Identifikasi Risiko Kesehatan dan Keselamatan Kerja (K3) Pada Tenaga Kesehatan Puskesmas Dalam Upaya Manajemen Kesehatan Masyarakat Kasus COVID-19 di Purwokerto Kabupaten Banyumas

BENITA FIRLIANA AJI, Dr.Dra.Retna Siwi Padmawati, MA; Marthinus Sutena,SKM.,MM.,M.Sc

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Jumlah kasus masyarakat terkonfirmasi COVID-19 di Kabupaten Banyumas yang terus meningkat terakumulasi tertinggi pada bulan Juli-September 2021. Tingginya angka kasus COVID-19 juga ditandai dengan tenaga kesehatan di puskesmas yang tercatat positif COVID-19, yang tersebar termasuk di puskesmas di Purwokerto. Tingginya risiko tenaga kesehatan untuk terpapar virus dapat disebabkan karena belum dilaksanakannya identifikasi risiko K3 secara menyeluruh. Selain risiko terpapar virus, risiko K3 lainnya juga berpotensi dialami oleh tenaga kesehatan puskesmas. Tujuan: Mengidentifikasi dan menganalisis risiko K3 pada tenaga kesehatan dalam upaya manajemen kesehatan masyarakat pada kasus COVID-19 di Purwokerto, dan mengeksplorasi pengendalian risikonya. Metode: Penelitian ini merupakan penelitian kualitatif dengan pendekatan studi kasus. Penelitian dilakukan di 4 puskesmas di Purwokerto. Informan penelitian berjumlah 14 orang, terdiri dari 2 orang tenaga surveilans, 2 orang tenaga analis kesehatan, 3 orang dokter Puskesmas, 2 orang perawat puskesmas, 1 orang kepala puskesmas, dan 4 orang petugas dinas kesehatan. Pengumpulan data dilakukan dengan wawancara mendalam, observasi, yang dilakukan oleh peneliti dengan konsep job hazard analysis (JHA), serta studi dokumen. Hasil: Risiko terpapar virus COVID-19 pada kegiatan manajemen kesehatan masyarakat pada kasus COVID-19 dialami oleh tenaga kesehatan puskesmas. Risiko stres akibat beban kerja yang bertambah juga dirasakan oleh tenaga kesehatan dalam menangani COVID-19 pada masyarakat. Ditemukan pula risiko iritasi kulit seperti gatal-gatal akibat dari pemakaian APD berupa sarung tangan selama bekerja lebih dari 5 jam pada tenaga kesehatan. Pengendalian risiko yang telah dilakukan meliputi pemasangan sekat transparan di ruang pelayanan, adanya prosedur kerja, penggunaan APD sesuai dengan indikasinya, serta pelaksanaan kewaspadaan standar seperti kebersihan tangan dan penempatan pasien infeksius yang terpisah dengan pasien non infeksius. Kesimpulan: Risiko K3 berpotensi dialami oleh tenaga kesehatan di puskesmas, sehingga manajemen risiko K3 melalui identifikasi dan pengendalian perlu dilakukan, disertai dengan pelaksanaan monitoring dan evaluasinya.

Background: The amount confirmed case of COVID-19 in Banyumas Regency continues to increase, with the highest accumulation in July-September 2021, even though public health centers have routinely tried to manage public health cases of COVID-19. The high number of cases is marked by health workers who are also recorded positive for COVID-19, and spread to the public health center in Purwokerto. The risk of health workers being exposed to the virus is high, can be caused by the absence of a comprehensive occupational health and safety identification process. In addition to the risk of exposure, other risks have the potential to impact on health care worker�s health and safety in Purwokerto health care centers. Objective: To identify, analyze occupational health and safety risks for health workers in health care centers in an effort to manage public health cases of COVID-19 in Purwokerto, Banyumas Regency and to explore risk control management. Methods: This research is qualitative research with a case study approach. The research was carried out in four health care centers in Purwokerto. The research subjects were 14 informants, consisting of 2 surveillance staf, 2 health analysts, 3 doctors, 2 nurses, 1 head of health care center, and 4 health service officers. Data was collected by means of in-depth interviews, observations, conducted by researchers with the concept of job hazard analysis (JHA), and document studies. Result: The risk of being exposed to the COVID-19 virus in public health management activities for COVID-19 cases also experienced by health care workers. In addition, the risk of stres due to an increased workload is also felt by health workers in dealing with COVID-19 in the community. It was also found that there was a risk of skin irritation such as itching in health center health workers due to using gloves for too long while working for more than five hours. Risk control that has been carried out includes technical control by installing transparent bulkheads in service rooms, administrative control with work procedures, and the use of PPE according to indications, as well as implementing standard precautions such as hand hygiene and placing infectious patients separately from non-infectious patients. Conclusion: Occupational health and safety risks are potentially experienced in health care workers, so that occupational health and safety risk management through risk identification and control needs to be carried out, accompanied by monitoring and evaluation.

Kata Kunci : Identifikasi risiko, tenaga kesehatan, puskesmas, COVID-19