The understanding of using universal precaution in medical student , ca-assistant and resident in the Faculty of Medicine , Universitas Udayana , Bali-Indonesia

1Faculty of Medicine, Universitas Udayana, Denpasar, BaliIndonesia 2Neurosurgery Department, Faculty of Medicine, Universitas UdayanaSanglah General Hospital, Denpasar, BaliIndonesia 3Oncology Surgery Division, Faculty of Medicine, Universitas UdayanaSanglah General Hospital, Denpasar, BaliIndonesia 4Digestive Surgery Division, Faculty of Medicine, Universitas UdayanaSanglah General Hospital, Denpasar, BaliIndonesia Volume No.: 11


INTRODUCTION
Universal precautions is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens, (Bloodborne Pathogens Standard 29 CFR 1910.1030(b) definitions). Universal precaution for operating room is an approach for operating team and patient to prevent spread of infectious diseases from patient to operating team or vice versa. 1 The operation room environment is charged with multiple inherent risks. So, the team in the operation room and the patient brought for surgical treatment may come across various unwanted incident. Inadequate safety measures thus can result in multiple negative effects. Constant vigilance, awareness with timely intervention, maintenance of a specific operative procedure, and an educated team culture can make the operation room environment a safe haven for the patient as well as for the operating team. 2 Exposure to bloodborne pathogens poses a serious occupational threat to health care workers. Surgical personnel are at high risk of infection from bloodborne pathogens, especially from percutaneous injuries and also from blood and body splashes during surgery. To improve safety and to reduce the risk of occupational transmission of diseases, the Centers for Disease Control and Prevention (CDC) recommended Universal Precautions in 1987. Barrier precautions also protect against other potentially harmful pathogens. 3 So the standard operative procedure for operating room etiquette is to be followed precisely to minimise the risk of random inappropriate practice. Well-designed plans and staff education will prepare the health care personnel to reduce the probability of unwanted incidents and permit safe, efficient, effective, and high standards of care to all patients at all times thus controlling unwanted incident in operating room. 4

METHOD
The study design that's chosen for this particular topic is cross sectional design. The survey would be conducted at 7th semester on given duration. The period of this survey would be for two weeks to

The understanding of using universal precaution in medical student, ca-assistant and resident in the Faculty of Medicine, Universitas Udayana, Bali-Indonesia
Tham Hong Yuan, 1* I Wayan Niryana, 2 Putu Anda Tusta Adiputra, 3 Made Agus Dwianthara Sueta 4 Published by DiscoverSys | Intisari Sains Medis 2020; 11(2): 759-762 | doi: 10.15562/ism.v11i2.688 three weeks. The survey will be given out to a group of random students in Udayana (medical student batch 2015), a group of random Co-Ass, and residents in Sanglah General Hospital. The questionnaire will be distributed at 3 different groups of health caregivers (medical student, Co-Ass, resident) with 30 people per group of sample. For a grand total of 90 people.

RESULT AND DISCUSSION
The understanding of eye protection, respiratory protection, body protection, foot protection, hand protection, donning and doffing are categories as poor, fair, average, good and excellent. Findings on understanding of personal protective equipment among medical students shows, within eye protection most of the medical students within average understanding (40%), then from the use of respiratory protection found mostly in the good range 43.3%, the use of body protection within good categories 53.3%, understanding of foot protection more in the good category 46.7%, use of hand protection within good condition 50%, then donning and doffing of personal protective equipment were within the average category 60% (Table 1).
Findings on understanding of personal protective equipment among Co-Assistant shows, within eye protection most within fair understanding (40%), then from the use of respiratory protection found mostly in the good range 43.3%, the use of body protection within good categories 53.3%, understanding of foot protection more in the good category 40%, use of hand protection within good condition 56.7%, then donning and doffing of personal protective equipment were within the average category 46.7% (Table 2).
Findings on understanding of personal protective equipment among residents shows, within eye protection most within average understanding (70%), then from the use of respiratory protection found mostly in the good range 70%, the use of body protection within good categories 70%, understanding of foot protection more in the good category 70%, use of hand protection within good category 73.3%, then donning within good category 73.3% and doffing of personal protective equipment were within the good category 73.3% (Table 3).
In contrast of genders, there is no significant difference in the understanding of universal equipment. The Laverne's test of.385 indicates that we should assume equal variances. The t-test significance is 0.033, so there does not appear to be a difference in means. Thus, further studies are needed to explore the relationship between universal precaution level of education among healthcare workers. The understanding of PPE among medical students, Co-Ass, resident significantly differ in the understanding of PPE (p<0.001). Resident is significantly different (p<0.001) than the other two groups, but there is no significant difference between the Co-Ass and Medical students (Table 4).
Research by John et al, 5 shows from surveillance conducted on residents and attending physicians found that only 22 residents (32%) and 17 people (55%) attended psychians who did donning and doffing correctly. Of course this becomes a surprising fact that the use of PPE actually can not be fully implemented by health practitioners. Besides that, in the study the training on the use of PPE was only obtained at the time of residency in 3% of the sample which meant that there were only a few public lectures about PPE in medical school.