Digital e-Dy Care Education and Nurses’ Personal Protective Equipment Compliance: A Controlled Before-and-After Study in Kudus

Abstract

Adherence to infection-prevention precautions depends on much more than knowledge: usability of protocols, workflow conditions, supervision and equipment supply all matter. This study examined digital e-dy care education and nurses’ personal protective equipment compliance using a two-group quasi-experimental pretest–posttest study. The study took place at RSUD dr. Loekmonohadi Kudus, Central Java, Indonesia, February–July 2026 and included 80 nurses purposively selected from four wards; 40 received the intervention and 40 received routine instruction. The intervention consisted of QR code–accessible e-Dy Care electronic book addressing appropriate use of personal protective equipment (PPE). Outcomes were assessed using questionnaire and observation-derived PPE compliance scores. Mean adherence scores increased from 51.83 to 61.70 in the e-Dy Care group, compared with 51.50 to 55.15 in controls. The analysis reports a within-intervention p value of 0.001 and an intergroup categorical Fisher exact p value below 0.001. However, its adherence-frequency table includes denominators of 48 and 52 in a nominal 40-participant group and conflicts with another table; therefore category percentages were not reproduced as participant proportions. In interpretation, a mobile-accessible educational resource can reduce the friction of retrieving instructions at the point of practice and reinforce consistent procedural knowledge. Improvement in an education-linked score does not necessarily establish correct PPE use on every clinical occasion. The design and measurement constraints mean that associations should not be represented as definitive causal effects.