•  
  •  
 

Abstract

The Tuberculosis (TB) remains a significant threat, especially to healthcare workers exposed by the infected patients in hospitals. Hospital staff with latent TB are at risk of developing active TB. To mitigate this risk, enhancing hospitals through infection prevention and control (IPC) measures is essential. This study aimed to identify policies and practices related to TB prevention, particularly in a teaching hospital where healthcare workers, including medical students, need protection. The research was conducted at a teaching hospital in Depok, West Java, from January to February 2024. The research took place at a teaching hospital in Depok, West Java, from January to February 2024. A qualitative method was used, including in-depth interviews with hospital committee members, nurses, and administrative staff to gather insights, along with policy analysis regarding TB. In the Indonesian hospital TB health services, the regulation of occupational health regarding TB protection for hospital workers state from constitution law, presidential regulation, ministry of health and ministry of Manpower. However, the findings revealed that there are no policies specifically addressing TB to protect the workers in the hospital. Challenges such as financing TB screenings and raising healthcare workers' awareness of TB were highlighted as crucial factors. The study emphasizes the importance of improving risk management strategies and IPC to safeguard healthcare workers, recommending specific regulations for hospitals with national policy. These results highlight the urgent need for specific TB prevention policies, particularly from the government, to ensure implementation across all hospitals.

References

1. Miggiano R, Rizzi M, Ferraris DM. Mycobacterium tuberculosis pathogenesis, infection prevention and treatment. Vol. 9, Pathogens. MDPI; 2020. p. 385.

2. Wensel CR, Pluznick JL, Salzberg SL, Sears CL. Next-generation sequencing: insights to advance clinical investigations of the microbiome. J Clin Invest. 2022;132(7).

3. Global Tuberculosis Report 2023. World Health Organization; 2023.

4. WHO. Global tuberculosis report 2023 [Internet]. 2023. Available from: https://www.who.int/publications/i/item/9789240083851

5. Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M. Diagnosis for latent tuberculosis infection: new alternatives. Front Immunol. 2020;11:2006.

6. Williams M, Ndlebe L, ten Ham-Baloyi W, Venter D. Employees’ knowledge and practices on occupational exposure to tuberculosis at specialised tuberculosis hospitals in South Africa. Curationis. 2020;43(1):1–8.

7. Grobler L, Mehtar S, Dheda K, Adams S, Babatunde S, Van der Walt M, et al. The epidemiology of tuberculosis in health care workers in South Africa: a systematic review. BMC Health Serv Res. 2016;16(1):1–15.

8. Apriani L, McAllister S, Sharples K, Aini IN, Nurhasanah H, Ratnaningsih DF, et al. High risk of Mycobacterium tuberculosis infection among medical and nursing students in Indonesia: a 1-year prospective study. Trans R Soc Trop Med Hyg. 2022;116(1):10–8.

9. Erawati M, Andriany M. The prevalence and demographic risk factors for latent tuberculosis infection (LTBI) among healthcare workers in Semarang, Indonesia. J Multidiscip Healthc [Internet]. 2020;197–206. Available from: https://www.tandfonline.com/doi/full/10.2147/JMDH.S241972

10. Wardani HR, Mertaniasih NM, Soedarsono. Faktor yang berhubungan dengan tuberculin skin test positif pada petugas kesehatan di rumah sakit di kota Jember. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing). 2020;6(2).

11. Noviana AC, Rahmawati F, Widyaningsih I, Arimbi MR, Theodora T. Tuberkulosis Laten pada Tenaga Kesehatan di RSI Jemur Sari Surabaya. Jurnal Ilmiah Kesehatan Masyarakat: Media Komunikasi Komunitas Kesehatan Masyarakat. 2022;14(1):30–4.

12. Apriani L, McAllister S, Sharples K, Nurul Aini I, Nurhasanah H, Ruslami R, et al. Mycobacterium tuberculosis infection and disease in healthcare workers in a tertiary referral hospital in Bandung, Indonesia. J Infect Prev. 2022;23(4):155–66.

13. Wang XN, He TL, Geng MJ, Song YD, Wang JC, Liu M, et al. Prevalence of and risk factors for tuberculosis among healthcare workers in Chinese tuberculosis facilities. Infect Dis Poverty. 2018;7(1):1–11.

14. Angelia A, Doda DVD, Manampiring AE. Prevalensi Tuberkulosis Laten Dan Evaluasi Kebijakan Rumah Sakit Berdasarkan Persepsi Tenaga Kesehatan Terhadap Pencegahan Tuberkulosis. Jurnal Biomedik: JBM. 2020;12(3):192–9.

15. Constitution Act Law. Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 tentang Kesehatan. 17 year 2023 Indonesia: https://peraturan.bpk.go.id/Details/258028/uu-no-17-tahun2023; 2023.

16. Government Regulation. Peraturan Pemerintah (PP) Nomor 2 Tahun 2018 tentang Standar Pelayanan Minimal. 2 year 2018 Indonesia: https://peraturan.bpk.go.id/Details/67029/pp-no-2-tahun-2018; 2018.

17. Presidential Regulation. Peraturan Presiden (Perpres) Nomor 67 Tahun 2021 tentang Penanggulangan Tuberkulosis. 67 year 2021 Indonesia: https://peraturan.bpk.go.id/Details/174557/perpres-no-67-tahun-2021; 2021.

18. Presidential Regulation. Peraturan Presiden (Perpres) Nomor 7 Tahun 2019 tentang Penyakit Akibat Kerja. 7 year 2019 Indonesia: https://peraturan.bpk.go.id/Details/101622/perpres-no-7-tahun-2019; 2019.

19. Ministry of Health. Peraturan Menteri Kesehatan Nomor 67 Tahun 2016 tentang Penanggulangan Tuberkulosis. 67 year 2016 Indonesia: https://peraturan.bpk.go.id/Details/114486/permenkes-no-67-tahun-2016; 2016.

20. Ministry of Health. Peraturan Menteri Kesehatan Nomor 27 Tahun 2017 tentang Pedoman Pencegahan Dan Pengendalian Infeksi Di Fasilitas Pelayanan Kesehatan. 27 year 2017 Indonesia: https://peraturan.bpk.go.id/Details/112075/permenkes-no-27-tahun-2017; 2017.

21. Ministry of Health. Peraturan Menteri Kesehatan Nomor 66 Tahun 2016 tentang Keselamatan dan Kesehatan Kerja Rumah Sakit. 66 year 2016 Indonesia: https://peraturan.bpk.go.id/Details/114482/permenkes-no-66-tahun-2016; 2016.

22. Young M, Smith MA. Standards and evaluation of healthcare quality, safety, and person centered care. 2022;

23. WHO. Keep health workers safe to keep patients safe: WHO. World Health Organization [Internet]. 2020 [cited 2023 Nov 30]; Available from: https://www.who.int/news-room/detail/17-09-2020-keep-health-workers-safe-to-keep-patients-safe-who

24. Lestari F, Modjo R, Kurniawidjaja M, Susanto AD, Alfiyyah A. Analysis of Instrument Development to Evaluate Employee Protection from Tuberculosis in Hospitals. Hospitals (Lond). 2023;13(1):37–43.

25. Gagne CA, Finch WL, Myrick KJ, Davis LM. Peer workers in the behavioral and integrated health workforce: opportunities and future directions. Am J Prev Med. 2018;54(6):S258–66.

26. Nadzifah Z, Arso SP, Nandini N. Evaluasi context, input, process, product dalam pelaksanaan pencegahan dan pengendalian infeksi tuberkulosis di klinik pengobatan penyakit paru kebumen: cipp evaluation in the implementation of tuberculosis infection prevention and control in the kebumen lung disease clinic. Quality: Jurnal Kesehatan. 2023;17(2):112–24.

27. Yunita S. Pengaruh Penerapan Instrumen Ppi Snars Terhadap Kesejahteraan Psikologis Petugas Penanggulangan COVID-19. JINTAN: Jurnal Ilmu Keperawatan. 2021;1(2):91–102.

28. Putra ANP, Wahyuni ID, Rupiwardani I. Program Pencegahan Dan Pengendalian Infeksi (PPI) Di Rumah Sakit X Kabupaten Malang. Media Husada Journal Of Environmental Health Science. 2022;2(1):135–44.

29. Taufiq AR. Penerapan standar operasional prosedur (SOP) dan akuntabilitas kinerja Rumah Sakit. Profita: Komunikasi Ilmiah dan Perpajakan. 2019;12(1):56–66.

30. Oh JE, Park JY. Influencing factors on performance for standard precaution of healthcare workers of general hospital for infection control. Journal of Digital Convergence. 2018;16(4):231–49.

31. Bekele T, Ashenaf T, Ermias A, Arega Sadore A. Compliance with standard safety precautions and associated factors among health care workers in Hawassa University comprehensive, specialized hospital, Southern Ethiopia. PLoS One. 2020;15(10):e0239744.

32. Istanti ND, Djaali NA, Hanifah L. Pembinaan Duta Mutu Dalam Peningkatan Mutu dan Keselamatan Pasien Dalam Menghadapi Pandemi Covid-19 di Rumah Sakit Grha Permata Ibu. Jurnal Pemberdayaan Komunitas MH Thamrin. 2021;3(2):154–60.

33. Rosamarlina R, Mariana N, Sundari T, Setianingsih TY, Jahiroh J, Pertiwi I, et al. Screening for Latent Tuberculosis Infection using Interferon-Gamma Release Assay Test among Healthcare Workers. Education (Chula Vista). 2023;22(62):22–6.

34. Szturmowicz M, Broniarek-Samson B, Demkow U. Prevalence and risk factors for latent tuberculosis in polish healthcare workers: The comparison of tuberculin skin test and interferon-gamma release assay (IGRA) performance. Journal of Occupational Medicine and Toxicology. 2021;16:1–12.

Bahasa Abstract

Pelayanan Tuberkulosis (TB) masih menjadi ancaman, terutama bagi petugas kesehatan yang terpapar pasien di rumah sakit. Petugas dengan TB laten berisiko mengembangkan TB aktif. Untuk mengurangi risiko ini, peningkatan kualitas rumah sakit melalui upaya pencegahan dan pengendalian infeksi (PPI) sangat penting. Penelitian ini bertujuan untuk mengidentifikasi kebijakan dan praktik pencegahan TB, terutama di rumah sakit pendidikan, di mana petugas kesehatan termasuk mahasiswa yang perlu dilindungi. Penelitian dilakukan di sebuah rumah sakit universitas di Depok, Jawa Barat dari Januari hingga Februari 2024. Metode kualitatif digunakan melalui wawancara mendalam dengan anggota komite rumah sakit, perawat, dan staf administrasi terkait kebijakan dan praktiknya juga analisis dokumen tentang standar PPI di rumah sakit. Layanan kesehatan TB rumah sakit Indonesia, setidaknya regulasi nasional terkait perlindungan TB bagi pekerja rumah sakit dikeluarkan melalui undang-undang, peraturan presiden, peraturan menteri kesehatan dan peraturan menteri ketenagakerjaan. Namun, temuan dari penelitian mengungkapkan bahwa tidak ada kebijakan yang secara khusus membahas TB untuk melindungi para pekerja di rumah sakit. Adanya tantangan dalam pembiayaan pemeriksaan TB dan peningkatan kesadaran petugas kesehatan terhadap TB. Studi ini menekankan pentingnya meningkatkan strategi manajemen risiko dan pengendalian infeksi untuk melindungi petugas kesehatan, merekomendasikan peraturan khusus untuk rumah sakit berdasarkan kebijakan nasional. Hasil penelitian mengungkapkan bahwa dibutuhkan kebijakan pencegahan TB yang spesifik, khususnya dari pemerintah, untuk mewajibkan penerapan perlindungan petugas di semua rumah sakit.

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.