**7. Healthcare worker safety**

Healthcare worker well-being is one pillar that contributes to patient safety [5]. It comprised physical and mental aspects. Healthcare workers should be protected from medical hazards. Standard PPE should be provided by the hospital. Vaccination programs including COVID-19 immunization should be given to all HW. Personal hygiene such as regular handwashing should be enforced according to the WHO protocol [5, 10]. Healthcare workers are working in high-demand and high-risk medical environments in which psychological stress can occur. Their mental problems should be addressed. Psychological support should be provided to ensure HW's well-being [10].

COVID-19 patients are admitted to hospitals with various comorbidities, including GI diseases. Those patients might require GIE for the evaluation and management of digestive diseases [17]. Gastrointestinal endoscopy procedures pose a transmission risk to the HW (endoscopist and endoscopic nurses). Body fluids from COVID-19 patients can spread during the procedure. Saliva can contaminate the pillow during esophagogastroduodenoscopy (EGD), and feces may contaminate the bed during colonoscopy. Prevention of infection to HW is important [24, 25].

The Indonesian Society for Digestive Endoscopy (ISDE) has released a particular recommendation for performing GIE during the COVID-19 pandemic. Their recommendations consisted of patient selection, selection of endoscopy room, medical staff protection, recovery room, and equipment disinfection. The highlights of these recommendations are defined as whether the patient has an indication for urgent,

*Patient Safety and Healthcare Worker Safety in Gastrointestinal Endoscopy during COVID-19… DOI: http://dx.doi.org/10.5772/intechopen.109128*

semi-urgent, or elective GIE. It is mandatory to limit the indications for GIE only for emergencies such as acute gastrointestinal bleeding, foreign bodies impaction, acute cholangitis, and cancer care only. All elective cases should be postponed to reduce the SARS-CoV-2 transmission [9].

To minimize the cross-infection, the number of involved HW is recommended to be restricted in endoscopy procedures. The HW should remain to stay in the endoscopy room until the procedure is finished and avoids encountering other staff. The staff restrictions also can be an effective way to wear PPE efficiently, since it is the commodity that is in great demand during the COVID-19 pandemic [10, 26].
