Correlation of Individual Perceptions with Infection Prevention Control Link Nurse (IPCLN) Performance During the Covid-19 Pandemic at Cicendo Eye Hospital

Covid-19 transmission until January 2021 reached 1,012,350 cases in 224 countries with a Case Fatality Rate in Indonesia of 33.2%. The Infection Control Prevention Program (PPI) has become essential during the COVID-19 pandemic. The objectives of PPI in COVID-19 management are strategies to help a facility prevent and reduce the impact of emergencies, evaluate prevention efforts, mitigation and response readiness, reduce infection transmission, improve the safety of staff, patients and visitors, and improve the organization's ability to deal with the COVID-19 pandemic. Infection Prevention Control Link Nurse (IPCLN) in health care facilities is the spearhead of implementing the PPI program. Cicendo Eye Hospital as one of the vertical hospitals of the Ministry of Health participates in treating COVID-19 patients with yellow criteria or with moderate symptoms. The purpose of this study was to identify the influence of individual factors, psychological factors and organizational factors on ipcln performance during the COVID-19 pandemic at Cicendo Eye Hospital. This study used a correlation research design that focused on individual factors to IPCLN's performance during the COVID-19 pandemic. The results of the research


INTRODUCTION
COVID-19 has become one of the world's health problems since January 2020 and was designated as a pandemic by the World Health Organization on March 11, 2020.On January 27, 2021, there were 100,270,602 confirmed cases of COVID-19 and 2,141,468 deaths afflicting 224 countries (WHO, 2021).In Indonesia, the Case Fatality Rate (CFR) in Indonesia is 8.13% and the Recovery Rate is 13.18% in April 2020 (Herlina J & El-Matury, 2020).The positive rate continues to increase until January 2021 it reaches 33.2% (WHO Standard < 5%) (Kemenkes RI., 2021).
PPNI on January 27, 2021 recorded 642 health workers consisting of 278 doctors and 202 nurses and 162 other health workers died due to COVID-19 (Persatuan Perawat Nasional Indonesia, 2021).The development of cases in West Java on January 27, 2021, confirmed 134,520 cases and 1638 deaths (Pikobar, 2021) Since then, the morbidity and death rate has continued to grow and has impacted the order of health care.(WHO, 2020).The impact on the health service order includes surveillance, laboratory examinations, clinical management, infection prevention and control, transmission prevention, risk communication, community empowerment and essential health services in the face of COVID-19 in all health care facilities.(RS Mata Cicendo, 2020).
Cicendo Eye Hospital as one of the vertical hospitals owned by the Ministry of Health, also implements guidelines for preventing the control of coronavirus disease (Kementrian Kesehatan RI, 2019).One of them is the implementation of COVID-19 tracing, testing, treatment, and screening for all employees (PPI RS Mata Cicendo, 2020).Cicendo Eye Hospital since January 20, 2021 has opened services for COVID-19 patients with yellow criteria (moderate symptoms) of 12 beds, and if there is a surge in cases, it can be converted to 23 beds.
The PPI (Infection Prevention and Control) unit at Cicendo Eye Hospital is the hospital's frontline in the COVID-19 pandemic.According to huang, chen, chen and wang (2020) research in Wuhan China, the PPI experience is essential in overcoming COVID-19.The PPI program will be effective when staff knowledge and education are good, adequate policies, analysis of places at risk of infection, and proper coordination across hospital units (Komisi Akreditasi Rumah Sakit, 2021).The PPI team in a hospital consists of IPCD (Infection Prevention and Control Doctor), IPCN (Infection Prevention and Control Nurse) and IPCLN (Infection Prevention and Control Linked Nurse) (Indonesia, 2017).IPCLN as a daily implementing nurse or liaison is on duty from each hospital inpatient unit or service unit.
There is 1 IPCD person, 1 IPCN person and 33 IPCLN people at Cicendo Eye Hospital.Ipcn standards at Cicendo Eye Hospital are in accordance with PMK 27 of 2017, namely IPCN which is full-time and amounts to 1 IPCN person, 1 compared to 100 beds (Kemenkes RI, 2017).IPCN acts as coordinator, while IPCLN acts as a spearhead in infection control prevention.IPCLN as the implementer of the PPI program in healthcare facilities is expected to be an "executor" to motivate all employees, patients and visitors in infection prevention and control.
IPCLN's performance during the COVID-19 pandemic includes filling out daily surveillance, conducting PPI education for officers, patients and visitors in their respective units, conducting officer compliance audits on the application of PPI, coordinating with IPCN if there are patients suspected of HAIs, and identifying possible outbreaks with IPCN coordination.Screening and 3T results during March 2020 to January 2021 obtained employees exposed to COVID-19, most of which 51 people consisted of doctors, nurses, refractions, and other support personnel.(PPI RS Mata Cicendo, 2021).
According to research by Santosaningsih et al., (2017) shows that there is an increase in hand hygiene compliance through increasing knowledge and training.Asemahagn's research (2020) which shows that most health care workers have good knowledge but the ability to prevent COVID-19 is still low.Results of literature review Astari & Susilaningsih (2021) states Infection Prevention Control (IPC) will be effective if there is good staff training and education, leadership, supervision, methods to identify and be proactive in places at risk of infection, appropriate policies and procedures and coordination to all health care facilities.IPC Management, PPE Fulfillment and IPC Surveillance are important platforms in dealing with COVID-19 (Astari & Susilaningsih, 2021).
According to Gibson, James L,. Ivancevich, John M., and Donelly Jr.James (1997) in Nursalam (2016)  According to research Simanjuntak (2011) increasing competence and work motivation is a way to improve IPCLN performance.Supervising knowledge and good skills, necessary for infection control (Lelonowati, Mustariningrum, & Koeswo, 2015).Sarifudin's research (2018), knowledge factors, supervision factors and motivational factors are the main factors that influence employee engagement in improving the performance of PPI nurses.
Research by Lelonowati et al (2015), the most dominant influential factors are work motivation and simultaneous supervision (Lelonowati, Mustariningrum, & Koeswo, 2015).According to Kopelman (1986) in Nursalam (2014)  To ensure safety and health at Cicendo Eye Hospital in the management of the COVID-19 pandemic requires a joint commitment, the ability to prevent exposure and transmission between fellow health workers and patients.Research on factors affecting IPCLN's performance in the conditions of the COVID-19 pandemic at Cicendo Eye Hospital has never been carried out.Therefore, in order to improve ipcln performance, the research team is interested in identifying the influence of factors affecting performance consisting of individual factors, psychological factors and organizational factors The results of the research in 2021 showed that almost most of the respondents, namely 24 people (70.6%) were female.Almost most of the respondents in the age range of 46 -55 years as many as 25 people (73.5%).All of the respondents in marital status were married as many as 34 people (100%).Almost most of the respondents in the last education level of S1 Nursing were 19 people (55.9%).Almost most of the respondents were in the most >20 years of service as many as 20 people (58.8%).Most of IPCLN's performance in the standard-compliant category was 61.8%, and a small percentage of respondents showed the nonstandard category at 38.2%.Almost most of the respondents in IPCLN knowledge were in the good category of 27 people (79.4 %), and a small percentage of respondents showed a category of less as many as 2 people (5.9 %).The correlation strength value is 0.682.The correlation direction obtained positive results, so it can be concluded that the higher the IPCLN knowledge, the higher the performance.The p-value of 0.000 is less than the alpha value of 0.05, so a meaningful correlation between knowledge and performance is stated.This shows that there is a correlation between knowledge and IPCLN's performance in infection prevention and control during the COVID-19 pandemic at Cicendo Eye Hospital The general purpose of this study was to identify the influence of individual perceptions on IPCLN performance during the COVID-19 pandemic at Cicendo Eye Hospital.

METHODS
This study uses a correlation research design, which is to connect free (independent) variables, namely psychological factors, organizational factors to bound variables (dependent) namely performance.
The data collection technique in this study used the questionnaire method given to IPCLN.After the respondent agreed to participate in the study, the respondent was asked for his willingness to fill out the questionnaire and return it to the data collection officer so that accurate and comprehensive data was obtained that would be analyzed for the influence of factors affecting the performance of ipcln.Data collection starts from planning, then data collection is carried out, then data analysis, after that preparation, making recommendations, and planning / monitoring are carried out.
The study sample was all IPCLN at Cicendo Eye Hospital as many as 28 people.Sampling is carried out by means of a total population.
The validity and reliability of quantitative data will be carried out using validity and reliability tests quantitatively against questionnaires that measure psychological factors, organizational factors.Questionnaires that measure psychological factors namely motivation, perception, learning and attitudes.A questionnaire that measures organizational factors namely perceptions and attitudes.In this study, for the measurement of psychological factors, namely perceptions and attitudes Perception questionnaire obtained from the study Hayati (2018) consists of 20 items of revelation regarding the perception of performance appraisal.Hayati (2018) creating a performance appraisal perception questionnaire derived from performance appraisal theory and Caring Theory: Helping-Trust Relationship, Jean Watson.The results of the validity test show that this instrument is valid because it has a CVI value of 0.98.During the CVI Process, one improvement was made in the form of a slight sentence change in questions no. 2, 15, 16, and 17.Each question in this instrument consists of 5 answer choices, namely strongly agree, agree, hesitate, disagree, and strongly disagree.If the participant answers strongly agree is worth 5, agreeing is worth 4, doubt is worth 3, disagree is worth 2, and strongly disagree is worth 1.The nurse's answer results will be divided into 5 classes, namely 20-35 categorized as very negative, 36-51 negative, 52-68 hesitant, 69-84 positive, and 85-100 very positive.
The performance questionnaire comes from an instrument that has been used at cicendo eye hospital Bandung about IPCLN performance.The performance form consists of 10 statement items based on SNARS Edition 1.1 and PMK 27 of 2017.Content Validity Index test result 0.938.This questionnaire assesses the implementation of surveillance and documentation (question no.1), providing motivation related to the implementation of infection control prevention (question no. 2), monitoring the compliance of health workers (question no.3), reporting to IPCLN if there is a HAI's (question no.4), conducting education or counseling (question no.5), coordination with IPCN (question no.6), accuracy and identification (question no.7), effectiveness and timeliness (question no 8), followup plan (question no 9), identification of chains of infection (question no 10).The score is obtained when the respondent answers yes given a value of 1, and if the respondent answers not given a value of 0. Performance is said to have met the standard when getting a score of 80 (0-100).
The data analysis method in this study uses descriptive statistical analysis, validity test, reliability test, hypothesis testing with Spearman Rank correlation test analysis to see the relationship between perception and performance.After the author performs data analysis on the data processing application, the data from the study will be presented in the form of a frequency and percentage distribution table .Then the results will be interpreted according to the concept Arikunto (2013).

RESULTS AND DISCUSSION
The results of the study, we present in the form of tabulations and interpretation as well as data analysis, including an overview of the characteristics of the respondents who are displayed as shown in the table below: Based on Table 2 it can be seen that more than half of respondents are in the range of 26-35 years, namely as many as 16 people (57.1%).When based on gender characteristics, more than half were women, namely 20 people (71.4%.)The education of more than half of respondents was the S1 Nursing level, which was 18 people (64.3%).As for the marital status, all respondents were married, which was 28 people (100%).\Based on table 3, it shows that more than half of the respondents perceived IPCLN was in the positive category of 21 people (75%), and some of the respondents showed perceptions in the very positive category as many as 7 people (25%) Based on table 4. showed almost most of IPCLN's performance in the good category of 64.2%, and a small percentage of respondents showed a less category of 35.8%.Based on table 5. shows a correlation strength value of 0.086 referring to Dahlan (2015) then it is stated that the correlation density is very weak (0.00 ≤ ρ <0.26).The correlation direction obtained positive results, so it was stated that the more positive the perception of IPCLN performance appraisal, the better the IPCLN performance.The p-value of 0.0663 is greater than alpha 0.05, so it is stated that there is no meaningful correlation between perceptions of performance appraisal and IPCLN's performance in infection prevention and control during the COVID-19 pandemic at Cicendo Eye Hospital DISCUSSION Perception is a process preceded by a sensing process, that is, it is the process of receiving a stimulus by an individual through a sensory apparatus or also called a sensory process (Walgianto, 2013).The perception of IPCLN performance appraisal is IPCLN's positive or negative assessment of the implementation of performance appraisals carried out in its workplace.According to research Ibrahim & Abdelaziz (2019) perception of work assessment can have an influence on nurse performance.The better the nurse's perception of the nurse's performance assessment, the better the performance shown.
Based on the results of the study, it can be seen that most nurses have a positive perception, namely 21 people (75%).The rest have a very positive perception of 7 people (25%).The results of the study are in line with the research Vahidi, Areshtanavb, & Bostanabad (2016) which shows that the majority of nurses have a level of perception of work assessment in the category above average.
IPCLN Performance Results at Cicendo Eye Hospital Bandung, showed that most of IPCLN's performance in the good category was 18 people (64.2%), and a small part showed a bad category of 10 people (35.8%).The results of this study agree with the research conducted by (Ibrahim, 2019) states that the successful interaction of several management systems, one of whose components is the most important organizational culture that affects the performance of IPCLN.The PPI management system must be able to facilitate infection prevention and control programs in the inpatient room, so that later the activities of the prevention and control program are relevant to the expected results.The performance of IPCLN that is not optimal will result in the quality of infection prevention and control in hospitals being not optimal.
Performance appraisal is a form of creating a professional service.A good IPCLN work culture can improve quality based on professionalism, science and technology, legal aspects based on ethics to support a comprehensive health service facility system in the prevention of infection control.Based on Permenkes Number 836 / Menkes / SK / VI / 2005 concerning Management and Performance Development (PMK) Nurses and Midwives state that PMK consists of 3 important elements, namely inputs, processes and outputs.PMK inputs include: standards (SOPs), job descriptions, responsibilities and accountability, functional positions, reward systems, training that has been attended.The PMK process includes: monitoring based on performance indicators, managing deviations, documenting activities, discussing case reflections, and strategic meetings.PMK outputs include: increasing staff awareness of duties and responsibilities, improving performance and increasing motivation, increasing job satisfaction and encouraging the development of a reward and reward system that has an impact on improving the quality of nursing care and overall health services.
The results of the correlation test found that the p-value of 0.0663 was greater than alpha 0.05, so it was stated that there was no meaningful correlation between the perception of performance appraisal and IPCLN's performance in infection prevention and control during the COVID-19 pandemic at Cicendo Eye Hospital.The correlation density is also very weak (0.00 ≤ ρ <0.26).However, the correlation direction obtained positive results, which means that the more positive the perception of IPCLN performance appraisal, the better IPCLN performance.
The results contradict several other studies, one of which is a study in Iran.Research Ibrahim & Abdelaziz (2019) shows that perception has a meaningful correlation and has a great influence on nurse performance.Although they show different levels of correlation strength, the two have something in common, namely showing a positive correlation, which means that the better the nurse's perception of the nurse's performance assessment, the better the performance shown.
When viewed from the level of perception, all nurses have had the above perception indecisive.A total of 21 people (75%) had a positive perception and the rest had a very positive perception of 7 people (25%).Although all nurses have a positive perception, in practice there are still nurses whose performance assessment results show poor results, namely as many as 10 people (35.8%).Still quite high the number of nurses who have poor performance can be influenced by several things, including the system in conducting research.
Nurses who have good perceptions can show poor performance when in the performance appraisal process feel uncomfortable and dissatisfied there is a rating system that exists at that time.This is as according to Handiyani & Purwaningsih (2020) which stated that as many as 150 nurses (36.62%) stated that their performance was less than optimal because in practice they were dissatisfied with the performance appraisal system.In addition, perception is also a more basic thing than knowledge and motivation (Hidayah, 2016).This allows that a good perception of performance appraisal is not always followed by good performance ability.

CONCLUSIONS AND SUGGESTIONS
Most of the perceptions of work assessment on IPCLN were in the positive category of 21 people (75 %), and a small percentage showed a very positive category of 7 people (25%).Most of IPCLN's performance in the good category was 17 (60.7%),and a small part showed a bad category of 11 people (39.3%).There is no correlation between perception and IPCLN performance in infection prevention and control during the COVID-19 pandemic at Cicendo Eye Hospital with a weak correlation strength value ( p= 0.086) with a positive correlation direction which means that the higher the IPCLN motivation, the higher the performance.Based on the lowest average of the IPCLN performance questionnaire, what must be improved in IPCLN performance is in conducting counseling on PPI for patients, families and visitors, as well as consultation procedures that must be carried out.
The authors suggest to subsequent researchers to be able to conduct more in-depth research related to the perception and performance of IPCLN, in particular the factors that affect perception and performance.Researchers may then be able to relate both variables to other factors that could affect those variables.The next stage that researchers may be able to do is first look for sources or references related to the factors that can influence it and compare them with some previous studies related to Perception and performance from IPCLN.

Funding Statement
The author does not receive financial support from any organization for the proposed work, funding is carried out independently.
states variables of knowledge, skills or abilities affect the performance of individuals.Labor skills are related to ability and knowledge.Influencing factors for the Infection Control Link Nurse (ICLN) program are motivation, knowledge factors and support from management (Mireille Dekker, Irene P. Jongerden, & Rosa van Mansfeld, 2019).

Table 1 .
Data Interpretation

Table 3 .
Overview of the Results of Perceptions of Work Assessment at IPCLN at Cicendo Eye Hospital Bandung (n= 28)

Table 4 .
Overview of IPCLN Performance Results at Cicendo

Table 5 .
Analysis of the relationship between the perception of performance appraisal and ipcln performance at Cicendo