Assessment Of Compliance Research Articles

Can the Behaviour Intervention Plan Quality Evaluation, Version 2, be simplified for use by stakeholders with limited experience of positive behaviour support?

Behaviour support plan (BSP) quality auditing tools like the Behaviour Intervention Plan Quality Evaluation, Version 2 (BIPQEII), assess the quality of a BSP from the perspective of technical compliance with behavioural principles. However, these principles may be inaccessible to interested stakeholders with limited experience and knowledge of positive behaviour support (PBS). The aim of this study was to test if a simplified version of the BIPQEII [the Behaviour Support Plan Audit Tool (BSPA-tool)] offers a reliable and valid assessment of a BSP's technical compliance with behavioural principles when used by professional stakeholders with varying levels of PBS experience and knowledge. Four scorers rated 50 de-identified BSPs using the BSPA-tool, with one scorer also rating the BSPs using the BIPQEII. Four weeks later, each scorer rated 25 of the 50 BSPs again using the BSPA-tool. Prior to BSP scoring, a group of PBS practitioners provided feedback on the BSPA-tool's content validity. The BSPA-tool was found to have acceptable content and parallel-form validity; however, acceptable internal consistency and inter-rater and intra-rater reliability were dependent on PBS experience/knowledge, that is, scorers with more experience/knowledge achieved more acceptable levels of reliability. This study confirms that even with simplification, BSP quality auditing tools based on technical compliance with behavioural principles are still only accessible to stakeholders with extensive experience/knowledge of PBS. To engage less-experienced stakeholders in BSP quality auditing processes, new audit tools need to be developed that focus on other aspects of BSP quality (e.g. readability and consultation).

The voluntary code of conduct for dolphin watching in Port Stephens, Australia: is self-regulation an effective management tool?

In the absence of guidelines or government regulation for a rapidly expanding industry, dolphin watching operators in Port Stephens, New South Wales, Australia, formulated and adopted a voluntary code of conduct in 1996. This code was designed to reduce perceived pressures on dolphins and was updated to conform to the Australian National Guidelines for Cetacean Observation when they were released in 2000. Compliance to this code of conduct was assessed in a shore-based survey over the austral summer of 2002/03. Operator compliance was generally high for: number of dolphin watching boats per dolphin school; time spent by individual operators with dolphins; method of approach to dolphins; and frequency of cruises conducted per day. However, operators did not discriminate between dolphin schools containing calves and those that did not (equating to a breach of the national guidelines) and three of nine regular operators committed most breaches of the code, particularly with regard to boat-handling around dolphins and frequency of cruises conducted per day. The code’s aim in reducing exposure of dolphins to boats was not achieved as dolphin schools were subject to consecutive approaches by numerous boats and interactions also involved boats to which the code did not apply. This voluntary code is thus of limited value without revision, education and enforcement. The inability of a voluntary code to manage the number of operators and other watercraft highlights the need for management alternatives that will increase compliance by all users of the waterways. Furthermore, widespread assessments of compliance are necessary, particularly where assessments of the effects of cetacean-based tourism are being conducted. To determine whether identified impacts are a result of inappropriate management strategies, or non-compliance with suitable management, requires that management strategies are tested while simultaneously testing or ensuring compliance.

The Healthy Eating Assessment Tool (HEAT): A Simplified 10-Point Assessment of CHILD-2 Dietary Compliance for Children and Adolescents with Dyslipidemia

Traditional dietary assessment tools used to determine achievement of cholesterol-lowering dietary targets, defined in the Cardiovascular Health Integrated Lifestyle Diet (CHILD-2), are time intensive. We sought to determine the utility of the Healthy Eating Assessment Tool (HEAT), a simplified 10-point dietary assessment tool, in relation to meeting dietary cut points of the CHILD-2, as well as its association with markers of adiposity and lipid variables. We performed a 2-year single-center, prospective cross-sectional study of pediatric patients with dyslipidemia. HEAT score associations with meeting CHILD-2 fat targets were modest. Only patients with the highest HEAT scores (good 43%, excellent 64%) met the CHILD-2 cut point of <25% total fat calories (p = 0.03), with a non-significant trend for limiting the percentage of daily saturated fat to <8% (excellent 64%), and no association with cholesterol intake. There were more consistent associations with markers of adiposity (body mass index z-score r = -0.31, p = <0.01 and waist-to-height ratio r = -0.31, p = <0.01), and there was no independent association with lipid levels. While fat-restricted diets are safe, they are not particularly effective for treatment of dyslipidemia or for weight management alone. The HEAT may be a more useful and simplified way of assessing and tracking broader dietary goals in clinical practice.

Towards a Flexible Assessment of Compliance with Clinical Protocols Using Fuzzy Aggregation Techniques

In healthcare settings, compliance with clinical protocols and medical guidelines is important to ensure high-quality, safe and effective treatment of patients. How to measure compliance and how to represent compliance information in an interpretable and actionable way is still an open challenge. In this paper, we propose new metrics for compliance assessments. For this purpose, we use two fuzzy aggregation techniques, namely the OWA operator and the Sugeno integral. The proposed measures take into consideration three factors: (i) the degree of compliance with a single activity, (ii) the degree of compliance of a patient, and (iii) the importance of the activities. The proposed measures are applied to two clinical protocols used in practice. We demonstrate that the proposed measures for compliance can further aid clinicians in assessing the aspect of protocol compliance when evaluating the effectiveness of implemented clinical protocols.

Assessment of knowledge, awareness and vaccination compliance of hepatitis B among students of health colleges of Al-Baha University

Assessment of knowledge, awareness and vaccination compliance of hepatitis B among students of health colleges of Al-Baha University

Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies

Wearable sensors, which are often embedded in commercial smartwatches, allow for continuous and non-invasive health measurements and exposure assessments in clinical studies. Nevertheless, the real-life application of these technologies in studies involving a large number of participants for a significant observation period may be hindered by several practical challenges. In this study, we present a modified protocol from a previous intervention study for the mitigation of health effects from desert dust storms. The study involved two distinct population groups: asthmatic children aged 6-11 years and elderly patients with atrial fibrillation (AF). Both groups were equipped with a smartwatch for the assessment of physical activity (using a heart rate monitor, pedometer, and accelerometer) and location (using GPS signals to locate individuals in indoor "at home" or outdoor microenvironments). The participants were required to wear the smartwatch equipped with a data collection application on a daily basis, and data were transmitted via a wireless network to a centrally administered data collection platform for the near real-time assessment of compliance. Over a period of 26 months, more than 250 children and 50 patients with AF participated in the aforementioned study. The main technical challenges identified included restricting access to standard smartwatch features, such as gaming, internet browser, camera, and audio recording applications, technical issues, such as loss of GPS signal, especially in indoor environments, and the internal smartwatch settings interfering with the data collection application. The aim of this protocol is to demonstrate how the use of publicly available application lockers and device automation applications made it possible to address most of these challenges in a simple and cost-effective way. In addition, the inclusion of a Wi-Fi received signal strength indicator significantly improved indoor localization and largely minimized GPS signal misclassification. The implementation of these protocols during the roll-out of this intervention study in the spring of 2020 led to significantly improved results in terms of data completeness and data quality.

Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies.

Wearable sensors, which are often embedded in commercial smartwatches, allow for continuous and non-invasive health measurements and exposure assessments in clinical studies. Nevertheless, the real-life application of these technologies in studies involving a large number of participants for a significant observation period may be hindered by several practical challenges. In this study, we present a modified protocol from a previous intervention study for the mitigation of health effects from desert dust storms. The study involved two distinct population groups: asthmatic children aged 6-11 years and elderly patients with atrial fibrillation (AF). Both groups were equipped with a smartwatch for the assessment of physical activity (using a heart rate monitor, pedometer, and accelerometer) and location (using GPS signals to locate individuals in indoor "at home" or outdoor microenvironments). The participants were required to wear the smartwatch equipped with a data collection application on a daily basis, and data were transmitted via a wireless network to a centrally administered data collection platform for the near real-time assessment of compliance. Over a period of 26 months, more than 250 children and 50 patients with AF participated in the aforementioned study. The main technical challenges identified included restricting access to standard smartwatch features, such as gaming, internet browser, camera, and audio recording applications, technical issues, such as loss of GPS signal, especially in indoor environments, and the internal smartwatch settings interfering with the data collection application. The aim of this protocol is to demonstrate how the use of publicly available application lockers and device automation applications made it possible to address most of these challenges in a simple and cost-effective way. In addition, the inclusion of a Wi-Fi received signal strength indicator significantly improved indoor localization and largely minimized GPS signal misclassification. The implementation of these protocols during the roll-out of this intervention study in the spring of 2020 led to significantly improved results in terms of data completeness and data quality.

SG-APSIC1091: Assessment of compliance to cleaning of computers by healthcare workers (HCWs) using adenosine triphosphate (ATP) measurement

Objectives: HCWs are recommended to wipe the computers with alcohol wipes before clinical use. Compliance assessment by direct observation is resource intensive. We used ATP measurement as a surrogate to assess the compliance to preutilization cleaning of computers. Methods: We conducted a pilot study to determine the median relative light unit (RLU) value reflective of preutilization cleaning of the computers. We identified values of &lt;250, 250–500, and &gt;500 RLU to reflect cleaned, probably cleaned, and not cleaned computers, respectively. Subsequently, we conducted a cross-sectional study of the computers in the inpatient wards in Tan Tock Seng Hospital and National Centre for Infectious Diseases. Using 3M Clean-Trace ATP swabs, we tested 5 computers in each ward: 2 computers on wheels, 2 from the nursing station, and 1 at the patients’ room entrance. All analyses were conducted using STATA version 15 software. Results: Between October 4 and 10, 2021, we collected 219 samples from 219 computers. Among them, 44 (20.1%) were cleaned, 49 (22.4%) were probably cleaned, and 126 (57.5%) computers were not cleaned. Higher compliance to computer cleaning was observed in COVID-19 wards [85 ATP samples; cleaned, 37 (43.5%); probably cleaned, 26 (30.6%); not cleaned, 22 (25.9%)] compared with non–COVID-19 wards [134 ATP samples; cleaned, 7 (5.2%); probably cleaned, 23 (17.2%); not cleaned, 104 (77.6%)] (P &lt; .01). No significant difference was observed in compliance with cleaning computers between the ICU [30 ATP samples; cleaned, 7 (23.3%); probably cleaned, 4 (13.3%); not cleaned, 19 (63.3%)] and general wards [189 ATP samples; cleaned, 37 (19.6%); probably cleaned, 45 (23.8%); not cleaned, 107 (56.6%)] (P = .47). Conclusions: ATP swab tests can be used as a surrogate marker to assess compliance to pre-utilization cleaning of computers. Enhanced awareness of environmental hygiene may explain the higher compliance to computer cleaning observed in COVID-19 wards.

NRG GI008: Colon adjuvant chemotherapy based on evaluation of residual disease (CIRCULATE-US).

TPS260 Background: Currently, there are no biomarkers validated prospectively in randomized studies for resected colon cancer (CC) to determine need for adjuvant chemotherapy (AC). However, circulating tumor DNA (ctDNA) represents a highly specific and sensitive approach (especially with serial monitoring) for identifying minimal/molecular residual disease (MRD) post-surgery in CC patients (pts), and may outperform traditional clinical and pathological features in prognosticating risk for recurrence. CC pts who do not have detectable ctDNA (ctDNA-) are at a much lower risk of recurrence and may be spared the toxicities associated with AC. Furthermore, for CC pts with detectable ctDNA (ctDNA+) who are at a very high risk of recurrence, the optimal AC regimen has not been established. We hypothesize that for pts whose CC has been resected, ctDNA status may be used to risk-stratify for making decisions about AC. Methods: In this prospective phase II/III trial, up to 1,912 pts with resected stage III A, B (all pts) and stage II, IIIC (ctDNA+ only) CC will be enrolled. Based on the post-operative ctDNA status using personalized and tumor-informed assay (Signatera™, bespoke assay), those who are ctDNA- (Cohort A) will be randomized to immediate AC with fluoropyrimidine (FP) + oxaliplatin (Ox) for 3-6 mos per established guidelines vs . serial ctDNA monitoring. Patients who are ctDNA+ post-operatively or with serial monitoring (Cohort B) will be randomized to FP+Ox vs . more intensive AC with addition of irinotecan (I) for 6 mos. The primary endpoints for Cohort A are time to ctDNA+ status (phase II) and disease-free survival (DFS) (phase III) in the immediate vs . delayed AC arms. The primary endpoint for Cohort B is DFS in the FP+Ox vs FP+Ox+I arms for both phase II and phase III portions of the trial. Secondary endpoints include prevalence of detectable ctDNA post-operatively, time-to-event outcomes (overall survival and time to recurrence) by ctDNA status, and the assessment of compliance to adjuvant therapy. Biospecimens including archival tumor tissue, as well as post-operative plus serial matched/normal blood samples, will be collected for exploratory correlative research. Active enrollment across the NCTN started in June, 2022. Support: U10-CA-180868, -180822; UG1CA-189867; Natera, Inc. Clinical trial information: NCT05174169 .

AGRICULTURAL MARKET INFORMATION GOVERNANCE: A CAPABILITY-ORIENTED NATIONAL FRAMEWORK FOR BENIN REPUBLIC

Information technologies are improving the Agricultural Market Information delivery to the beneficiaries. The conceptualizationof the governance of disseminatedinformation, used by stakeholders to take important decisions, has become urgent.Therefore, the aim of this work is to design an Agricultural Market Information Governance Framework (AMIGov) focusing on governance capabilities of Benin.The designedcapability-oriented Agricultural MarketInformation Governance frameworkextends the existing Governance model of the Harmonized Information System ofAgricultural Markets of Benin. AMIGov is a three capability vertical layers framework with described practices to support each capability layer for achieving the Governance vision. The noveltyof AMIGovlies in the use of three main principles: (i) differentiation of governance and management functions and roles (ii) horizontal interactions between key stakeholders (co-governance of the Market Informationwith the involvement of the public and private sectors) (iii) compliance assessments at different levels across the country. Three key governance roles are suggested to improve the Governance practices: theNational Agricultural Market Information Leadership Group, the Information Governance Committee and the Information Governance Team. TheInformation Governance Team is theofficial operational workforce responsible for performance evaluation, and various compliance assessments(risk, regulatory, deployment, information quality).This team controls the actions of the Information Managerson the basis of predefined criteria and Service level Agreement, and reports to the Governance committee. The proposed framework can be recommended for use in the countries with a low level of digital organizational culture or where the MarketInformation Governance is not standardized.

Bayesian Hierarchical Framework from Expert Elicitation in the South African Coal Mining Industry for Compliance Testing.

Occupational exposure assessment is important in preventing occupational coal worker's diseases. Methods have been proposed to assess compliance with exposure limits which aim to protect workers from developing diseases. A Bayesian framework with informative prior distribution obtained from historical or expert judgements has been highly recommended for compliance testing. The compliance testing is assessed against the occupational exposure limits (OEL) and categorization of the exposure, ranging from very highly controlled to very poorly controlled exposure groups. This study used a Bayesian framework from historical and expert elicitation data to compare the posterior probabilities of the 95th percentile (P95) of the coal dust exposures to improve compliance assessment and decision-making. A total of 10 job titles were included in this study. Bayesian framework with Markov chain Monte Carlo (MCMC) simulation was used to draw a full posterior probability of finding a job title to an exposure category. A modified IDEA ("Investigate", "Discuss", "Estimate", and "Aggregate") technique was used to conduct expert elicitation. The experts were asked to give their subjective probabilities of finding coal dust exposure of a job title in each of the exposure categories. Sensitivity analysis was done for parameter space to check for misclassification of exposures. There were more than 98% probabilities of the P95 exposure being found in the poorly controlled exposure group when using expert judgments. Historical data and non-informative prior tend to show a lower probability of finding the P95 in higher exposure categories in some titles unlike expert judgments. Expert judgements tend to show some similarity in findings with historical data. We recommend the use of expert judgements in occupational risk assessment as prior information before a decision is made on current exposure when historical data are unavailable or scarce.

P403 Therapeutic compliance in patients with chronic inflammatory bowel disease.

Abstract Background The World Health Organization estimates that half of all patients do not take their treatment as agreedwith the prescriber. Thus, the evaluation of compliance is essential in the management of patients withchronic diseases, particularly chronic inflammatory bowel diseases (IBD). This evaluation cansometimes be variable. Hence, it is of clinical significance to develop objective scales unifying compliance assessment methods. The aim of our study was to assess therapeutic compliance in IBD patients and to identify predictivefactors of non compliance. Methods A cross-sectional study over a period of six months (from June to November 2022) including all IBD patients from our department was conducted.The data collection was carried out by one investigator. We used an analytical chart containingdemographic and clinical questions, the Perceived Stress Scale (PSS) questionnaire in its French version to evaluate the degree of stress and the "Morisky medication adherence scale -8 MMAS" and the "Girerd" questionnaires to evaluate compliance to treatment. Results Forty-seven patients were included, with a mean age of 43 years [20-71 years] and a M/F sex ratio of0.59. Forty patients had Crohn's disease and seven had ulcerative colitis. Only 19 patients were recently (less than two years) diagnosed of IBD. Whereas, 20 patients were followed for more than 10years. All were undergoing maintainance therapy with azathioprine in 34%, anti TNF in 19%, combotherapy in 19%, 5 ASA in 8.5%. Among our population, 17% presented a flare and were under corticosteroids during our study.Most of our patients did not have a secondary or a university degree (n= 22). When it comes to patients’ perceptions of the disease, 14 patients showed a good understanding while seven showed poor knowledge. The remaining 26 patients had average knowledge about the disease and its management.Regarding the level of stress caused by their disease, 40% were able to cope with it, while 25.5% had major difficulty in stress management.Fifty-one patients were considered to be well compliant according to the MMAS-8, 32% were moderately compliant and 17% were not compliant. The results were comparable using both scores(Morisky and Girerd). The main predictors of poor compliance were level of education (p=0.042),degree of knowledge of the disease (p=0.011) and poor stress coping (p=0.001). Conclusion Adherence to treatment is the most important predictor of success or failure of therapeutic care. It isimportant to educate patients about the importance of compliance both at treatment initiation andduring periodic visits. It is also important to identify and act on the factors that lead to non-adherence.

Assessment of Compliance with Medical Waste Management Practice in Selected Hospitals in Urban Bauchi, Nigeria

This study assesses compliance with medical waste management practice in hospitals across urban Bauchi. Ten hospitals were randomly selected in each ward, representing the ten administrative wards of urban Bauchi, in which 148 set of questionnaires were administered among the waste handlers in the selected hospitals. In addition, the heads of units in each of the selected hospitals were interviewed. The results were compared with standard guidelines stipulated by the World Health Organization (WHO). It was revealed that the main treatment and disposal method in 50% of the hospitals were incineration and deep burial which were mostly in compliance with the stipulated guidelines. In the remaining 50% of the hospitals, the dominant treatment and disposal methods used were general collection of the waste, open dumping and burning. This is of significant concern because open dumping and open burning are not sustainable practices. Therefore, the study recommends that waste handling manual be developed and provided to all waste handlers to guide on handling medical waste properly.

Observational assessment of hand hygiene compliance among healthcare workers in public hospitals of Northeastern Ethiopia

ABSTRACT This study examined the magnitude and predictors of hand hygiene compliance among 325 healthcare workers in three public hospitals of Northeastern Ethiopia using standardized observational tool. A multivariable logistic regression analysis was computed to identify factors associated with non-compliance. The overall proportion of observed hand hygiene non-compliance was 41.8% (95%CI: 36.6–48.1). Having <5 years of work experience (AOR = 1.5; 95%CI: 1.2–2.5), absence of hand washing soap (AOR = 3.1; 95%CI: 2.3–5.4), work overload (AOR = 2.5; 95%CI: 1.9–4.1), pipe water supply interruption (AOR = 2.8; 95%CI: 2.1–4.9), lack of hand hygiene training (AOR = 3.1; 95%CI: 2.2–4.4), and absence of infection prevention committee (AOR = 2.1; 95%CI: 1.5–4.9) were determinant factors for hand hygiene non-compliance. Therefore, regional health bureau and hospitals’ managers should work towards the provision of regular hand hygiene trainings, uninterrupted piped water supply, hand washing soap, and establishment of functional infection prevention committee. Moreover, healthcare workers should be also committed to comply with hand hygiene.

Measurements of pulse rate using facial video cameras from smart devices in patients diagnosed with atrial fibrillation

Clinical applications of passive long-term heart rate (HR) monitoring in patients with cardiac arrhythmias include adequate drug titration of atrioventricular (AV) nodal drugs and assessment of medical compliance with treatment. A majority of patients treated with beta-blockers, especially patients with atrial fibrillation (AF), require some degree of drug titration during the first 6 months of treatment to ensure that adequate HR control and medicine compliance has been achieved. Failing to achieve adequate rate control in patients with AF can lead to worsening symptoms, heart failure exacerbations, and potentially tachycardia-induced cardiomyopathy. Enabling video-based monitoring during telehealth patient visits could facilitate providers to measure heart rate (HR) without the need for a dedicated home device (smartwatch, SPO2 device, or others). Videoplethysmography (VPG) is a monitoring technology that measures pulse rate by utilizing front-facing cameras embedded in smart devices. VPG provides a remote and contactless cardiac monitoring solution. We conducted a clinical experiment to evaluate the accuracy of VPG in measuring HR while running on two portable devices: Samsung S10 smartphones and S3 tablets. We used a single‑lead ECG to measure the heart rate at the time of the VPG recordings in AF patients. We employed the Bland-Altman method to measure the level of agreement between videoplethysmography and ECG-based measurements of HR. The findings reveal that the mean difference in videoplethysmography and ECG-based heart rate was inferior to 1 bpm across the 2 devices with confidence intervals ranging from 3 to 12 BPM. Our facial video-based HR monitoring solution could assist providers in measuring heart rates in their patients with AF during remote telehealth visits.

Features of open respiratory tract care in patients undergoing prolonged artificial lung ventilation

A visual assessment of compliance with the requirements of epidemiological safety of 52 open-air respiratory tract care procedures in 8 operated adult patients undergoing long-term artificial lung ventilation in the department of anesthesiology and resuscitation of a cardiac hospital showed a high frequency of violations of the technology of these procedures. To optimize the care of the respiratory tract in such patients and improve epidemiological safety, an improved manipulation algorithm is proposed. The issue of the priority of rehabilitation of the tracheobronchial tree and upper respiratory tract requires further epidemiological and microbiological assessmen.

Improving Nursing Medication Administration Practice in Inpatient Units: A Quality Improvement Project

Background: Nurses play a unique and crucial role in medication administration. In hospital units, the medication administration process is frequently viewed as a series of sequential steps, beginning with prescribing, then dispensing, and finally administering to the patient. Local problem: Data from 2020 indicated improper nursing medication administration practices in the hospital's inpatient units, despite adherence to medication safety standards and policies, so the current project was created to improve nursing medication administration compliance. Methods: A quality improvement project was conducted using the Standards for Quality Improvement Reporting Excellence Revised Publication Guidelines (SQUIRE 2.0). Common quality improvement tools were used, including the fishbone diagram, Focus PDCA, and the General Medication Administration (GMA) instrument. Interventions: Staff audit interviews and observations, as well as engaging and educating processes, were conducted weekly. A final medication administration compliance assessment was performed on the staff. Results: The present project found high medication administration compliance and an excessive enhancement of awareness among nurses related to medication administration. Conclusion: This quality improvement project summarizes the steps of using quality improvement tools to find and treat improper medication administration practices. As is obvious, there has been improvement in nursing compliance.

Experimental Research of Impact Toughness of the Kazakhstani Construction Steel— Assessment of Compliance with the Provisions of 1993 Eurocode

Experimental Research of Impact Toughness of the Kazakhstani Construction Steel— Assessment of Compliance with the Provisions of 1993 Eurocode

Compliance assessment regarding the PVC management on normal wards of a university hospital.

The risk of peripheral venous catheter (PVC) infections in inpatients is often underestimated, even if it is lower than that for central venous catheters. Guidelines for the prevention of PVC-associated infections describe the evidence-based management of PVCs. The aims of this study were the development of standardized methods for compliance assessment regarding PVC management and the evaluation of self-reported knowledge and implementations among healthcare providers regarding PVC care. We developed a checklist based on the recommendation of the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO) Berlin for the standardized evaluation of PVC management. The following parameters were collected and evaluated: condition of the puncture site, condition of the bandage, presence of an extension set, presence of a plug, and documentation. The checklist was applied in 14 normal wards in 2019. After feedback of the ward staff on the results, it was applied again in 2020 in the same wards. For retrospective data analysis, we used a newly developed PVC-quality index. After the second evaluation in 2020, we carried out an anonymous survey among the healthcare providers. The evaluation of 627 indwelling PVCs showed a significant increase in compliance related to the presence of an extension set (p=0.049) and documentation (p<0.001) in the 2nd year. The quality index increased in 12 out of 14 wards. The participants of the survey were aware of the in-house standard "Prevention of vascular catheter-associated infections", with a mean score of 4.98 on a Likert scale (1=not aware, 7=completely aware). The main barrier to implementation of the preventive measures was the time factor. Survey participants were more aware of PVC placement than PVC care. The PVC quality index is a valuable tool for the assessment of compliance regarding PVC management in daily practice. Feedback from the ward staff on the results of compliance assessment improves PVC management, but the outcome is very heterogeneous.

Technique for assessing the position of temporomandibular joint

With the development of new technologies of X-ray diag-nostics, various methods of their application are used in modern dentistry. Cone beam computed tomography (CBCT) is mainly used to visualize the bone structures of the skull — temporomandibular joint, structures of the upper and lower jaw, the location of teeth in bone tissue for further use of reconstructed three-dimensional models for digital treatment planning and prediction of results. Aim of the study: technique of three-dimensional analysis of the parameters of the temporomandibular joint (TMJ) optimization, possible deviations analysis. Materials and methods: computed tomography data was obtained and an assessment of compliance with the neces sary criteria was carried out in the Ez3D Plus software (Vatech, Korea). A three-dimensional analysis technique of the individual position of the condyle in the articular fossa was provided with use of Mimics software (Materialise, Belgium), based on the data acquired from computed tomography (CT) re-search. The accuracy of positioning of three-dimensional models of dentition on segmented models from comput-ed tomography was evaluated. By a certain algorithm of actions, the segmented model was moved to the position corresponding to the central occlusion. Results. The study showed that the main reason for the inaccuracy of multi-stage positioning of the mandible are the automatic algo-rithms of model matching and poor detail of computed tomography sli ces. In this regard, zoning of the compared model’s parts was used, which demonstrated its effective-ness and result’s stability. The greatest inaccuracy of the results of measuring the position of the TMJ is associated with the quality of CT and manual correction of masks and contours of the surfaces of condyles. The algorithm was developed for obtaining the necessary information when assessing the position of the condyles before planning the orthodontic treatment. Conclusion. А reasonable tech-nique for constructing condyle contours in central occlu-sion has been determined, which can be used as a basis for positioning the mandible in a digital orthodontic treat-ment planning.