Optimalisasi Manajemen Alat Pelindung Diri dan Pelayanan Farmasi Klinis selama Pandemi COVID-19: Narrative Review

https://doi.org/10.22146/jmpf.71090

Kartika Citra Dewi Permata Sari(1), Nadia Farhanah Syafhan(2*), Imanuel Sianipar(3)

(1) Department of Clinical Pharmacy and Social Pharmacy, Faculty of Pharmacy, Universitas Indonesia
(2) Department of Clinical Pharmacy and Social Pharmacy, Faculty of Pharmacy, Universitas Indonesia
(3) Instalasi Farmasi RSUPN Dr. Cipto Mangunkusumo
(*) Corresponding Author

Abstract


Personal protective equipment (PPE) usage in health services plays an essential role in ensuring healthcare workers’ (HCW) and patients’ safety, especially during COVID-19 pandemic. On the other hand, the diversity of PPE types in the market, limited hospital budget and supplies, required PPE must be rationally managed. Pharmacists as supply managers and clinical care providers must implement PPE management optimization strategies to ensure PPE’s availability and avoid negative impacts such as increasing health service’s costs or PPE waste. This article aims to provide evidence-based strategies for PPE management in hospitals based on managing supply stages and clinical pharmacy services. The article was prepared using narrative literature review method from Google Scholar, ScienceDirect, and SpringerLink databases. Articles with topics related to PPE management; alternative uses of PPE, selection, planning, distribution, reuse, and clinical pharmacy services during the COVID-19 pandemic were included in this study. Based on the search, 30 articles and 13 policy guidelines were obtained which were included in this literature review. Management strategies included identifying and cohort supply need based on transmission risk, selecting PPE’s type, forecasting with calculation tools, avoiding just-in-time procurement, centrally distributed, and potential reuse. Clinical pharmacy services modification to minimize PPE use was also an optimizing strategy. For its implementation, pharmacists need to collaborate with other professionals in the hospital because it enhances success with a comprehensive approach. The recommended strategies are expected to assist the management of PPE in Indonesian hospitals, but its application must be tailored for each hospital.

Keywords


alat pelindung diri; apoteker; COVID; pelayanan farmasi klinis; rumah sakit

Full Text:

PDF


References

  1. Cook TM. Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic – a narrative review. Anaesthesia. 2020;75(7):920-927. doi:10.1111/anae.15071
  2. Wang X, Abdelrahman Z, Li M. Comparative Review of SARS-CoV-2, SARS-CoV, MERS-CoV, and Influenza A Respiratory Viruses. Front Immunol. 2019;11(552909). doi:10.3389/fimmu.2020.552909
  3. World Health Organization. Rational Use of Personal Protective Equipment for Coronavirus Disease 2019 (COVID-19): Interim Guidance.; 2020. Accessed March 5, 2021. https://www.who.int/csr/resources/publications/putontakeoff
  4. Yuniarti E. Strategi Mitigasi Pada Kondisi Kekurangan Alat Pelindung Diri Di Tengah Pandemi COVID-19. Fakultas Farmasi UGM. Published 2020. Accessed March 5, 2021. https://farmasi.ugm.ac.id/id/strategi-mitigasi-pada-kondisi-kekurangan-alat-pelindung-diri-di-tengah-pandemi-covid-19/
  5. Dai T, Zaman MH, Padula W V., Davidson PM. Supply chain failures amid Covid-19 signal a new pillar for global health preparedness. J Clin Nurs. 2021;30(1-2):e1-e3. doi:10.1111/jocn.15400
  6. Rowan NJ, Laffey JG. Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic – Implications for efficacy, re-use and sustainable waste management. Sci Total Environ. 2021;752(142259). doi:10.1016/j.scitotenv.2020.142259
  7. Maxwell DN, Perl TM, Cutrell JB. “the Art of War” in the Era of Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2020;71(16):2215-2217. doi:10.1093/cid/ciaa229
  8. The Lancet Microbe. COVID-19 vaccines: the pandemic will not end overnight. The Lancet Microbe. 2021;2(1):e1. doi:10.1016/S2666-5247(20)30226-3
  9. Agarwal R, Gopinath G. A Proposal to End The COVID-19 Pandemic. International Monetary Fund; 2021. doi:https://doi.org/10.5089/9781513577609.006
  10. Dai T, Bai G, Anderson GF. PPE Supply Chain Needs Data Transparency and Stress Testing. J Gen Intern Med. 2020;35(9):2748-2749. doi:10.1007/s11606-020-05987-9
  11. World Health Organization. Rational Use of Personal Protective Equipment for COVID-19 and Considerations during Severe Shortages: Interim Guidance 23 December 2020.; 2020.
  12. Cohen J, Van Der Y, Rodgers M. Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Published online 2020. doi:10.1016/j.ypmed.2020.106263
  13. Prihartanto. Perkiraan Timbulan Limbah Medis Bahan Berbahaya dan Beracun (B3) dari Rumah Sakit Penanganan Pasien COVID-19. J Sains dan Teknol Mitigasi Bencana. 2020;15(1):12-18.
  14. Kementerian Kesehatan RI. KEMENKES AJAK K / L BERSINERGI DALAM AKSELERASI PENANGANAN LIMBAH MEDIS. Berita dan Informasi. Published 2020. https://www.kemkes.go.id/article/view/20111500006/kemenkes-ajak-k-l-bersinergi-dalam-akselerasi-penanganan-limbah-medis.html
  15. Behera BC. Challenges in handling COVID-19 waste and its management mechanism: A Review. Environ Nanotechnology, Monit Manag. 2021;15(100432). doi:10.1016/j.enmm.2021.100432
  16. Wardani RA, Azizah R. Management of Solid Medical Waste on One of the Covid19 Referral Hospitals in Surabaya, East Java. J Kesehat Lingkung. 2020;12(1):38-44. doi:10.20473/jkl.v12i1si.2020.38-44
  17. Prasetiawan T. Permasalahan Limbah Medis COVID-19 Indonesia.pdf. Info Singkat-Kajian Singk Terhadap Isu Aktual dan Strateg. 2020;XII(No. 9/Puslit/Mei/2020):13-18.
  18. Hu B, Guo H, Zhuo P, Shi Z-L. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19:141-159. doi:https://doi.org/10.1038/ s41579-020-00459-7
  19. Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control. J Clin Med. 2020;9(4):1225. doi:10.3390/jcm9041225
  20. World Health Organization. An Update on SARS-CoV-2 Virus Mutations & Variants.; 2021. https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update47-sars-cov-2-variants.pdf?sfvrsn=f2180835_4
  21. Centers for Disease Control and Prevention. SARS-CoV-2 Variant Classifications and Definitions. CDC. Published 2021. Accessed March 26, 2021. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html#print
  22. Centers for Disease Control and Prevention. Science Brief: SARS-CoV-2 and Potential Airborne Transmission | CDC. COVID-19. Published 2020. Accessed March 9, 2021. https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html
  23. Chua MH, Cheng W, Goh SS, et al. Face Masks in the New COVID-19 Normal : Materials , Testing , and Perspectives. Res (Wash D C). 2020;Aug 7(2020):7286735. doi:10.34133/2020/7286735
  24. World Health Organization. Infection Prevention and Control of Epidemic-and Pandemic-Prone Acute Respiratory Infections in Health Care WHO Guidelines. (Conly J, Eremin S, Seto WH, Pessoa-Silva CL, eds.). World Health Organization; 2014. www.who.int/about/licensing/copyright_form/en/index.html
  25. Centers for Disease Control and Prevention. Scientific Brief: SARS-CoV-2 Transmission | CDC. COVID-19. Published 2021. Accessed September 6, 2021. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html#print
  26. Peraturan Menteri Kesehatan RI No. 72 Tahun 2016 Tentang Standar Pelayanan Kefarmasian Di Rumah Sakit. Kementerian Kesehatan RI; 2016.
  27. Thong KS, Selvaratanam M, Tan CP, et al. Pharmacy preparedness in handling COVID-19 pandemic: a sharing experience from a Malaysian tertiary hospital. J Pharm Policy Pract. 2021;14(1):1-4. doi:10.1186/s40545-021-00343-6
  28. Centers for Disease Control and Prevention. Guidance for The Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings.; 2020. https://www.cdc.gov/hai/pdfs/ppe/ppeslides6-29-04.pdf
  29. Kementerian Kesehatan RI. Aplikasi Info Alat Kesehatan dan PKRT. Published 2021. Accessed March 5, 2021. http://infoalkes.kemkes.go.id/
  30. Direktorat Jenderal Kefarmasian dan Alat Kesehatan. Standar Alat Pelindung Diri (APD) Dalam Manajemen Penanganan COVID-19. Kementerian Kesehatan RI; 2020. https://farmalkes.kemkes.go.id/unduh/standar-alat-pelindung-diri-apd-dalam-manajemen-penanganan-covid-19/
  31. Gugus Tugas Percepatan Penanganan Covid-19. Standar Alat Pelindung Diri (APD) Untuk Penanganan Covid-19 Di Indonesia Revisi 3. Vol Revisi 3.; 2020.
  32. Park SH. Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic. Infect Chemother. 2020;52(2):165-182. doi:10.3947/ic.2020.52.2.165
  33. Binkley CE, Kemp DS. Ethical Rationing of Personal Protective Equipment to Minimize Moral Residue During the COVID-19 Pandemic. J Am Coll Surg. 2020;230(6):1111-1113. doi:10.1016/j.jamcollsurg.2020.03.031
  34. Forouzandeh P, O’Dowd K, Pillai SC. Face masks and respirators in the fight against the COVID-19 pandemic: An overview of the standards and testing methods. Saf Sci. 2021;133(September 2020):104995. doi:10.1016/j.ssci.2020.104995
  35. Centers for Disease Control and Prevention. Use Personal Protective Equipment (PPE) When Caring for Patients with Confirmed or Suspected COVID-19 Before caring for patients with confirmed or suspected COVID-19, healthcare personnel (HCP) must: COVID-19 Personal Protective Equipment (PPE) for Health. Centers for Disease Control and Prevention. Published 2020. www.cdc.gov/coronavirus
  36. Centres for Disease Control and Prevention. COVID-19 Decontamination and Reuse of Filtering Facepiece Respirators | CDC. Optimizing PPE Supplies-CDC. Published 2020. Accessed September 8, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html
  37. Centers for Disease Control and Prevention. Counterfeit Respirators / Misrepresentation of NIOSH-Approval | NPPTL | NIOSH | CDC. CDC. Published 2021. Accessed September 8, 2021. https://www.cdc.gov/niosh/npptl/usernotices/counterfeitResp.html
  38. Howard J, Huang A, Li Z, et al. An evidence review of face masks against COVID-19. Proc Natl Acad Sci U S A. 2021;118(4):1-12. doi:10.1073/pnas.2014564118
  39. Yoon C, Go S, Park J. Comparisons of Certification Standards for Mask and Review on Filtration Efficiency for Viruses. J Korean Soc Occup Environ Hyg. 2020;30(2):109-123. doi:https://doi.org/10.15269/JKSOEH.2020.30.2.109
  40. Verbeek JH, Rajamaki B, Ijaz S, et al. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane database Syst Rev. 2020;(5):Art No: CD011621. doi:10.1002/14651858.CD011621.pub5
  41. World Health Organization. Mask Use in the Context of COVID-19-Interim Guidance 1 December 2020.; 2020. https://www.ashrae.org/technical-resources/resources%0Ahttps://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
  42. Sickbert-Bennett EE, Samet JM, Clapp PW, et al. Filtration Efficiency of Hospital Face Mask Alternatives Available for Use during the COVID-19 Pandemic. JAMA Intern Med. 2020;180(12):1607-1612. doi:10.1001/jamainternmed.2020.4221
  43. Ha JF. The COVID-19 pandemic, personal protective equipment and respirator: A narrative review. Int J Clin Pract. 2020;74(10):1-9. doi:10.1111/ijcp.13578
  44. Torjesen I. Covid-19: PPE guidance is upgraded as evidence of airborne transmission grows. BMJ. 2021;373(n1422). doi:10.1136/bmj.n1422
  45. Agius RM, MacDermott N. COVID-19 and workers’ protection: lessons to learn, and lessons overlooked. Occup Med (Chic Ill). 2021;(Editorial):1-3. doi:10.1093/occmed/kqab034
  46. Dowd KO, Nair KM, Forouzandeh P, et al. Face Masks and Respirators in the Fight Against the COVID-19 Pandemic: A Review of Current Materials, Advances and Future Perspectives. Materials (Basel). 2020;13(3363). doi:10.3390/ma13153363
  47. Jessop ZM, Dobbs TD, Ali SR, et al. Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing. Br J Surg. 2020;107(10):1262-1280. doi:10.1002/bjs.11750
  48. Centers for Disease Control and Prevention. Improve How Your Mask Protects You | CDC. COVID-19. Published 2021. Accessed September 10, 2021. https://www.cdc.gov/coronavirus/2019-ncov/your-health/effective-masks.html
  49. Huang XL, Yang JR, Sun YX, et al. Novel combined shield design for eye and face protection from COVID-19. Adv Manuf. 2021;9(1):130-135. doi:10.1007/s40436-020-00333-y
  50. Anedda J, Ferreli C, Rongioletti F, Atzori L. Changing gears: Medical gloves in the era of coronavirus disease 2019 pandemic. Clin Dermatol. 2020;38(6):734-736. doi:10.1016/j.clindermatol.2020.08.003
  51. Lum K, Johndrow J, Cardone A, et al. Forecasting PPE Consumption during a pandemic: The case of Covid-19. medRxiv. Published online August 23, 2020. doi:10.1101/2020.08.20.20178780
  52. Centers for Disease Control and Prevention. Personal Protective Equipment (PPE) Burn Rate Calculator | CDC. COVID-19. Published 2021. Accessed September 10, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html
  53. Francis JR. COVID-19: Implications for Supply Chain Management. Front Health Serv Manage. 2020;37(1):33-38. doi:10.1097/HAP.0000000000000092
  54. Alberto Gonzatto O, Nascimento DC, Russo CM, et al. Safety-Stock: Predicting the demand for supplies in Brazilian hospitals during the COVID-19 pandemic. medRxiv Prepr. Published online 2020:1-14. doi:10.1101/2020.05.27.20114330
  55. Haque M, Kumar S, Charan J, et al. Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications. Front Pharmacol. 2021;11(January):1-17. doi:10.3389/fphar.2020.582154
  56. Sharma N, Hasan Z, Velayudhan A, A EM, Mangal DK, Dutt Gupta S. Personal Protective Equipment: Challenges and Strategies to Combat COVID-19 in India: A Narrative Review. J Health Manag. 2020;22(2):157-168. doi:10.1177/0972063420935540
  57. Patel A, O’Donnell A, Bonebrake A, et al. Stewardship of personal protective equipment ( PPE ): An important pandemic resource for PPE preservation and education. Infect Control Hosp Epidemiol. 2021;42:636-637. doi:https://doi.org/10.1017/ice.2020.311
  58. Centers for Disease Control and Prevention. Summary for Healthcare Facilities: Strategies for Optimizing the Supply of PPE during Shortages | CDC. COVID-19. Published 2020. Accessed September 10, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/strategies-optimize-ppe-shortages.html
  59. Toomey EC, Conway Y, Burton C, et al. Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review. Infect Control Hosp Epidemiol. 2021;42(1):75-83. doi:10.1017/ice.2020.1243
  60. Paudyal V, Cadogan C, Fialová D, et al. Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries. Res Soc Adm Pharm. 2021;17(8):1507-1517. doi:10.1016/j.sapharm.2020.11.017
  61. Herzik KA, Bethishou L. The impact of COVID-19 on pharmacy transitions of care services. Res Soc Adm Pharm. 2021;17(1):1908-1912. doi:10.1016/j.sapharm.2020.10.017
  62. Cheong MWL. “To be or not to be in the ward”: The impact of COVID-19 on the role of hospital-based clinical pharmacists—A qualitative study. JACCP J Am Coll Clin Pharm. 2020;3(8):1458-1463. doi:10.1002/jac5.1315
  63. Yerram P, Thackray J, Modelevsky LR, et al. Outpatient clinical pharmacy practice in the face of COVID-19 at a cancer center in New York City. J Oncol Pharm Pract. 2021;27(2):389-394. doi:10.1177/1078155220987625



DOI: https://doi.org/10.22146/jmpf.71090

Article Metrics

Abstract views : 2995 | views : 2896

Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats