1




Compliance with the Implementation of Health
Protocols During the COVID-19 Pandemic for
Employees in Hospitals
1
Gita Fajrianti*,
2
Dhesi Ari Astuti,
3
Destu Satya Widyaningsih
Corresponding Author:
*
[email protected]
1 Sekolah Tinggi Ilmu Kesehatan Abdi Nusa, Pangkalpinang, Indonesia
2 Universitas Aisyiyah Yogyakarta, Indonesia
3
Akademi Analis Kesehatan Manggala, Yogyakarta, Indonesia


ARTICLE INFO ABSTRACT

Article history
Received 5 October 2022
Revised 10 November 2022
Accepted 30 December 2022

RSUD Depati Hamzah (hospital) is a referral hospital for
COVID-19 patients. Efforts need to be carried out to prevent
and control COVID-19 for employees because it is
categorized as a workplace with a high risk of exposure or
high potential for close contact with people or patients who
are known or suspected to be infected with COVID-19. Non-
compliance with implementing health protocols can
potentially expand the spread of COVID-19. The purpose of
the research is to determine employees' compliance with the
implementation of health protocols during the COVID-19
pandemic at RSUD Depati Hamzah. This research is
analytical with a quantitative approach with a cross-
sectional design. This study's population was all RSUD
Depati Hamzah members, and the sample number was 94
respondents. Hospitals need to increase socialization about
the impact of COVID-19 disease. It should provide complete
facilities and infrastructure in all parts of the work that
support the implementation of employee compliance in
preventing the transmission of COVID-19, such as symbols
or signs of social distancing, posters to provide education
and remind employees and visitors of hospital junk about
COVID-19.

Keywords
Compliance
COVID-19
Hospital
Protocols

This is an open-access article under the CC–BY-SA license.



Journal of Health Sciences and Medical Development
Vol. 2, No. 01, pp. 1-6
journal.iistr.org/index.php/HESMED
DOI: 10.56741/hesmed.v2i01.166

HESMED Vol. 2, No. 01, April 2023, pp. 1-6
2 P-ISSN 2962-5769 ● E-ISSN 2962-0007
Introduction
Corona Virus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute
Respiratory Syndrome Coronavirus 2 (SARSCoV-2). SARS-CoV-2 is a new type of coronavirus
that has never been identified before in humans. WHO has designated COVID-19 as a pandemic
[1]. The increase in cases proceeded quite quickly, spreading to different countries quickly. As
of July 9, 2020, WHO reported 11,84,226 confirmed cases with 545,481 deaths worldwide
(Case Fatality Rate /CFR 4.6%). Indonesia declared its first case on March 2, 2020. Chances are
increasing and spreading rapidly throughout the territory of Indonesia. As of July 9, 2020, the
Ministry of Health reported 70,736 confirmed cases of COVID-19 with 3,417 deaths (CFR 4.8%)
(Ministry of Health RI, 2020). The Ministry of Health of the Republic of Indonesia is part of the
task force for the acceleration of handling COVID-19. It issued Ministerial Decree concerning
Health Protocols for the Community in Public Places and Facilities in the context of preventing
COVID-19 Control [2]. Health protocols, in general, must contain individual health protection:
using masks, washing hands regularly using soap and running water or using antiseptic fluids,
maintaining distance, and increasing endurance by applying the protocol.
Through various publication media, socialization of health protocols has been carried
out so that all people can comply with recommendations/ instructions, not only about health
protocols but knowledge about the symptoms, causes, prevention and statistics of COVID-19 is
also socialized [3]. But in reality, many people still need to implement health protocols, such as
not wearing masks, not keeping their distance, and not maintaining the cleanliness of wishful
thinking. Based on a survey, the percentage of compliance that have not been compliant in
avoiding crowds (34%), maintaining a minimum distance of 2 meters (36%), and reducing
mobility (36%) [4].
Non-compliance with implementing health protocols can potentially expand the spread
of COVID-19 in the community. A fight is an attitude that will appear in a person that is a
reaction to something in the rules that must be carried out. This attitude arises when the
individual is faced with a stimulus that requires an individual response [5].
The Depati Hamzah Regional General Hospital is one of the referral hospitals for
COVID-19 patients. Therefore, it is necessary to prevent and control COVID-19 for workers or
employees because it is categorized as a workplace with a high risk of exposure. Work or work
duties have a high potential for close contact with people or patients known or suspected to be
infected with COVID-19 and contact with objects and surfaces that may be contaminated by the
virus [6].
Employees confirmed with COVID-19 at The Depati Hamzah Regional Hospital in 2020
totalled 26 people consisting of 8 men and 18 women. In 2021 there were 157 people

HESMED Vol. 2, No. 01, April 2023, pp. 1-6
Compliance with the Implementation of Health Protocols During the COVID-19 Pandemic for
Employees in Hospitals (Fajrianti, et al.)

3
comprised of 49 men and 107 women. In 2022, the period from January to May amounted to
120 people consisting of 22 men and 88 women.
Methods
The research method used in this study is a quantitative research using a Cross-
Sectional design, which is a study that studies the relationship between the risk factors and the
effect factor. The observations were applied at once at the same time. This research was
conducted at the Regional General Hospital Depati Hamzah. The variables were independent
knowledge and attitudes of employee compliance with the implementation of health protocols.
The population in this study was all employees at the Depati Hamzah Regional General Hospital.
The total sample was 94 respondents. Statistical descriptive analysis was used in this study.
Results
Fig. 1 shows the level of adherence to the protocols. Respondents tend to comply with
protocols during a pandemic (84%).

Fig. 1. Compliance distribution amog respondens
Fig. 2 shows the level of knowledge and attitudes of respondents regarding the protocol
showing respondents' sound knowledge and attitude towards health protocols. This result is
in line with the results in Fig. 1.

Fig. 2. Distribution of Knowledge and Attitude of Respondents
84%
16%
ObedientDisobedient
62
28
4
51
43
0
0
10
20
30
40
50
60
70
Upper satisfied Satisfied Not satisfied
Percentage
Knowledge Attitude

HESMED Vol. 2, No. 01, April 2023, pp. 1-6
4 P-ISSN 2962-5769 ● E-ISSN 2962-0007
Discussion
A. The Relationship between Knowledge and Compliance with Health Protocol
Implementation
The statistical test results obtained a value ρ= 0.522 where ρ > 0.05. It means that Ho
received it. There is no significant relationship between knowledge and employee compliance
in implementing health protocols. Knowledge is the result of "knowing, " which happens after
people have sensed a particular object [7]. This sensing occurs through the five human senses.
Knowledge or cognition is a binding domain for forming a person's actions [8]. Behaviours
based on knowledge will be more lasting than behaviours not based on knowledge.
Knowledge and compliance with the implementation of health protocols are separate
during the COVID-19 pandemic at RSUD Depati Hamzah. Based on the results of research by
employees who have good knowledge of 54 (87.1%) with obedient compliance, more excellent
when compared to respondents who are well-informed about those who do not comply. Based
on the results of interviews, respondents have excellent knowledge about COVID-19. It can be
seen from the assessment results from discussions related to knowing, learning and
understanding all aspects of COVID-19, including its signs and symptoms, causes, originators
and management. Therefore knowledge affects decisions. With expertise, a person has a basis
for making choices. The educational background of the respondents also strengthens it. The
majority are graduate-level with good knowledge and quickly receive information. Then from
the occupational safety health installation section, the hospital has provided socialization
about the prevention and control of COVID-19 to increase the insight and knowledge of
respondents. This finding is supported by other research results concerning the knowledge [9].
This study aimed to determine community compliance in implementing health protocols in
their daily routines. Ref. [10] also reported the same finding about the knowledge influence on
the decision to implement the protocols in another issue.
B. The Relationship between Attitudes and Compliance with Health Protocol
Implementation
The statistical test results obtained ρ = 0.441 where ρ > 0.05. It means that Ho received it.
There is no significant relationship between attitudes and employee compliance in
implementing health protocols. An attitude is a still-closed reaction or response of a person to
a stimulus or object. That attitude cannot be directly seen but can only be interpreted in
advance from closed behaviour. The attitude manifestly shows the connotation of the
appropriateness of a reaction to a particular stimulus that, in everyday life, is a reaction of an
emotional nature to social motivation. Attitude is not yet an action or activity but is a
predisposition to the act of behaviour. Other research on attitude and compliance with the

HESMED Vol. 2, No. 01, April 2023, pp. 1-6
Compliance with the Implementation of Health Protocols During the COVID-19 Pandemic for
Employees in Hospitals (Fajrianti, et al.)

5
protocol explained this situation [11]. Nurses play an essential role in reducing infection
among home healthcare patients by complying with infection control procedures.
There is no relationship directly between attitudes and employee compliance with the
implementation of health protocols during the COVID-19 pandemic due to the large number of
employees who behave well 41 (80.4%) with obedient submission. This finding was more
significant than those who act well but do not comply. It can be assumed that employees behave
well because they can accept, respond, and respect themselves and others in preventing
COVID-19 and implementing health protocols. It can be proven by the high level of compliance,
84%. The positive attitude of the respondents is also related to motivation and way of thinking,
which is based on the understanding gained from good knowledge so that it can influence the
respondent. Based on the results of interviews with several respondents, there were concerns
from employees who were afraid of contracting it if they found friends or other employees who
had symptoms of COVID-19 and reported to the homework safety department for screening
efforts for those who were in close contact. So that the employee already has an excellent
attitude to comply to prevent transmission. The issue of protocol compliance is essential in
many areas. Ref. [11] discussed this issue in home healthcare concerning the nurse's
knowledge and attitude. Ref [12] studied the many factors related to protocol compliance
based on socio-demographic disparities. In the future, there are many possibilities to handle
the pandemic using technology [13]. But, the hospital staff or employees still have a crucial
impact on the success of the health protocol implementation [14].
Conclusion
Based on the study results, it was concluded that there was no relationship between
knowledge and attitudes with compliance with the implementation of health protocols during
the COVID-19 pandemic in employees at the hospital. The next study should focus on the
critical factors infulencing the implementing health protocols. Other discussion should find the
knowledge and attitude to the motivation on implementing a particular policy.
Conflict of Interest
The authors declare that there is no conflict of interest.
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Authors
Gita Fajrianti was born in Krui Lampung Barat. Undergraduate education in the field of
Public Health graduated from STIK Bina Husada Palembang. Master's degree in the field of
K3 Promotion from Diponegoro University. Currently, she is a lecturer at STIKES Abdi Nusa
Pangkalpinang. Her position is as Vice Chair I for Academic Affairs at the same institution.
In addition, she serves as a Regional Administrator at the Indonesian Occupational Health
Experts Association, a Regional Administrator of the Indonesian Association of Public
Health Experts, and a member of the Provincial Education Council of Bangka Belitung.
(email: [email protected]).

Dhesi Ari Astuti is an educator and lecturer of Universitas Aisyiyah Yogyakarta. Her
doctorate degree is from Universitas Gadjah Mada. He has expertise in midwive in the digital
era. She has published her idea in many international journal. She is also a member of the
Indonesian Institute of Science and Technology Research. (email: [email protected]).




Destu Satya Widyaningsih is a lecturer of Medical Laboratory Technology Study
Program, Akademi Analis Kesehatan Manggala Yogyakarta, Indonesia. Her scientific field
is Public Health Sciences. Her current position is the Head of the Research and Community
Service Unit at her campus. She actively publishes her works in national journals and
participates in seminars. (email: [email protected]).