Upaya Rumah Sakit dalam Merespon Pandemi COVID-19 berbasis WHO SPRP 2021: Scoping Review

WAHYU KRISTIANTO, Andreasta Meliala, Dr. dr. DPH., MKes, MAS; Dr. dr. Dwi Handono, M.Kes

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Pandemi COVID-19 yang melanda di seluruh dunia turut memberikan dampak yang besar bagi pelayanan kesehatan di Rumah Sakit dan menghadapi berbagai tantangan untuk tetap dapat memberikan pelayanan kesehatan, baik pada penderita COVID-19 maupun pasien umum di Rumah Sakit. Tujuan: Mengidentifikasi upaya rumah sakit dalam menghadapi COVID-19 di dalam merespon pandemi COVID-19 berbasis WHO SPRP 2021. Metode: Penelitian ini merupakan penelitian deskriptif kualitatif dengan pendekatan desk research serta menggunakan penelusuran dokumen dan informasi yang tersedia melalui metode scoping study. Penelusuran dilakukan dari 2 basis data jurnal daring yaitu Google Scholar dan Pubmed. Judul/abstrak hingga full text dilakukan 3 tahap skrining secara independen oleh penulis. Proses ekstraksi dan sistesis data dilakukan dari agustus-september 2021. Proses seleksi dilaporkan dengan PRIMA chart dan kemudian diekstraksi dalam format ekstraksi untuk kemudian menjelaskan gambaran umum terhadap literatur dan tema yang ditemukan Hasil Penelitian: Jumlah artikel yang digunakan dalam scoping review ini berjumlah 19 artikel. Artikel-artikel ini membahas mengenai penegakan diagnosis, pencegahan dan pengendalian infeksi (PPI), dan manajemen kasus terkait COVID-19. Solusi yang dipaparkan dalam artikel yang kami inklusikan adalah terkait alat diagnosis COVID-19, pemeriksaan radiografi dada dapat direkomendasikan apabila pemeriksaan RT-PCR menunjukan hasil negatif pada pasien suspek COVID-19, pemeriksaan sputum dan BAL menunjukan angka positif tertinggi. Terkait PPI, peningkatan kompetensi staf melalui pelatihan, edukasi kepada seluruh staf dan pengunjung mengenai pentingnya penerapan hand hygiene dan etika bernafas, pemantauan rutin kesehatan staf rumah sakit, dan sistem penanganan COVID-19 berbasis tim perawatan medis dapat direkomendasikan sebagai upaya PPI di rumah sakit. Terakit manajemen kasus setiap negara memiliki caranya tersendiri dalam menangani kasus COVID-19, terdiri dari pemeriksaan fisik, wawancara awal, pemeriksaan laboratorium darah, CT-Scan dada, pemeriksaan tes swab, pemasangan oksigen, ventilasi mekanik, pemberian obat antivirus, obat penunjang gejala pernapasan, suplemen dan multivitamin. Kesimpulan: Diagnosis awal, PPI dan manajemen kasus COVID-19 merupakan hal yang perlu diidentifikasi sedini mungkin, karena dapat berdampak bagi keselamatan pasien dan staf rumah sakit dan mengakibatkan kerugian yang besar bagi rumah sakit. Oleh karena itu, terdapat beberapa solusi yang dapat dipertimbangkan RS yaitu, pemeriksaan RT-PCR melalui spesimen sputum dan BAL menunjukan tingkat sensitifitas tertinggi, radiografi dada menunjukan hasil yang lebih singkat dibandingkan RT-PCR, peningkatan kompetensi staf melalui pelatihan APD, edukasi mengenai pentingnya penerapan hand hygiene, social distancing dan etika bernafas, pemantauan rutin kesehatan staf rumah sakit, hingga sistem penanganan COVID-19 berbasis tim perawatan medis terpisah.

Background: The COVID-19 pandemic that hit all over the world also had a major impact on health services in hospitals and faced various challenges to continue to be able to provide health services, both for COVID-19 sufferers and general patients in hospitals. Objectives: To identify hospital efforts in dealing with COVID-19 in responding to the COVID-19 pandemic based on the WHO SPRP 2021. Methods: This study is a qualitative descriptive study with aapproach desk research and uses the search for documents and information available through themethod scoping study. The search was carried out from 2 online journal databases, namely Google Scholar and Pubmed. Titles/abstracts to full text are screened in 3 stages independently by the author. The data extraction and synthesis process was carried out from August-September 2021. The selection process was reported using a PRISMA chart and then extracted in an extraction format to then explain thedescription generalof the literature and themes found. Research Results: The number of articles used in this scoping review is 19 articles. These articles discuss diagnosis, infection prevention and control (PPI), and case management related to COVID-19. The solutions presented in the articles that we include are related to COVID-19 diagnostic tools, chest CT examination can be recommended if the RT-PCR examination shows negative results in suspected COVID-19 patients, sputum and BAL examinations show the highest positive numbers. Regarding PPI, increasing staff competence through training, educating all staff and visitors about the importance of implementing hand hygiene and breathing ethics, and routine monitoring of hospital staff's health can be recommended as PPI efforts in hospitals. Regarding case management, each country has its own way of dealing with COVID-19 cases, consisting of a physical examination, initial interview, blood laboratory examination, chest CT scan, swab test examination, oxygen installation, mechanical ventilation, administration of antiviral drugs, drugs to support respiratory symptoms. , supplements and multivitamins. Conclusion: Early diagnosis, PPI and case management of COVID-19 are things that need to be identified as early as possible, because they can have an impact on the safety of patients and hospital staff and result in huge losses for the hospital. Therefore, there are several solutions that can be considered by hospitals, namely, RT-PCR examination through sputum and BAL specimens shows the highest level of sensitivity, chest radiography shows shorter results than RT-PCR, increasing staff competence through PPE training, education about the importance of implementing hand hygiene, social distancing and breathing ethics, routine monitoring of the health of hospital staff, to the COVID-19 handling system based on a separate medical care team.

Kata Kunci : COVID-19, Laboratorium dan Diagnosis, Pencegahan dan Pengendalian Infeksi, dan Manajemen Kasus