Effectiveness of a Comprehensive Education Model for Compliance with Handwashing and Use of Personal Protective Equipment to Prevent Corona Virus Disease (Covid-19) Transmission to Nurses in Bali

Health workers are at high risk of being infected by occupational diseases which can threaten their safety. Coronavirus Desease (Covid-19) which has become a pandemic since it was discovered at the end of 2019 also occurred among health workers due to direct or indirect contact with positive confirmed patients. Data on health workers in Indonesia, especially nurses who have confirmed positive Covid-19 including 24 nurses in Depok, a nurse in Mojokerto, and a nurse in Bali (Detik, 2020; Nusa Bali, 2020). In addition, two nurses in Denpasar were assigned as patients under surveillance (PDP) due to having a history of supervising PDP in the hospital. This figure is expected to continue to increase along with the development of Covid-19 disease (Seconds, 2020). Covid-19 can be transmitted from human to human through the splash of droplets that are released when someone coughs or sneezes. The people who are most at risk of contracting this disease are people who are in close contact with Covid-19 patients, including those who treat COVID-19 patients. The standard recommendations for preventing the spread of infection are through regular hand washing with soap and clean water, applying an ethical cough and sneezing, and avoiding close contact with anyone who shows symptoms of respiratory illnesses such as coughing and sneezing. In addition, the Prevention and Control of Infection (PPI) while in a health facility is very important to be implemented (Ministry of Health Republic of Indonesia, 2020). Based on this, an effort is needed to increase nurses' compliance in washing their hands and using personal protective equipment (PPE) in accordance with procedures. Based on the study of several theories of behavior change, the factors that influence compliance are not only from individual factors of nurses but also external factors in this case the work environment of nurses. The comprehensive health education model is a program designed to change nurses' behavior towards a better, in this case increasing compliance with washing hands and using PPE to prevent Covid-19 transmission among nurses. using the Preceede-Proceed Model (PPM) by Green et al in the 1970s (Crosby & Noar, 2011; Green & Kreuter, 2005).