Analysis of Personal Protective Equipment in The Pandemic Period of Covid-19 on Medical Recording and Health Information Officers

ABSTRACT


INTRODUCTION
More than 117 million cases of covid-19 were reported worldwide (Yeh & Tung, 2021), resulting in more than 2.6 million deaths (Hansen et al., 2021).Data from the Centers for Disease Control and Prevention (CDC) states that at least 64,479 health workers in America were infected covid-19 and 309 deaths due to Covid-19 (Podboy et al., 2020).In Italy, 10% of medical personnel are affected by the total number of patients infected with the coronavirus (Felice et al., 2020).In addition, Spain recorded at 22% of the cases in medical personnel (Suárez-García et al., 2020), and in Malaysia, there were 5.8% of positive cases in health workers (Hashim et al., 2021).In Indonesia, 647 medical and health workers who have died from being infected with covid-19 (Pramana et al., 2021).
Covid-19 is spread from person to person transmission of the virus through direct contact (Cho et al., 2020;Hu et al., 2020;Opel et al., 2021), and the splashing of infectious droplets onto the mucosal layer is the primary method of transmission (Park, 2020;Sosnowski, 2021).Control of droplet transmission hazards in health services requires comprehensive control activities, including technical control, administrative control, and using Personal Protective Equipment (PPE) (Conly et al., 2020;Melo et al., 2021;J. Wong et al., 2020).
Personal protective equipment (PPE) is a tool to protect workers from injuries or diseases from chemical, biological, radiation, physical, electrical, and other hazardous contacts (Javed et al., 2022;Nill, 2019;Onyango, 2022).To stop the transmission of covid-19 by using personal protective equipment,

Analysis of Personal Protective Equipment in The Pandemic Period of Covid-19 on Medical Recording
and Health Information Officers (Nurcahyati, S., Sri Tanti Rahmayani, S., T., Amaliah, L., Jayanti, K., D. & Handayani, S.) using PPE is very important to reduce the risk of contracting covid-19 (Aloweni et al., 2022;Chaka et al., 2022).Deaths due to covid-19 can be prevented with the proper use of PPE, especially by wearing masks, face shields, gowns, and gloves.The use of PPE is the lowest level of control because it is difficult to obtain when its use is massive, it is often not the right choice, and how to use it is uncomfortable, so it requires supervision of compliance and the accuracy of use.
The transmission of covid-19 occurs between officers where they do not have signs and symptoms from repeated meetings in closed rooms.The use of complete PPE will certainly greatly disrupt the process and method of working, including when the availability of PPE is increasingly difficult during a pandemic.This study aimed to determine the factors that influence the use of personal protective equipment during the pandemic by medical record officer.

METHOD
This research is an analytic observational quantitative with a cross sectional study design (Amaliah et al., 2022).In this study, respondents were all medical record officers in Kuningan Regency, Indonesia, which 56 respondents.They were interviewed about their knowledge, attitudes, availability of PPE and tenure of work.Observation using a checklist to the used and compliance in using PPE.
The analysis was carried out using the chi-square test and logistic regression to find the determinants of the factors that influence the use of PPE during the pandemic of medical record officers in Kuningan Regency, Indonesia.

Demographic characteristics of participants
Based on the results of data collection regarding demographic characteristics, details can be seen in table 1 as follow: Based on the table 1, it can be seen that the most age characteristics are at the age of 26-30 years, which is 29 people (51.8%).For the gender the most were male as many as 42 people (75%).More working period > 5 years as many as 35 people (62.5%).The most educated people were diploma III as many as 46 people (82.1%).

Bivariate Analisys
Based on the results of the bivariate analysis, it was found that the variables associated with the use of PPE were knowledge (pvalue = 0.017), attitude (pvalue = 0.01), PPE availability (pvalue = 0.014).While the variable not related to the use of PPE was years of service (p-value = 0.730).Detail can be seen in table 2  Knowledge concludes that there is a significant relationship between knowledge and the use of PPE with p-value = 0.019 with OR = 8.878 (CI = 1.710-46.101),which means that respondents who have good knowledge have a potential of 8.878 times greater to use PPE Attitude is also a determinant factor related to the use of PPE with pvalue = <0.001with OR = 22.529 ) which means that respondents who have good attitudes have 22.529 times greater potential to use PPE compared to respondents who have sufficient attitudes.
The availability of PPE does not have a significant relationship with the use of PPE, this is indicated by the p-value = 0.203 with a OR value = 2.624, which means that respondents who do not have the availability of PPE are 2.624 times more likely to not use PPE compared to respondents whose instances have the availability of PPE.

Education
A higher level of knowledge about PPE is expected to have behavior when using PPE (Hassan et al., 2022).The high level of respondents' knowledge about PPE is in line with the behavior of using PPE, which shows that the respondent knows that apart from knowing also applies it in their daily work.The domain of knowledge starts from knowing the domain application (Grant & Baden-Fuller, 2004), the domain knowing only about the principles of PPE but not necessarily applying it to work (De Camargo, 2022;Istriningsih et al., 2022).Besides that, behavior is influenced not only by knowledge (predisposing factors) but also by supporting factors and driving factors.
Supporting factors include the availability of PPE equipment at the place of practice can influence the behavior of using PPE among respondents (Tamene et al., 2022).Driving factors influencing the behavior of using PPE on respondents include human resources who interact directly with respondents.In this study, the supervisors of medical record officers and other health workers, such as nurses, can supervise the use of respondents' PPE.

Attitude
The majority of respondents have a positive attitude toward the use of PPE.With this positive attitude, using personal protective equipment will be good in the future.However, the attitude of good results is not necessarily accompanied by good results because the attitude is not an action or activity.However, attitude is a predisposition to the action of behavior.
Attitude contains three components, including the cognitive component, namely components related to knowledge, views, beliefs, perceptions or opinions and beliefs (Hidayat & Perdana, 2021;Klop & Severiens, 2007).The affective component is a component related to feeling happy or unhappy with

Table 2 .
Bivariate AnalysisMultivariateBased on the results of research using logistic regression analysis, it is known that knowledge and attitude are determinant factors related to the use of Personal Protective Equipment at medical record officers in Kuningan Regency.Detail can be seen in table 3 as follow: