Risk mitigation measures by vaccination, hospital zoning, ventilation management, physical distancing, screening and triage, IPC education, work hours regulation, and the use of PPE had been implemented. Conclusion: Close contact, inadequate PPE, and inadequate ventilation increased the risk of Covid-19 among healthcare workers. Hospital Readiness evaluation during pandemic was suboptimal. Risk mitigation strategies using hierarchy of control against infection transmission has been implemented in RSU Harapan Bersama.

Kata Kunci : Mitigasi risiko, tenaga kesehatan, SARS-CoV-2