Main Article Content
The pandemic has placed health-care workers (HCW) under an unprecedented strain where surgeries are being delayed and health care workers’ deaths because of COVID-19 are prominent and causing staff shortages. An effective, fast, and concise approach to preoperative screening is very much needed. Hospitals are suggested to develop their own algorithm to minimize delays and complications. The objective of this study was to optimize HCW safety by developing a working system based on the hospital’s service capability in treating orthopedic surgeries.
A retrospective study was conducted involving 305 HCW. Data were collected on the application of a novel elective and emergency orthopedic surgery clinical pathway and scoring method based on questionnaires, and laboratory and radiographic chest examinations for several months to ensure the safety of HCW. HCW COVID-19 status was routinely checked as the indicator of HCW’s safety.
Mean age of all patients was 47.0 ± 22.41 years. The screening process was done in a series of questionnaires and laboratory examinations, with the majority of patients (82 or 35.9%) having a score of 0. Patients with a score of 3 or more and testing positive for COVID-19 were immediately referred to a hospital having adequate facilities to prevent delays. There were 51 patients (16.7%) with positive rapid test results, and 21 patients (6.8%) with positive PCR tests. There were 4 (1.3%) COVID-19 positive HCW.
Despite COVID-19 being a new threat, we have shown that developing an effective perioperative clinical pathway could eventually optimize healthcare worker safety.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.The journal allow the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
Mi B, Chen L, Xiong Y, Xue H, Zhou W. Liu G. Characteristics and early prognosis of COVID-19 infection in fracture patients. J Bone Joint Surg Am 2020;102:750-8. doi: 10.2106/JBJS.20.00390.
Meng Y, Leng K, Shan L, et al. A clinical pathway for pre-operative screening of COVID-19 and its influence on clinical outcome in patients with traumatic fractures. Int Orthop 2020; 44:1549-55. doi:10.1007/s00264-020-04645-3.
Black JR, Bailey C, Przewrocka J, et al. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet 2020; 395:1418-20. doi: 10.1016/S0140-6736(20)30917-X.
World Health Organization Indonesia. Coronavirus Disease 2019 (COVID-19) Situation Report-13. Jakarta: World Health Organization Indonesia;2020.
Wong JS, Cheung KM. Impact of COVID-19 on orthopaedic and trauma service: an epidemiological study. JBJS 2020;102:e80. doi: 10.2106/JBJS.20.00775.
Geng Ramos G, Cronin JA, Heitmiller E, et al. Implementation and expansion of a preoperative COVID 19 testing process for pediatric surgical patients. Pediatr Anesth 2020;30:952-3. doi: 10.1111/pan.13963.
Vieceli T, Oliveira Filho CM, Berger M, et al. A predictive score for COVID-19 diagnosis using clinical, laboratory and chest image data. Braz J Infect Dis 2020;24:343-8. doi: 10.1016/j.bjid.2020. 06.009.
Song CY, Xu J, He JQ, Lu YQ. COVID-19 early warning score: a multi-parameter screening tool to identify highly suspected patients. MedRxiv 2020. doi: https://doi.org/10.1101/2020.03.05. 20031906.
Tang G, Chan AK. Perioperative management of suspected/confirmed cases of COVID-19. Anaesth Tutor Week 2020;19:1-3.
Arif SK, Muchtar F, editors. Manajemen perioperatif pasien Covid-19. Makassar: Perhimpunan Dokter Anestesiologi dan Terapi Intensif Indonesia (PERDATIN);2020.
Senapathi TG, Ryalino C, Wiryana M, et al. Perioperative safety during Covid-19 pandemic: a review article. Bali J Anesth 2020;4:8. doi: 0.4103/BJOA.BJOA_83_20.
Forrester JD, Nassar AK, Maggio PM, Hawn MT. Precautions for operating room team members during the COVID-19 pandemic. J Am Coll Surg 2020;230:1098-101. doi: 10.1016/j.jamcollsurg. 2020.03.030.
Parvizi J, Gehrke T, Krueger CA, et al. Resuming elective orthopaedic surgery during the COVID-19 pandemic: guidelines developed by the International Consensus Group (ICM). J Bone Joint Surg Am 2020;102:1205-12. doi: 10.2106/JBJS.20.00844.
Perrone G, Giuffrida M, Bellini V, et al. Operating room setup: how to improve health care professionals safety during pandemic COVID-19-a quality improvement study. J Laparoendoscopic Advanced Surgical Techniques 2021;31:85-9. doi: 10.1089/lap.2020.0592.
Manoochehry S, Saboori F, Faraji M, et al. Coronavirus disease 2019: a revolution in biological triage in the emergency setting. Univ Med 2020;39:212-23. doi: 10.18051/UnivMed.2020. v39.212-223.
Hidayat R, Aini N, Ilmi AF, Azzahroh F, Giantini A. Test, trace, and treatment strategy to control COVID-19 infection among hospital staff in a COVID-19 referral hospital in Indonesia. Acta Med Indones 2020;52:206-13.
Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. The Lancet Global Health 2020;8:e790-8. doi: 10.1016/S2214-109X(20)30214-X.
Alnur RD, Veruswati M, Asyary A. Has it done properly? The difference between before and after social distancing’s policy implementation in controlling Covid-19 in Jakarta, Indonesia. InE3S Web of Conferences 2020;202:12031. doi: e3sconf/202020212031.
Windarwati HD, Ati NA, Paraswati MD, et al. Stressor, coping mechanism, and motivation among health care workers in dealing with stress due to the COVID-19 pandemic in Indonesia. Asian J Psychiat 2021;56:102470.j.ajp.2020. 102470.
Yusuf E. Primary health care for all: lessons from its failure to achieve its goal and COVID-19. Univ Med 2021;40:1-2. doi: 10.18051/UnivMed.2021. v40.1-2.