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"Latar Belakang: Tenaga kesehatan (nakes) menjadi garda terdepan dalam pelayanan kesehatan di saat pandemi COVID-19. Tidak hanya dokter, perawat atau bidan dan nakes penunjang seperti petugas radiologi rentan untuk risiko terinfeksi COVID-19. Zona kerja nakes merupakan salah satu faktor yang berpengaruh terhadap risiko terinfeksi COVID-19. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian COVID-19 pada nakes yang bekerja di perawatan isolasi COVID-19.Metode Penelitian: Penelitian ini merupakan studi potong lintang dengan metode total sampling pada tenaga kesehatan yang bekerja di ruang rawat inap isolasi COVID-19 periode Maret sampai Desember 2020. Respons kuesioner penelitian elektronik yang disebarkan akan ditabulasi dan dianalisis.Hasil Penelitian: Subjek penelitian yang memenuhi kriteria inklusi sebanyak 292 orang dengan mayoritas berusia ≥30 tahun (75,7%), profesi nondokter (91,8%), bekerja di zona kerja non-ICU (70,2%) dan hasil PCR COVID-19 negatif (64%). Zona kerja non-ICU, jenis kelamin, kekerapan kadang-kadang, jarang dan tidak pernah dalam penggunaan APD level 3 serta pelatihan PPI dari RS dalam hal standar APD era pandemi bermakna meningkatkan peluang risiko kejadian COVID-19. Sedangkan, kepatuhan protokol kesehatan dalam hal kontak erat dengan selain orang serumah, salah satu tidak memakai masker dan lama kontak >15 menit, pemasangan kanula hidung dan kontak dengan kolega positif COVID-19 bermakna menurunkan peluang risiko kejadian COVID-19.

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Background: : Health workers are at the forefront of health services during the COVID-19 pandemic. Not only doctors, nurses or midwives and supporting health workers such as radiology officers are vulnerable to being infected with COVID-19. The health worker's work zone is one of the factors that influences the risk of contracting COVID-19. This study aims to determine the risk factors for the occurrence of COVID-19 in health workers who work in isolation care for COVID-19.

Methods: This research is a cross-sectional study using total sampling method on healthcare workers who work in the COVID-19 isolation ward from March to December 2020. The responses of the distributed electronic research questionnaire will be tabulated and analyzed.

Results: There were 292 subjects who met the inclusion criteria with the majority aged ≥30 years (75.7%), non-doctors (91.8%), working in non-ICU work zones (70.2%) and negative COVID-19 PCR results (64%). Non-ICU working zone, gender, frequency of sometimes, rarely and never in the use of level 3 PPE as well as PPI training from hospitals in terms of PPE standards in the pandemic era significantly increased the risk of COVID-19 incident. Meanwhile, adherence to health protocols in terms of close contact with other than people in the household, one of them does not wear a mask and the duration of contact is >15 minutes, installation of nasal cannulae and contact with positive COVID-19 colleagues significantly reduced the COVID-19 incident."

"Latar belakang: Coronavirus Disease 2019 (COVID-19) adalah penyakit baru. Infeksi saluran napas akibat virus yang disertai infeksi bakteri akan meningkatkan derajat keparahan dan angka mortalitas. Insidens ventilator associated pneumonia (VAP) pada kelompok COVID-19 yaitu 21-64%. Kasus VAP dapat menjadi penyebab tingginya mortalitas pada pasien COVID-19 terintubasi.Metode penelitian : Penelitian ini adalah penelitian retrospektif di RS Persahabatan. Seluruh sampel yang digunakan adalah kelompok pasien COVID- 19 terintubasi >48 jam dalam periode tahun 2020-2022 yang memenuhi kriteria inklusi dan eksklusi.Hasil penelitian : Penelitian ini meliputi 196 data penelitian yang memenuhi kriteria inklusi. Proporsi laki-laki lebih banyak dibandingkan perempuan dan hanya 29% adalah populasi usia lanjut. Proporsi VAP pada COVID-19 terintubasi pada tahun 2020-2022 mencapai 60% dengan VAP rates 92,56. Terdapat dua faktor bermakna terhadap VAP pada pasien COVID-19 terintubasi yaitu penggunaan azitromisin (OR 2,92; IK95% 1,29-6,65; nilai-p 0,01) dan komorbid penyakit jantung. (OR 0.38; IK95% 0,17-0,87; nilai-p 0,023). Proporsi terbesar biakan mikroorganisme aspirat endotrakeal adalah Acinetobacter baumannii (44%), Klebsiella pneumoniae (23%), Escherichia coli (9%).Kesimpulan : Proporsi VAP pada COVID-19 terintubasi adalah 60%. Terdapat hubungan bermakna pada penggunaan azitromisin dan komorbid penyakit jantung sedangkan usia lanjut dan penggunaan steroid tidak memiliki hubungan bermakna terhadap VAP pada pasien COVID-19 terintubasi.

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Background : Coronavirus Disease 2019 (COVID-19) is a novel disease. Viral respiratory infection following bacterial infection could increase the severity and mortality of the disease. The incidence of Ventilator (VAP) in COVID-19 group is 21-64%. VAP might be the leading cause of high mortality in intubated COVID-19 patient.

Methods : This research is a retrospective study at Persahabatan hospital. The collected samples is a group of COVID-19 patient intubated for >48 hours in the period of 2020 to 2022 that meet the inclusion and exclusion criteria.

Results : This study consist of 196 data fulfilling the inclusion criteria. Male proportion much greater than female and only 29% is an elderly population. The proportion of VAP in the period of 2020-2022 is 60% with the VAP rates 92,56. There are two factors significantly affected VAP in intubated COVID-19 patient which are the usage of azitromisin (OR 2,92; CI95% 1,29-6,65; p-value 0,01) and cardiovascular disease comorbidity(OR 0.38; CI95% 0,17-0,87; p-value 0,023). The most abundance proportion of endotracheal aspirate microorganism culture are Acinetobacter baumannii (44%), Klebsiella pneumoniae (23%), and Eschrichia coli (9%).

Conclusion : The proportion of VAP in intubated COVID-19 is 60%. There are significant association of azitromicin usage and cardiovascular comorbidity while elderly and the usage of steroid are not significantly associated to VAP in intubated COVID-19 patient."

"Latar Belakang: Kejadian pandemi penyakit Coronavirus disease 2019 (COVID-19) telah menyebar ke berbagai belahan dunia dengan peningkatan angka pasien terkonfirmasi dan meninggal. Cedera miokard akut merupakan salah satu manifestasi klinis yang sering timbul pada pasien terkonfirmasi COVID-19 yang mengakibatkan meningkatnya risiko morbiditas dan mortalitas. Meskipun demikian, kejadian cedera miokard akut pada pasien COVID-19 belum banyak didokumentasikan. Penelitian ini bertujuan mengetahui kejadian cedera miokard akut pada pasien COVID-19 serta faktor-faktor yang mempengaruhinya.Metode: Penelitian ini merupakan penelitian potong lintang dengan menggunakan data rekam medis pasien COVID-19 yang dirawat di RSUP Persahabatan, Jakarta, selama periode Juni-Desember 2020. Prevalens cedera miokard akut dinilai dengan menggunakan kadar pemeriksaan high sensitivity Troponin I (hsTrop-I). Penelitian ini juga menentukan hubungan antara faktor demografi, riwayat penyakit komorbid kardiovaskular, derajat penyakit, penanda respon inflamasi serta faktor koagulasi dengan kejadian cedera miokard akut pada pasien terkonfirmasi COVID-19.Hasil: Dari total 340 sampel yang diikutkan dalam penelitian ini didapatkan sebanyak 62 (18,2%) sampel mengalami cedera miokard akut, mayoritas berusia diatas 40 tahun (93,5%). Cedera miokard akut lebih dominan terjadi pada sampel dengan riwayat komorbid (90,3%) dan derajat penyakit berat-kritis (87,1%). Prokalsitonin dan d-Dimer secara konsisten menunjukkan hubungan yang bermakna pada uji bivariat dan multivariat dengan kejadian cedera miokard akut.Kesimpulan: Prevalens cedera miokard akut pada pasien COVID-19 di RS Persahabatan sebesar 18,2%. Cedera miokard akut berhubungan dengan kadar prokalsitonin, d-Dimer dan komorbid kardiovaskular.

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Background: The pandemic of Coronavirus disease 2019 (COVID-19) has spread worldwide with the growing number of confirmed patients and deaths. Acute myocardial injury is one of the most common clinical manifestations in COVID-19 patients, results in higher risk of morbidity and mortality. However, the prevalence of acute myocardial injury in COVID-19 patients is not well documented. This study aimed to assess the prevalence of acute myocardial injury in COVID-19 patients.

Methods: This is a cross-sectional study utilizing medical record on COVID-19 patients admitted to Persahabatan hospital, Jakarta, within the period of June to December 2020. The prevalence of acute myocardial injury was assessed through high sensitivity Troponin I (hsTrop-I) levels examination. The association of demographic factors, cardiovascular disease comorbidities, disease severity, levels of inflammatory biomarkers and coagulation factor with acute myocardial injury were also determined.

Results: From a total of 340 patients enrolled in the study, 62 (18.2%) samples experienced acute myocardial injury, in which majority (93.5%) aged >40 years. The prevalence of acute myocardial injury was more dominant in patients with the history of comorbidities (90.3%) and severe-critically ill COVID-19 patients (37.1%). Procalcitonin and d-Dimer levels consistently showed significant association with acute myocardial injury from bivariate and multivariate analysis.

Conclusion: The prevalence of acute myocardial injury in COVID-19 patients in Persahabatan Hospital was 18,2%. Acute myocardial injury was significantly associated with procalcitonin levels, d-Dimer levels and cardiovascular comorbidities."

"Latar Belakang: Pandemi COVID-19 telah menjadi tantangan besar bagi dunia kesehatan. Tenaga kesehatan merupakan populasi yang sangat rentan tertular dikarenakan tingginya intensitas dan frekuensi pajanan SARS-CoV-2. Risiko penularan meningkat apabila tenaga medis melakukan tindakan yang memicu aerosilisasi, salah satunya adalah intubasi endotrakeal karena tingginya viral load pada saluran napas. Sebanyak 3,2% pasien COVID-19 memerlukan tindakan intubasi endotrakeal dan ventilasi mekanis. Intubasi endotrakeal yang efektif pada pasien COVID-19 penting dilakukan untuk menurunkan mortalitas dan risiko penularan. Penelitian ini bertujuan intuk mengetahui faktor-faktor yang memengaruhi efektivitas intubasi endotrakeal pada pasien terkonfirmasi COVID- 19 di RSUP Persahabatan.Metode: Penelitian ini merupakan penelitian observasional yang menggunakan desain potong lintang yang dilakukan di IGD, ICU Rasmin Rasjid dan ICU PINERE RSUP Persahabatan pada bulan Juni 2021 – Juni 2022. Subjek peneltian ini adalah pasien terkonfirmasi COVID-19 yang dilakukan tindakan intubasi endotrakeal yang memenuhi kriteria inklusi dan eksklusi. Tindakan intubasi endotrakeal dinilai dari observasi rekaman CCTV. Selanjutnya karakteristik subjek, karakteristik intubasi endotrakeal dan faktor-faktor yang memengaruhi intubasi endotrakeal dievaluasi.Hasil: Pada penelitian ini didapatkan 59 subjek penelitian. Proporsi intubasi endotrakeal efektif pada pasien COVID-19 sebesar 20,34%. Median lama waktu tindakan intubasi endotrakeal adalah 38 (19-189) detik. Sebanyak 32 (54,24%) tindakan intubasi endotrakeal dilakukan oleh spesialis anestesi dan 27 (45,76%) oleh PPDS Pulmonologi dan Kedokteran Respirasi. Hasil analisis bivariat didapatkan hasil bermakna secara statistik pada variabel penyakit kardiovaskular+DM (OR 0,24 (IK 95% 0,06-0,91), p=0,028) dan variabel operator (OR 0,07 (IK 95% 0,01-0,62), p=0,004). Hasil analisis multivariat menunjukkan hasil bermakna secara statistik hanya pada variabel operator (adjusted OR 0,06 (IK 95% 0,01-0,60), p=0,016).Kesimpulan: Terdapat hubungan penyakit kardiovaskular+DM dan operator terhadap intubasi endotrakeal efektif pada pasien COVID-19 di RSUP Persahabatan.

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Background: The COVID-19 pandemic has become a major challenge for the healthcare system. Healthcare workers are vulnerable population of COVID-19 transmission due to high intensity and frequency of exposure to SARS-CoV-2. The risk of transmission increases in aerosolization procedure such as endotracheal intubation because of the high viral load in the airways. Approximately 3.2% of COVID-19 patients require endotracheal intubation and mechanical ventilation. Effective endotracheal intubation in COVID-19 patients is important parameter to reduce mortality and the risk of transmission to healthcare workers. This study aims to determine the factors that influence the effectiveness of endotracheal intubation in patients with COVID-19 in National Respiratory Center, Persahabatan Hospital.

Methods: This study is an observational study using a cross-sectional design which was carried out in the emergency department, ICU Rasmin Rasjid and ICU PINERE of National Respiratory Center, Persahabatan Hospital in June 2021 – June 2022. The subjects of this study were COVID-19 patients who underwent endotracheal intubation who met the criteria inclusion and exclusion. The endotracheal intubation procedure was assessed from the observation of CCTV recordings. The characteristics of the subject, the characteristics of endotracheal intubation and the factors that influence endotracheal intubation were evaluated.

Results: In this study, there were 59 subjects. The proportion of effective endotracheal intubation in COVID-19 patients was 20.34%. The median length of time for endotracheal intubation was 38 (19-189) seconds. Among the subjects, 32 (54.24%) endotracheal intubation were performed by anesthesiologists and 27 (45.76%) were performed by Pulmonology and Respiratory Medicine residents. The results of the bivariate analysis showed statistically significant results on the cardiovascular disease + DM comorbid (OR 0.24 (95% CI 0.06-0.91), p=0.028) and operator (OR 0.07 (95% CI 0.01-0.62), p=0.04). The results of the multivariate analysis showed statistically significant results only for operator (adjusted OR 0.06 (95% CI 0.01-0.60), p=0.016).

Conclusion: There is relationship of cardiovascular disease + DM comorbid and operator with effective endotracheal intubation in COVID-19 patients at National Respiratory Center, Persahabatan Hospital."

"Latar Belakang: Coronavirus Disease 2019 (COVID-19) merupakan penyakit saluran pernafasan yang menjadi pandemi dasawarsa terakhir dan dapat menyebabkan disfungsi jantung. Galectin-3 diduga terkait dengan proses inflamasi yang berlanjut pada remodelling dan akhirnya fibrosis organ. Diharapkan penilaian terhadap Galectin-3 akan memperoleh gambaran perburukan jantung pasien COVID-19 sehingga diperoleh data faktor-faktor yang berpengaruh terhadap peningkatan Left Ventricular End Diastolic Volume (LVEDV) yang nantinya menjadi gagal jantung pada pasien COVID-19.Metode: Rancangan penelitian ini adalah observasional prospektif analitik di ICU COVID-19 RSUP Sanglah. Penelitian dilakukan sejak bulan Juni sampai Oktober 2021. Semua subjek penelitian diperiksa kadar Galectin-3 menggunakan pemeriksaan Enzyme-Linked Immunosorbent Assay (ELISA). Subjek juga dilakukan evaluasi Left Ventricular End Diastolic Volume (LVEDV) dengan ekokardiografi, diidentifikasi menggunakan skor SOFA saat di ICU COVID-19, serta pemeriksaan terhadap kadar Troponin I. Subjek penelitian tetap akan mendapat terapi COVID-19 sesuai dengan protokol standar Kementerian Kesehatan RI. Setelah 72 jam pasca admisi ICU COVID-19, subjek penelitian akan dilakukan pemeriksaan ulangan terhadap kadar Galectin-3 dan LVEDV. Data yang didapatkan dianalisis dengan uji statistik menggunakanSTATATM.Hasil: Didapatkan total 45 subjek penelitian. Dari hasil analisis bivariat terhadap selisih Galectin-3 dengan LVEDV didapatkan tidak signifikan (r=0,08), uji korelasi antara Galectin-3 dan LVEDV saat masuk ruang rawat ICU ternyata tidak signifikan (r=0,191), dan korelasi antara Galectin-3 dan LVEDV pasca rawat 72 jam juga tidak signifikan (r=0,197). Dari hasil multivariat variabel bebas yakni selisih Galectin-3, usia, jenis kelamin, troponin I, skor SOFA dan CHARLSON terhadap variabel LVEDV ternyata tidak ada satu pun variabel yang memiliki hasil yang bermakna secara statistik (p<0,05) terhadap LVEDV.Simpulan: Tidak ada korelasi antara Galectin-3 dengan peningkatan LVEDV dalam penelitian ini

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Background: Coronavirus Disease 2019 (COVID-19) is a respiratory disease that has become the largest pandemic and also could put heart at risk of dysfunction. Galectin-3 is thought to be related to the inflammatory process that continues with remodeling and eventually fibrosis. By using Galectin-3 assesment, we could overview the possible worsening of the heart and evaluate data on influencing factors in increased Left Ventricular End Diastolic Volume (LVEDV) which could later become heart failure.

Methods: This is an observational prospective analytic study in the COVID-19 ICU of Sanglah Hospital. The study was started from June to October 2021. All research subjects will have their blood samples taken for Galectin-3 levels using Enzyme-Linked Immunosorbent Assay (ELISA). Subjects were also evaluated for Left Ventricular End Diastolic Volume (LVEDV) with echocardiography, identified using SOFA scores, and also examined their Troponin I levels. Subjects were treated with COVID-19 standard protocol from the Health Ministry. After 72 hours post-admission, subjects were re-examined for Galectin-3 levels and LVEDV. The data were analyzed by statistical tests using STATATM.

Results: A total of 45 research subjects were analysed. Bivariate analysis of the difference of Galectin-3 and LVEDV shown to be insignificant (r=0.08), no correlation was found between Galectin-3 level and LVEDV while admitted to the ICU (r=0.191), and no correlation found between Galectin-3 level and LVEDV after 72 hours of hospitalization (r=0.197). Multivariate analysis also showed that none of variables namely difference of Galectin-3 level, age, gender, troponin I, SOFA and CHARLSON had statistically significant results (p<0.05) on LVEDV.

Conclusions: No correlation was found between Galectin-3 level and an increase in LVEDV."

"Latar Belakang. COVID-19 menyebar hampir ke seluruh dunia. Di Indonesia, pada 2 Maret 2020 telah dilaporkan dua kasus COVID-19 pertama yang terkonfirmasi positif. Karena banyaknya kasus COVID-19 yang terjadi di Indonesia terutama pada tenaga kesehatan, KEMENKES menerbitkan pedoman pencegahan dan pengendalian COVID- 19 sebagai acuan untuk meminimalisasi terjadinya penularan COVID-19.Tujuan. Penelitian ini bertujuan untuk merancang sistem skoring untuk memprediksi terjadinya infeksi COVID-19 pada tenaga kesehatan di Rumah Sakit Umum Pusat Nasional (RSUPN CM).Metode. Penelitian ini menggunakan metode total sampling. subyek penelitian ini adalah tenaga kesehatan yang bekerja di RSUPN Dr. Cipto Mangunkusumo. Pengumpulan data menggunakan kuisioner. Analisa data dengan analisis multivariat untuk melihat faktor risiko yang ada dapat dijadikan sebagai prediktor terjadinya infeksi berbahaya.Hasil. Desain penelitian ini adalah potong lintang dengan jumlah subjek sebanyak 125 orang. Tenaga kesehatan yang dinyatakan positif COVID-19 sebanyak 48,7% dari seluruh jumlah tenaga kesehatan di RSUPN Dr. Cipto Mangunkusumo periode bulan Maret sampai Oktober 2020 yang memenuhi kriteria inklusi. Faktor risiko yang dapat digunakan sebagai prediktor yaitu usia, tempat bekerja di RSCM, riwayat kontak erat dan status merokok.Kesimpulan. Sistem skoring dalam penelitian ini dapat digunakan sebagai prediktor tenaga kesehatan terhadap kemungkinan berisiko tinggi atau rendah terinfeksi COVID- 19.

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Background. COVID-19 has been spread almost all over the world. In Indonesia, on March 2, 2020, the first two confirmed cases of COVID-19 were reported. Due to the large number of COVID-19 cases occurring in Indonesia, especially in healthcare workers, the Ministry of Health issues guidelines for preventing and controlling COVID- 19 as a reference to minimize the occurrence of COVID-19 based on transmission. Objective. This study aims to design a scoring system to predict the occurrence of COVID-19 infection among health workers at RSUPN CM.

Method. This research used total sampling method. The subjects of this study were healthcare workers who worked at RSUPN. Dr. Cipto Mangunkusumo. Data was collected using questionnaires. Then, data was analyzed until multivariate analysis to see whether the existing risk factors can be utilized as predictors of the occurrence of COVID- 19 infection.

Results. This study’s design is cross-sectional with 125 people as an respondent. Health workers who tested positive for COVID-19 as many as 48.7% of the total number of health workers at RSUPN CM for the period from March to October 2020 which meets the inclusion criteria. Risk factors that contributed as predictors including age category, place of work at RSCM, history of close contact and smoking.

Conclusion. The scoring system in this study can be implemented as a predictor of having created by COVID-19 in healthcare workers in RSUPN CM, whether the health worker is in a high or low risk condition of being infected with COVID-19."

"Di tengah pemberlakuan kebijakan new normal, risiko para tenaga kesehatan terinfeksi COVID-19 masih tinggi. Pemerintah Provinsi Jawa Tengah memberikan arahan terhadap rumah sakit untuk melaksanakan langkah preventif, kuratif dan promotif dalam penanganan COVID-19. Brebes merupakan kabupaten dengan tingkat kepadatan penduduk tertinggi kedua di Jawa Tengah yaitu sebanyak 1.925.365 jiwa dengan luas wilayah Kabupaten Brebes mencapai 1.769,62 km2. Dengan tingkat kepadatan penduduk serta luas wilayah yang tinggi, rumah sakit di Kabupaten Brebes tentunya dituntut untuk dapat memberikan pelayanan maksimal dengan pemenuhan standar rumah sakit dan tenaga kesehatan. Pelaksanaan pencegahan dan pengendalian COVID19 di rumah sakit merupakan upaya penting dalam melindungi tenaga kesehatan dari risiko infeksi COVID-19. Penelitian ini bertujuan untuk menganalisa penerapan manajemen risiko pada tenaga kesehatan yang menangani COVID-19 di RSUD Brebes tahun 2022. Penelitian kualitatif dengan desain studi kasus deskriptif ini menggunakan data primer yang berasal dari wawancara mendalam dan data sekunder yang berasal dari telaah dokumen. Hasil penelitian menunjukkan penerapan manajemen risiko COVID-19 pada tenaga kesehatan di RSUD Brebes belum berjalan secara maksimal. Hal utama yang menyebabkan belum dilaksanakannya manajemen risiko secara maksimal ini adalah belum adanya komitmen dari seluruh staf terutama pimpinan dalam mengupayakan dan mendukung terlaksananya program manajemen risiko. Kondisi ini juga didukung dengan masih minimnya jumlah personil tenaga kesehatan sehingga menjadi pemicu kendala dalam penerapan manajemen risiko COVID-19.Oleh karena itu, peneliti menyarankan untuk memasukkan manajemen risiko sebagai salah satu kebijakan strategis rumah sakit dalam upaya peningkatan keselamatan dan kesehatan kerja. Untuk tenaga kesehatan, disarankan untuk lebih berpartisipasi aktif dalam penerapan dan pengembangan manajemen risiko.

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In the midst of the implementation of the new normal policy, the risk of health workers being infected with COVID-19 is still high. The Central Java Provincial Government provides directions for hospitals to carry out preventive, curative and promotive steps in handling COVID-19. Brebes is the district with the second highest population density in Central Java, which is 1,925,365 people with the area of ​​Brebes Regency reaching 1,769.62 km2. With a high level of population density and area, hospitals in Brebes Regency are certainly required to be able to provide maximum service by meeting hospital standards and health workers. The implementation of the prevention and control of COVID-19 in hospitals is an important effort to protect health workers from the risk of COVID-19 infection. This study aims to analyze the application of risk management to health workers who handle COVID-19 at the Brebes Hospital in 2022. This qualitative research with a descriptive case study design uses primary data from in-depth interviews and secondary data from document review. The results showed that the application of COVID-19 risk management to health workers at the Brebes Hospital had not run optimally. The main reason why risk management has not been implemented to its full potential is the lack of commitment from all staff, especially the leadership, in seeking and supporting the implementation of risk management programs. This condition is also supported by the still minimal number of health personnel so that it triggers obstacles in the implementation of COVID-19 risk management. Therefore, the researchers suggest including risk management as one of the hospital's strategic policies in an effort to improve occupational safety and health. For health workers, it is recommended to actively participate in the implementation and development of risk management."

"Latar belakang: Kematian pasien lansia dengan COVID-19 di ICU memiliki angka yang tinggi. Pandemi COVID-19 menjadi kendala bagi penerapan perawatan akhir hayat pada lansia dengan COVID-19 yang dirawat di ICU karena adanya pembatasan interaksi antara pasien dengan keluarga pasien. Gambaran kasus: Pasien merupakan seorang lansia berusia 82 tahun berjenis kelamin laki-laki dengan diagnosis COVID-19 derajat kritis, diabetes mellitus tipe 2, hipertensi, serta demensia. Observasi dilakukan terhadap perawatan akhir hayat pada pasien dan keluarga pasien. Perawatan utama pada pasien berfokus pada pemenuhan kebutuhan dasar pasien dan kenyamanan pasien. Pasien tidak dapat dilibatkan secara langsung karena kondisi dalam pengaruh sedasi. Keterlibatan keluarga dilakukan melalui media gawai karena keluarga tidak bisa dihadirkan langsung kepada pasien untuk mencegah transmisi virus. Kesimpulan: Komunikasi dan interaksi melalui gawai kurang optimal dalam memfasilitasi kebutuhan spiritual akhir hayat pasien dan keluarga, sementara perawat tidak dapat menggantikan peran keluarga.

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Background: Elderly patients with COVID-19 in ICU have a high mortality rate. COVID-19 pandemic creates an obstacle in implementing end-of-life care for the elderly with COVID-19 in ICU because there is a limitation of interaction between patients and their families. Case illustration: A 82 years old male patient with diagnosis critical level COVID-19, type 2 diabetes mellitus, hypertension, and dementia. The focus of the observation is for the end-of-life care to the patient and his family. The primary interventions for the patient are basic needs support and patient comfort. The patient cannot be directly involved because he is under sedation. The family involvement is done with the help of gadget devices because they cannot meet the patient to prevent virus transmission. Conclusion: Communication and interaction using devices cannot optimally facilitate patient and family’s spiritual needs at the end-of life, while the nurses cannot replace the family roles."

"Rumah sakit adalah sarana layanan kesehatan yang tidak terhindar dari masalah kesehatan dan keselamatan kepada pekerja, pasien atau pengunjung rumah sakit. Saat pandemi Covid-19, rumah sakit penting untuk memastikan kesehatan dan keselamatan kerja (K3RS) penyedia layanan, namun selama pandemi, pelaksanaan dan evaluasi bagi Rumah Sakit kurang diprioritaskan untuk dilakukan. Tujuan penelitian untuk mengevaluasi penerapan kesehatan dan keselamatan kerja di Ruang Rawat Isolasi COVID-19 RS. Graha Juanda Tahun 2022.Penelitian ini merupakan studi kasus dengan pendekatan kuantitatif dan kualitatif. Penelitian kuantitatif menggunakan ukuran consecutive sampling sebanyak 48 responden. Penelitian kualitatif menggunakan ukuran purposive sampling dimana informan yang diteliti berkompeten di bidangnya.Hasil studi menunjukkan dari 48 responden mengatakan penerapan kebijakan K3RS skor rata-rata sebesar 20.04 ≥20 berjalan baik, perencanaan K3RS skor rata – rata sebesar 19.68 <20 kurang baik dan pelaksanaan K3RS skor rata – rata sebesar 101.89 ≥100 berjalan baik. Wawancara informan menjelaskan kebijakan K3RS di rumah sakit memiliki peraturan tertulis mengenai K3RS dan disosialisasikan kepada seluruh tenaga kesehatan. Penerapan fungsi perencanaan K3RS dilakukan dengan baik dari aspek sumber daya manusia, anggaran serta pelayanan. Pelaksanaan dilakukan sesuai hirarki dari pimpinan secara berkala mengevaluasi hambatan apa yang mungkin terjadi dilapangan serta memberikan motivasi kepada petugas yang memberikan pelayanan Covid-19. Kesesuaian penerapan K3RS dengan peraturan masih belum sesuai pada pengelolaan sarana dan prasarana. Angka kecelakaan kerja di RS Graha Juanda Tahun 2022 terdiri dari 4 (empat) kejadian, diantaranya 2 tertusuk benda tajam, 2 terjatuh dan terpeleset.

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Hospitals are health service facilities that cannot avoid health and safety issues to workers and patients or hospital visitors. The Covid-19 pandemic its very important to ensure occupational health and safety (K3RS) for service providers, but during the pandemic the implementation and evaluation for hospitals is not prioritized. The purpose of the study was to analysis of an evaluation on application of occupational health and safety program in the COVID-19 Isolation Ward of the Hospital. Graha Juanda in 2022.

This study is a case study with a quantitative and qualitative approach. Quantitative research used a consecutive sampling measures of 48 respondents. Qualitative research using a purposive sampling measure where the informants studied are competent in their fields.

The results of the study showed that 48 respondents, said that the implementation of the K3RS policy had an average score of 20.04 ≥20 was going well, the K3RS planning an average score of 19.68 <20 was not good and the K3RS implementation an average score of 101.89 ≥100 was going well. Informant interviews explained that the K3RS policy at the hospital had written regulations regarding K3RS and disseminated to all health workers. The implementation of the K3RS planning function carried out well from the aspects of human resources, budget and services. The implementation of K3RS is carried out according to the hierarchy from the leadership, periodically evaluating what obstacles may occur in the field and providing motivation to officers who provide Covid-19 services. The suitability of the implementation of K3RS with regulations is still not in accordance with the management of facilities and infrastructure. The number of work accidents at Graha Juanda Hospital in 2022 consists of 4 (four) incidents, including 2 being stabbed by a sharp object, 2 falling and slipping."

"Latar Belakang: The Coronavirus disease 2019 (COVID-19) merupakan infeksi oleh severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) yang menjadi perhatian internasional pada Januari 2020. Manifestasi kasus ringan terjadi sekitar 81%, kasus berat sebanyak 14%. Mortalitas akibat pneumonia COVID-19 meningkat secara global akibat transmisi cepat dan gejala awal yang atipikal. Usia ≥ 60 tahun, jenis kelamin laki-laki dan komorbiditas merupakan faktor risiko untuk menjadi berat dan kematian sehingga dibutuhkan kontrol ketat pada pasien berisiko.Metode Penelitian: Penelitian ini merupakan penelitian retrospektif dengan studi potong lintang. Sampel penelitian merupakan pasien yang datang ke IGD dan terkonfirmasi pneumonia COVID-19 yang masuk dalam kriteria inklusi. Sampel pada penelitian ini adalah sebanyak 299 pasien.Hasil Penelitian: Pada penelitian ini didapatkan subjek penelitian adalah 299 dari 336 pasien yang masuk dalam kriteria inklusi. Jenis kelamin laki-laki sebanyak 162 orang (54,18%), nilai IMT obesitas I (29,77%) dan diikuti IMT normal (28,76%), paling banyak tidak memiliki komorbid dengan derajat pneumonia berat (60,2%) dan luaran pasien sebanyak 69,2% adalah hidup. Komorbid terbanyak yaitu hipertensi (30,77%), Diabetes mellitus (24%) dan kardiovaskular (14%). Usia median hidup pasien pneumonia COVID-19 di RS Persahabatan adalah 52 th (20-84) dan median usia meninggal adalah 59 th (28-92). Terdapat hubungan bermakna antara derajat klinis, HT, IMT dan DM terhadap luaran pasien pneumonia COVID-19 di RS Persahabatan.Kesimpulan: Usia median hidup pasien pneumonia COVID-19 di RS Persahabatan adalah 52 th (20-84) dan median usia meninggal adalah 59 th (28-92). Terdapat hubungan bermakna antara derajat klinis, HT, IMT dan DM terhadap luaran pasien pneumonia COVID-19 di RS Persahabatan.

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Background: The Coronavirus disease 2019 (COVID-19) is an infection by severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) which became international attention in January 2020. The manifestation of mild cases occurred about 81%, severe cases as much as 14%. Mortality of COVID-19 pneumonia increasing globally due to rapid transmission and atypical symptoms. Age of 60 years, male gender and comorbidities are risk factors for severe and death so that strict control is needed.

Methods: This study is retrospective cross-sectional study, which samples were patients who came to emergency room and confirmed of COVID-19. The samples are 299 patients who included of inclusion criteria.

Results: The sample of this study were 299 patients out of 336 patients who were include in inclusion criteria. Male (54.18%) are the most common, Obesity class I was the most common (29.77%) followed by normal BMI (28,76%) and didn’t have comorbid with severe (60.2%) and outcome are survived (69.2%). Hypertension (30,77%) is the most comorbid, followed by diabetes melitus (24%) and cardiovascular (14%). The median age of survivor is 52 (20-84) years old and median age of non survivor is 59 (28-92) years. There was relationship between severe pneumonia to respiratory rate and peripheral oxygen saturation. Gender, number of comorbidities and BMI were not related to the outcome. There is a relationship between the severity of pneumonia, obesity, diabetes and hypertension to the outcome.

Conclusion: The median age of survivor is 52 (20-84) years old and median age of non survivor is 59 (28-92) years. There was relationship between severe pneumonia to respiratory rate and peripheral oxygen saturation. Gender, number of comorbidities and BMI were not related to the outcome. There is a relationship between the severity of pneumonia, obesity, diabetes and hypertension to the outcome."