Construction and clinical application of a quality evaluation index system for digital intraoral impression scanning

Construction and clinical application of a quality evaluation index system for digital intraoral impression scanning | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Construction and clinical application of a quality evaluation index system for digital intraoral impression scanning Fali Zhang, Xinchun Zou, Shunyi Wu, Leilei Zhang, Lijia He, Jun Su, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6903044/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 19 You are reading this latest preprint version Abstract Background With the popularization of digital intraoral impression scanning technology, the lack of standardized quality evaluation criteria has increasingly affected the development of the industry, especially in nursing-led scanning procedures. Therefore, exploring the construction of a scientific quality evaluation index system for digital intraoral impression scanning is a matter of great significance. Methods Based on Donabedian's “Structure-Process-Outcome” model, this study constructed an index system through literature review, semi-structured interviews (n = 19), and two rounds of Delphi expert consultations (n = 22), and conducts clinical verification via RCT from May to June 2025. from January to March 2025. A total of 200 patients requiring posterior single crown restoration-impression scanning were randomly divided into a control group and an experimental group. The control group received routine impression scanning and nursing, while The experimental group performed scanning and nursing according to the standardized impression scanning nursing intervention program formulated based on the evaluation index system of Donabedian's three-dimensional quality model. The primary outcomes included scanning time, data qualification rate (assessed by 5 dimensions), and patient satisfaction (measured by a 5-item Likert scale). Results The constructed index system comprised 3 first-level indicators, 12 second-level indicators, and 35 third-level indicators, with an expert authority coefficient (Cr = 0.982) and Kendall's W coefficient (W = 0.687, P < 0.001), that All met the screening criteria of the Delphi method. Clinical application showed that the experimental group had significantly shorter scanning time (9.05 ± 2.79 min vs. 14.86 ± 2.56 min), higher patient satisfaction (98.24% vs. 94.35%) with statistically significant differences (P < 0.05) in t-tests for time and satisfaction, and improved data qualification rate (91% vs. 84%) although non-statistically significant differences but positive trend in qualification rate. Conclusion The evaluation index system significantly enhances scanning efficiency, scanning quality and patient satisfaction, providing an effective and standardized practical model for clinical standardization of digital intraoral impression scanning, with high clinical application value. Clinical trial number This trial has been registered with the Chinese Clinical Trial Registry.12/05/2025 with identifier: ChiCTR2500102285. Digital stomatology Digital impression Digital intraoral scanning Oral nursing quality Delphi method Figures Figure 1 Introduction With the deepening implementation of the “Healthy China 2030” Plan Outline, oral health, as a vital part of national health, has gained increasing attention. The “Healthy Oral Action Plan (2019–2025)” emphasizes that strengthening the construction of oral professional talent teams is a strategic priority for improving oral medical service quality [1]. In the context of rapid development in digital oral diagnosis and treatment, digital impression technology has become a core technique due to its efficiency and precision [2]. Notably, approximately 78% of digital impression scanning operations in clinical practice are performed by nursing staff [3], posing new challenges to their professional technical capabilities. Studies have shown that scanning quality is significantly “operator-dependent” with experienced operators reducing scanning time by 40% and increasing data accuracy by 25% [4]. However, existing quality control research has three limitations: (1)excessive focus on equipment performance parameters (83.4% of existing literature), neglecting standardized operation process research [5]; (2)lack of a systematic quality evaluation framework, especially for nursing operations; (3)insufficient clinical evidence, with only 12% of studies using RCT or clinical validation designs [6]. These limitations lead to inconsistent training standards and variable scanning quality across institutions [7]. This study, based on Donabedian's classic “Structure-Process-Outcome” quality model [8], innovatively constructed the first quality evaluation index system for nursing-led digital impression scanning. Through two rounds of Delphi expert consensus (n = 22, Cr = 0.98), the system researches and determines 3 first-level, 12 second-level and 35 third-level indicators, covering key elements such as personnel qualifications, equipment management, operational norms and humanistic care. The subsequent clinical validation (n = 200) confirmed that the system reduced scanning time by 39.1%, improved data qualification rate by 8.3%, and increased patient satisfaction by 4.1%. This study firstly applies the medical quality evaluation model systematically to the field of oral digital nursing. It has established quantifiable evaluation criteria for nursing operations, provided a scientific framework for the cultivation of oral digital nursing talents, and laid an evaluation foundation for the research and development of “human-machine collaboration” operation modes and AI quality control systems. These achievements respond to the national strategic needs for the digital transformation of oral health services, and play an important role in promoting the improvement of oral medical nursing service quality. Materials and methods Phase 1:Construction of the quality evaluation index system Establishment of the research team. the research team composed of 7 members, including 1 PhD(team-leader), 4 master's degree holders, and 2 undergraduates; 1 chief physician, 2 associate chief physicians, 1 attending physician, 2 senior nurses and 1 technician. The team covered fields of oral management, clinical dentistry, oral nursing and oral scanning, responsible for literature retrieval, interview outline development, index draft construction, expert selection and data analysis. Literature retrieval. Chinese and English databases (CNKI, VIP, Wanfang Data, CBM, PubMed, Web of Science) were searched using terms like“digital oral care” “digital impression” “Delphi method” and so on. Two researchers used “Mendeley one” software for Initial screening, then all members of team, with solving issues and breaking through bottlenecks in clinical practice, review full-text and thematic analysis to identify relevant indicators and draft interview outlines. Semi-structured interviews. Nineteen participants from a tertiary hospital's department of stomatology (including two directors, two charge-nurses,two tooth-reparative dentists, three technicians, five oral-scanning nurses and five patients) were purposively sampled. Based on a pre-prepared interview outline which include the characteristics and requirements of oral management, oral treatment, oral scanning and patient experience, etc, Interviews explored multi-dimensional aspects of digital impression scanning, with content analyzed using Colaizzi's 7-step method [9], yielding 13 themes (staffing, environmental layout, equipment configuration, regulations and standards, training and assessment, oral scanning evaluation, oral scanning operations, health education, communication skills, hospital infections, adverse event occurrence, humanistic care and satisfaction), then draft of an initial evaluation index system for the quality of oral digital impression scans. The interview content is detailed in Supplementary Table 1. Draft an expert consultation questionnaire. Taking the three-dimensional quality structure model as the theoretical framework, based on the initial draft of the evaluation index system and combined with clinical nursing routines, after two rounds of group discussions, 3 first-level indicators, 13 second-level indicators, and 51 third-level indicators have been preliminarily formulated and compiled into an expert consultation questionnaire. The questionnaire consists of three parts: ① Instructions of the questionnaire, which expound the research purpose and content; ②The main body of the questionnaire, including the consultation form for the evaluation index system of the scanning quality of oral digital impressions (using the Likert 5-point scale [10] to evaluate the importance of each item) and modification suggestions; ③The questionnaire on the basic information of experts, the basis for index judgment, and the degree of familiarity. Select expert consultants. According to the principles of rationality of knowledge structure and professional complementarity, we use the purposive sampling method to select oral experts. The selection criteria are as follows: ① Oral management experts, oral nursing experts, or oral clinical experts from Grade III Class A general hospitals or stomatological specialized hospitals in Yunnan Province; ② Bachelor's degree or above; ③ Intermediate professional title or above, and have been engaged in oral-related work for more than 10 years; ④ Willing to participate in the Delphi expert consultation. Implement expert consultation. According to the Delphi principles [11, 12, 13, 14], 22 oral experts were selected in March 2025 to conduct two rounds of consultation through Wenjuanxing (an online questionnaire platform). Each round of consultation was completed within two weeks. After each round of consultation, the indicators with an average importance score of equal or above 4.0 and a coefficient of variation of less than 0.25 were retained [15]. Combined with the suggestions of experts and group discussions, modified the indicators, then the next round of consultation was carried out. After two rounds of consultation, the opinions of experts tended to be consistent, and the quality evaluation index system was settled down. See Fig. 1 for details. Phase 2:Clinical application Participants. A total of 200 patients who underwent intraoral scanning of digital impressions for single crown restoration of posterior teeth in the Dental Department of a tertiary hospital in Yunnan Province from May to June 2025 were selected. They were divided into a control group and an experimental group according to the treatment time, with 100 cases in each group. Among them, there were 107 females and 93 males, aged from 20 to 78 years old, with an average age of 44.3 years old. The restored tooth positions included 59 maxillary molars, 69 mandibular molars, 34 maxillary premolars and 38 mandibular premolars. Inclusion criteria: ① Age equal or above 18 years old; ② Good periodontal condition; ③ The adjacent teeth and the opposite teeth are intact or the filling/restoration treatment has been completed; ④ The patient gives informed consent. Withdrawal criteria:Patients who request to withdraw during the intervention period; ② Participants who fail to complete the study for various reasons. This study has been approved by the Medical Research Ethics Committee of the 920th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army (Review No.: 920IEC/AF/71 − 02/2024 − 02.1). Grouping. Control group: The scanning nursing staff were trained through the master-apprentice teaching method. Conventional intraoral scanning operations were carried out, including preparations before the operation, quality control during the operation, and health education after the operation. Oral specialty nursing was implemented throughout the scanning process. Experimental group: According to the constructed quality evaluation index system for oral digital impression scanning, a quality evaluation and nursing implementation plan for oral impression scanning was formulated. The plan was strictly implemented, and intraoral scanning and nursing were carried out for the patients. It included forming a special intraoral scanning team, perfecting the scanning specifications and systems, optimizing the training plan and implementing it [4, 16, 17], strictly assessing the admission qualifications, and implementing quality control and personalized intraoral scanning nursing [18]. The specific implementation plan is shown in Table 1 . Table 1 Standardized Impression Scanning Nursing Intervention Program Based on Donabedian's Three-Dimensional Quality Model Standardized Impression Scanning Nursing Intervention Program Based on Donabedian's Three-Dimensional Quality Model Structure Optimization (Basic Support) Establish a Special Oral Scanning Team 1.Establish a three-level quality control framework:Oral Scanning Operation Group (clinical execution layer);Data Quality Control Group (technical supervision layer)༛Nursing Management Group (decision-making layer). 2.Configure a standardized oral scanning room (including environmental control, equipment segmentation, and privacy protection) Standardization of Systems and Processes 1.Formulate the Digital Oral Scanning Operation Specifications Manual (including standard procedures for equipment operation, oral scanning, emergency handling, etc.). 2.Establish an oral scanning admission and dynamic reward-punishment mechanism:Link scanning quality with nursing performance;Reward teams that meet standards, and require non-compliant teams to receive intensive training Dynamic Training and Assessment 1.Optimize the training program:Clarify training duration, frequency, content, and methods (e.g., peer role-playing) to enhance nurses' operational proficiency. 2.Implement hierarchical modular training:Junior nurses: Focus on basic theories and practical operations (e.g., equipment calibration, single-tooth scanning);Senior nurses: Strengthen complex case management (e.g., full-mouth scan stitching, management of patients with hypersensitive gag reflex). 3.Assessment criteria:Nurses must score ≥ 85 points in both theoretical and practical exams to qualify for duty.Those who fail to meet the standards will receive one-on-one intensive training. Process Management (Operational Specifications) Stage-Based Quality Control 1.Pre-scanning assessment:Comprehensively evaluate the patient's physiological characteristics (age, mouth opening degree, pharyngeal reflex sensitivity) and psychological state, and formulate a personalized nursing pathway. 2.Equipment pre-inspection:Ensure sufficient battery power, clean lens, and compliant software parameter settings. 3.Material preparation Dynamic Adjustment During Scanning: Follow standardized procedures and proficiently apply scanning techniques. 1.Post-scanning data verification:Instantly validate and evaluate data (five dimensions), and rescan unqualified data. 2.On-site feedback on patient satisfaction (Likert 5-point scale), with immediate rectification of issues. 3.Statistics on oral scanning time and patient recommendation rate for oral scanning Personalized Intervention Measures 1.For patients with limited mouth opening:Provide preoperative guidance on mouth opening exercises;Use vaseline lubrication assistance during the scan. 2.For anxious patients:Offer 3D animation operation demonstrations;Implement empathic communication during the scan (e.g.,“We can pause and adjust the pace at any time”) and progressive relaxation training. 3.Real-time scanning progress broadcasting:Adopt dynamic progress updates (e.g.,“Maxillary scanning completed; approximately 2 minutes remaining”)༛Incorporate progressive relaxation training with 4-second inhalation-6-second exhalation guidance.4.Positive feedback mechanism:Provide specific encouragement for patient cooperative behaviors (e.g., maintaining stable posture), such as “You're cooperating very well—the images are extremely clear!” to enhance confidence. Result-Oriented (Quality Enhancement) Quantified Evaluation Indicators 1.Key indicators:Scanning time (target ≤ 10 minutes/single crown);Data qualification rate (target ≥ 90%);Patient satisfaction (target ≥ 98%);Patient oral scanning recommendation rate (target ≥ 80%). 2.Data feedback mechanism:Summarize and analyze unqualified data monthly;Use quality control tools to identify and analyze causes;Implement improvements through the PDCA cycle. Patient Experience Optimization Humanistic care:Strengthen communication during the operation;Assist patients in oral cleaning and facial tidying after the operation;Distribute the Oral Health Maintenance Guide to enhance health education. Patient satisfaction tracking:Collect patient satisfaction with oral scanning, recommendation rate for oral scanning operations, feedback on scanning experience, and improvement suggestions for communication effectiveness. Evaluation indicators. ① Intraoral scanning time: The entire process from the entry of patient information to the successful submission of intraoral scanning data [19, 20, 21]. ② Qualification rate of intraoral scanning data: Technicians conduct professional evaluations of the submitted data from five dimensions [22, 23, 24], which are classified into two categories: “qualified” and “unqualified”. Subsequently, the corresponding qualification rate is calculated. The higher the qualification rate, the better the scanning quality.③ Patient satisfaction: After the scanning is completed, patients use a self-made satisfaction evaluation form to conduct on-site scoring of the scanning situation from five dimensions [4, 25, 26, 27, 28, 29, 30]. The satisfaction score was calculated using the Likert 5-point scale and weighted average. The higher the satisfaction, the more satisfied the patients are. The evaluation indicators are detailed in Supplementary Material Table 2. Statistical analysis. The SPSS 27.0 software was used for data analysis. Measurement data conforming to the normal distribution are expressed as mean ± standard deviation ( \(\:\stackrel{-}{x}\) ±s), and qualitative data are expressed as frequency and percentage (%). The weights of each index were calculated by the Analytic Hierarchy Process [31]. The importance of the indicators is expressed as༈ \(\:\stackrel{-}{x}\) ±s༉. The basic situation of the experts is described by frequency and constituent ratio. The enthusiasm of the experts is expressed by the questionnaire recovery rate. The authority degree of the experts is expressed by the authority coefficient (Cr). The coordination degree of the experts' opinions is evaluated by the coefficient of variation and Kendall's W. For the inter-group comparison of the intraoral scanning time and patient satisfaction (expressed as a percentage), an independent samples T-test was used (P < 0.05). For the inter-group comparison of the qualification rate of intraoral scanning data (expressed as a percentage), a chi-square test was used (P < 0.05). Result the basic information of the expert 22 experts aged between 36 and 55 (average 41.09 ± 4.72 years); their work experience ranged from 10 to 35 years (average 21.14 ± 7.23 years). The basic information of the experts is shown in Table 2 . Table 2 Experts general information form(n = 22) Project Classification number of people (n = 22) percent(%) gender man 5 22.73 woman 17 77.27 age 30 ~ 40 13 59.09 41 ~ 50 7 31.82 50 or more 2 9.09 educational background Doctor 4 18.18 Master's degree 5 22.73 bachelor's degree 13 59.09 professional title Senior 2 9.09 Associate Senior 6 27.27 Intermediate 14 63.64 Years of experience 10 ~ 20 16 72.73 21 ~ 30 5 22.73 30 or more 1 4.55 Professional field oral care 4 18.18 Oral healthcare 6 27.27 Oral care management 10 45.45 Oral clinical management 2 9.09 A supervisor or not postgraduate supervisor 3 13.64 PhD supervisor 2 9.09 Other 17 77.27 Experts' enthusiasm, authority, and alignment of opinions According to the criterion that an expert questionnaire recovery rate of above 60% indicates a high level of enthusiasm [32], the recovery rate of the questionnaires in both rounds of this study reached 100%, suggesting that the experts showed a high level of enthusiasm. The acceptable reliability is defined as an expert authority coefficient Cr ≥ 0.70 [33]. In this study, the Cr values in the two rounds of Delphi consultations were 0.972 and 0.982 respectively, indicating a high level of authority. The authority coefficients are shown in Table 3 . The degree of coordination reflects the consistency of experts' judgments, which is evaluated through the coefficient of variation and Kendall's coefficient of concordance. In the two rounds of Delphi consultations, the coefficient of variation of each indicator was 0.000 ~ 0.111 and 0.000 ~ 0.104 respectively, and Kendall's coefficients of concordance were 0.625 and 0.687 respectively, indicating that the experts' opinions were consistent. Kendall's coefficients of concordance are shown in Table 4 . Table 3 Experts' activity coefficient and authority coefficient letter of inquiry (round) hand out questionnaires (copys) Collect valid questionnaires (copys) Effective recovery rate (%) criterion for judgment (Ca) level of familiarity (Cs) Coefficient of Authority (Cr) The first round 22 22 100 0.961 0.982 0.972 The second round 22 22 100 0.974 0.989 0.982 Table 4 The degree of coordination of experts' opinions times of inquiry Number of indicators Kendall's W χ2 value P value The first round 53 0.625 714.854 0.000 The second round 53 0.687 786.483 0.000 Expert consultation results After two rounds of expert Delphi consultations, discussions and revisions were carried out by integrating the experts' opinions respectively. Eventually, 3 first-level indicators, 12 second-level indicators, and 38 third-level indicators were formed. The results of the Delphi consultations are shown in Table 5 . Table 5 The results of the Delphi consultations first-level second-level third-level Importance score( \(\:\stackrel{-}{\varvec{x}}\) ±σ) CV Weight (%) 1 Structural indicator 4.909 ± 0.294 0.06 30.7692 1–1 staffing 4.909 ± 0.294 0.06 8.7912 1-1-1 The ratio of chairs to caregivers 4 ± 0.309 0.077 0.8791 1-1-2 The ratio of medical staff to nursing staff 4.909 ± 0.294 0.06 3.5165 1-1-3 The ratio of nurses' professional levels 4.909 ± 0.294 0.06 3.5165 1-1-4 The ratio of specialized nurses 4 ± 0.309 0.077 0.8791 1–2 Environmental layout and equipment configuration 4.909 ± 0.294 0.06 8.7912 1-2-1 The cleanliness of the oral scanning room and the oral scanning chair position 4.864 ± 0.468 0.096 1.7582 1-2-2 The compliance rate of disinfection implementation on the surface of environmental objects 4.909 ± 0.294 0.06 2.3442 1-2-3 The completeness rate of items used for oral scanning 4.909 ± 0.294 0.06 2.3442 1-2-4 The availability rate of oral scanning equipment 4.909 ± 0.294 0.06 2.3442 1–3 rules and regulations 4.864 ± 0.351 0.072 6.5934 1-3-1 The improvement rate of the oral scanning system, process, operation specifications, quality supervision structure and the relevant solution plans. 4.909 ± 0.294 0.06 5.2747 1-3-2 The implementation rate of the post responsibilities for oral scanning 4 ± 0.309 0.077 1.3187 1–4 Training and assessment 4.864 ± 0.351 0.072 6.5934 1-4-1 The implementation rate of the oral scanning training plan 4.909 ± 0.294 0.06 2.6374 1-4-2 The coverage rate of oral scanning training 4 ± 0.309 0.077 0.6593 1-4-3 The pass rate of the theoretical and practical operation examinations for oral scanning 5.00 0.00 3.2967 2 Process indicator 5.00 0.00 38.4615 2 − 1 Oral scanning assessment 4.909 ± 0.294 0.06 12.8205 2-1-1 The implementation rate of the pre-oral scanning assessment 4.864 ± 0.351 0.072 9.6153 2-1-2 The accuracy rate of personalized assessment for patients 4 ± 0.309 0.077 3.2051 2–2 Oral scanning operation 5.00 0.00 16.0256 2-2-1 The timeliness rate of oral scanning operation 4.864 ± 0.351 0.072 1.4687 2-2-2 The accuracy rate of oral scanning chair position adjustment 4.864 ± 0.351 0.072 1.4687 2-2-3 The accuracy rate of oral scanning information entry 4.955 ± 0.213 0.043 1.9620 2-2-4 The accuracy rate of oral scanning equipment usage 4.864 ± 0.468 0.096 1.4687 2-2-5 Patient cooperation degree 5.00 0.00 2.4191 2-2-6 The accuracy rate of oral scanning process 4.909 ± 0.294 0.06 1.9441 2-2-7 The qualified rate of oral scanning quality 5.00 0.00 2.4191 2-2-8 The implementation rate of preventive measures for oral scanning complications 4.091 ± 0.249 0.072 0.9720 2-2-9 Oral scanning proficiency 4.909 ± 0.294 0.06 1.9033 2–3 Communication ability 4.864 ± 0.351 0.072 9.6154 2-3-1 The effective rate of communication with patients or their families 4 ± 0.309 0.077 3.2051 2-3-2 The effective communication methods tailored for special patients 4 ± 0.309 0.077 3.2051 2-3-3 accept or adopt the constructive suggestions from patients 4 ± 0.309 0.077 3.2051 3 Outcome indicator 4.909 ± 0.294 0.06 30.7692 3 − 1 Hospital-acquired infection 4.909 ± 0.294 0.06 8.2051 3-1-1 Hand - hygiene compliance rate 4.909 ± 0.294 0.06 2.9837 3-1-2 The qualified rate of personal protective equipment wearing 4.818 ± 0.501 0.104 2.2378 3-1-3 The implementation rate of cross - infection prevention measures 4.909 ± 0.294 0.06 2.9837 3 − 2 Incidence rate of adverse events 4.909 ± 0.294 0.06 8.2051 3-2-1 Incidence rate of adverse events such as mandibular dislocation and aspiration 4.864 ± 0.351 0.072 8.2051 3–3 Humanistic care 4 ± 0.309 0.077 2.0513 3-3-1 Implementation rate of humanistic care 4 ± 0.309 0.077 2.0513 3–4 Satisfaction degree 5.00 0.00 10.2564 3-4-1 Satisfaction degree of patients and their families 4.909 ± 0.294 0.06 2.5641 3-4-2 Satisfaction degree of doctors 4.909 ± 0.294 0.06 2.5641 3-4-3 Satisfaction degree of technicians 4.909 ± 0.294 0.06 2.5641 3-4-4 Satisfaction degree of intra - oral scanner operators 4.909 ± 0.294 0.06 2.5641 3–5 Health education 4 ± 0.309 0.077 2.0513 3-5-1 The rate of health education implementation 4 ± 0.309 0.077 0.6838 3-5-2 The awareness rate of patients about intra - oral scanning and oral health care knowledge 4.091 ± 0.294 0.072 1.3675 Comparison between two group indicators After performing oral scanning and nursing using the constructed evaluation index system for the scanning quality of oral digital impressions, the oral scanning time of the experimental group was (9.05 ± 2.79) minutes, which was shorter than that of the control group [(14.86 ± 2.56) minutes]. The patient satisfaction rate of the experimental group was 98.24%, higher than 94.35% of the control group. Both of these two indicators showed statistical significance after analysis (P 0.05), but the qualified rate of 91% in the experimental group was significantly higher than 84% in the control group, reflecting the comparative advantage of the quality of oral scanning data in the experimental group. It indicates that the constructed evaluation index system for the scanning quality of oral digital impressions has high clinical application value.The evaluation indicators of the two groups are shown in Table 6 . Table 6 The evaluation indicators of the two groups category Number of cases (cases) Intra-oral scanning time (min, \(\:\stackrel{-}{\mathbf{x}}\) ±s ) Qualified rate of intraoral scanning data(%) Patient satisfaction degree(%) control group 100 14.86 ± 2.56 84 94.35 experimental group 100 9.05 ± 2. 79 91 98.24 X 2 /t -15.315 2.24 13.44 P value 0.000 0.134 0.000 Discussion Scientific validity and clinical applicability With the rapid development of oral digital technology, the quality evaluation of digital impression scanning has become a research focus. However, Alkadi's [34] systematic review shows that approximately 80% of related studies overly focus on technical parameters such as equipment accuracy and seriously neglect the crucial dimension of standardization of nursing operations. Among them, standardized training processes account for only 12% of the total number of studies, and infection control standards account for 9% [5]. In this study, innovative methodological integration was adopted. Through systematic literature review, in-depth qualitative interviews, and rigorous Delphi expert consultations, the first quality evaluation index system for digital impression scanning from the perspective of nursing management was constructed. After two rounds of strict consultations, the questionnaire recovery rate of 22 senior experts in the field of stomatology reached 100%. The expert authority coefficients (Cr values) were 0.972 and 0.982, and the Kendall's coefficients of concordance (W values) were 0.625 and 0.687 (P < 0.001), fully demonstrating the scientific nature of this system. Based on the three-dimensional quality model of “structure-process-result”, this system covers 12 dimensions and 38 specific indicators. It innovatively incorporates clinically practical indicators such as “proficiency in oral scanning operation” (weight 1.90%), “patient cooperation degree” (weight 2.42%) and “technician satisfaction” (weight 2.56%). Clinical application has confirmed that the application of this system can significantly improve clinical efficacy. The operation time is shortened by 39.1%, quality and safety are ensured, the qualified rate of data is increased by 8.3%, the service experience is optimized, and the satisfaction is increased by 4.1%, strongly confirming the clinical applicability of this index system. Key steps in practical application Firstly, patient cooperation is the foundation for ensuring the quality of scanning. It is necessary to comprehensively evaluate factors such as the patient's age, educational level, sensitivity of the pharyngeal reflex, and mouth opening degree, and formulate a personalized oral scanning nursing intervention measures. Studies have shown that combining cognitive education with progressive relaxation training can effectively relieve patients' nervousness and improve their cooperation ability [35, 36, 37], thus helping patients better adapt to the scanning process and giving full play to the advantages of digital scanning in terms of comfort and convenience. Secondly, the scanning quality is the core of the evaluation index system. Before scanning: It is necessary to strictly control the quality control links, including ensuring that all the items for oral scanning are complete, the equipment has sufficient power supply and is in good performance, and completing the calibration and debugging of the equipment [38] and parameter settings [39, 40, 41] to make the equipment in the best working state. During scanning: The operator needs to follow the standardized process and skillfully apply scanning techniques [42, 43, 44]. An in vitro study by Resende et al. [4] shows that an experienced operator can not only shorten the scanning time but also improve the accuracy of the data. After scanning: It is necessary to optimize and repair the data to further improve the data quality [42, 45, 46]. Thirdly, the qualified rate and satisfaction are the key points for optimizing the scanning work. The feedback mechanism of the "qualified rate of scanning data" should be strengthened. The digital oral scanning work should be continuously optimized through the quality evaluation system, with a focus on studying the accuracy, integrity, and clarity of the scanning data, as well as reducing errors and the number of rework, so as to improve the work efficiency and production quality of technicians [47]. At the same time, the feedback function of "patient satisfaction" should be strengthened. In-depth research should be carried out in aspects such as the improvement of nursing techniques, the optimization of operation processes, the implementation of infection control, the communication between nurses and patients, humanistic care, and the patient experience, so as to comprehensively improve the level of digital oral nursing service. The significance of an evaluation index system Guiding modular training . The quality evaluation index system constructed in this study provides a data-driven scientific basis for the training of oral digital scanning. Based on the systematic analysis of key quality indicators such as scanning integrity, accuracy, clarity, and scanning efficiency, a hierarchical modular training model is established. For newly admitted scanning nurses, the focus is on basic operation specifications, while for skilled scanning nurses, the emphasis is on the optimization of scanning for complex cases. At the same time, special training courses are developed for common clinical problems (such as blurriness in the posterior tooth area, gingival bleeding, splicing errors, etc.). The study by Li P et al. [48] shows that hierarchical modular training can increase the speed of mastering operation skills and significantly reduce the operation error rate.By combining the quality evaluation index system for digital impression scanning with modular hierarchical training, targeted courses are designed according to different clinical needs (such as implantation, orthodontics, etc.); the training requirements for different scanning technologies (such as full-mouth scanning and local fine scanning) are met; and the personalized learning needs of personnel at different levels are satisfied. This data-driven training system significantly improves the pertinence and efficiency of training, and provides a standardized solution for the cultivation of digital talents in oral nursing. Establish a standardized system for evaluating job competencies .This system solves the problem of the lack of a unified standard for the assessment of oral digital scanning personnel by means of quantitative scoring, covering multi-dimensional evaluations such as technical ability, operation processes, infection control, and humanistic care. Based on the weak points identified in the assessment results, personalized training and development suggestions are provided for oral scanning nurses to help them continuously improve their professional skills and comprehensive qualities. Standardize the access criteria for the digital scanning position. The access to the oral digital scanning position is the first "threshold" to ensure the quality of oral medical services. By constructing the quality evaluation index system for digital impression scanning, specific standard requirements are provided for the professional knowledge, skill level, and practical experience required for the position, offering a scientific basis for position access. These standards can include the operation specifications for digital scanning work, the evaluation criteria for scanning quality, the requirements for the scanning position, etc. Only when scanning personnel meet or exceed these standards can they be allowed to enter the oral digital scanning position. Research limitations. All the experts consulted in this study are stomatological experts within Yunnan Province, and the constructed evaluation index system has only been applied in a Class III Grade A general hospital in the province, so its applicability is limited. In the follow-up, the scope of the consulted experts and the scope of medical institutions using the index will be expanded, and the index system will be continuously improved in combination with clinical practice to make it more valuable for clinical application. Conclusion This study takes the three-dimensional quality structure model as its theoretical foundation, focuses on the existing problems in the field of oral digital impression scanning, and systematically constructs a quality evaluation index system for oral digital impression scanning by comprehensively applying literature review, qualitative interviews, and the Delphi expert consensus method. Through clinical verification via RCT, research data shows that this evaluation index system can significantly shorten the operation time of impression scanning, improve the qualification rate of scanning data, and enhance patient satisfaction, achieving a complete closed loop from theoretical construction to clinical practice verification. Adopting a mixed research approach, this study aligns with international academic frontier trends, providing an innovative methodology for research on oral digital nursing quality. It not only offers an evaluation benchmark and theoretical framework for the construction of standardized training systems for digital impression scanning, qualification certification for scanning positions, and the research and development of human-machine collaborative operation modes and AI quality-controlled scanning systems, but also pioneers a new application model for theories of oral nursing quality management in the context of digital transformation. Follow-up research will focus on developing a hierarchical modular training system based on this evaluation index system, continuously promoting the standardized development of oral digital diagnosis and treatment technologies. Abbreviations CNKI China National Knowledge Infrastructure VIP Chongqing VIP Information Co., Ltd CBM China Biology Medicine Database Cr Credibility Coefficient p-value Probability value Kendall's W Kendall's coefficient of concordance Declarations Acknowledgements We are deeply grateful to all who contributed to this study. Thanks to the 22 experts for their expertise in the Delphi consultations and the 19 interviewees for their valuable insights. The patients in the clinical trial are also greatly appreciated for their cooperation. Our sincere gratitude goes to the research team for their dedicated work. We also thank the Stomatology Department of the Yunnan tertiary hospital for its support. Their help was crucial to the success of this research. Funding This work was funded by the Yunnan Provincial Health Commission and the 920th Hospital, grant number: 017102. Author information 1.Department of Stomatology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming 650032, China Fali Zhang, Shunyi Wu, Leilei Zhang, Lijia He, Jianmei Guo, Zhuzhu Tian, Min Wang, Wenyun Zhang & Jun Su 2.Department of Infection Management, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China Xinchun Zou Authors’ contributions Research plan conception:WYZ, XCZ, JS, LLZ, LJH. Interviews and questionnaires conduction: JMG, FLZ, ZZT, MW. Data collection: ZZT, MW, FLZ. Data analysis: LLZ and SYW. Writing the first and final versions of the manuscript: FLZ. revising the manuscript: WYZ. making the figures and tables: SYW. All authors have approved the final version of the manuscript for publication. Data availability The data-set used and/or analyzed during the current study is available from the corresponding author upon reasonable request. Ethics approval and consent to participate This study was approved by the Ethics Review Committee of the 920th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army, in accordance with Document 920IEC/AF/71-02/2024-02.1. The approval number is: 伦审2025-075(科)-01. Informed consent was obtained from all study participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References National Health Commission of the People’s Republic of China. Healthy Oral Action Plan (2019–2025) [EB/OL]. (2022-05-20) [2023-10-11]. Xu H, Xu XQ, Shi Y, et al. The mediating role of psychological capital in the relationship between job competency and work engagement among dental nurses [J]. Evidence-Based Nursing, 2024, 10(14): 2644-2647. Chen L, Chen C, Li ZY, et al. 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The role of psychology and communication skills in orthodontic practice: a systematic review [J]. BMC Medical Education, 2024, 24(1): 1472. Çoban Büyükbayraktar Z, Doruk C. Dental Anxiety and Fear Levels, Patient Satisfaction, and Quality of Life in Patients Undergoing Orthodontic Treatment: Is There a Relationship? [J]. Turkish Journal of Orthodontics, 2021, 34(4): 234-241. Ho JCY, Chai HH, Lo ECM, et al. Strategies for Effective Dentist-Patient Communication: A Literature Review [J]. Patient Preference and Adherence, 2024, 18: 1385-1394. Patel C, Barot GN, Patel MC, et al. Accuracy and Comfort in Digital and Conventional Impression in Pediatric Dental Patients: A Randomized Comparative Study [J]. Cureus, 2025, 17(1): e76882. Park S, Kim HK, Lee M. An analytic hierarchy process analysis for reinforcing doctor-patient communication [J]. BMC Primary Care, 2023, 24(1): 24. Guo Y, Li X, Chen D, Zhang H. Evaluation Study on the Use of Non-Contact Prevention and Protection Products in the Context of COVID-19: A Comprehensive Evaluation Method from AHP and Entropy Weight Method [J]. International Journal of Environmental Research and Public Health, 2022, 19: 16857. Qabool H, Sukhia RH, Fida M. Assessment of cooperation and compliance in adult patients at three stages of orthodontic treatment at a tertiary care hospital: A cross-sectional study [J]. International Orthodontics, 2020, 18(4): 794-800. Alkadi L. A Comprehensive Review of Factors That Influence the Accuracy of Intraoral Scanners [J]. Diagnostics, 2023, 13(21): 3291. Ray CD, Floyd K, Mongeau PA, Randall AK. Success Bias and Inflation Bias After Planning and Communicating Emotional Support [J]. Journal of Cancer Education, 2020, 35(5): 972-976. Bowers EM, Woolley MG, Muñoz K, et al. Acceptance and commitment therapy versus progressive relaxation training for misophonia: Randomized controlled trial protocol, interventions, and audiological assessments [J]. Contemporary Clinical Trials, 2024, 145: 107671. Richert R, Goujat A, Venet L, et al. Intraoral scanner technologies: a review to make a successful impression [J]. Journal of Healthcare Engineering, 2017, 2017: 8427595. Kim MK, Kim JM, Lee YM, et al. The effect of scanning distance on the accuracy of intra-oral scanners used in dentistry [J]. Clinical Anatomy, 2019, 32(3): 430-438. Camcı H, Salmanpour F. Effect of saliva isolation and intraoral light levels on performance of intraoral scanners [J]. American Journal of Orthodontics and Dentofacial Orthopedics, 2020, 158(5): 759-766. Lim JH, Park JM, Kim M, et al. Comparison of digital intraoral scanner reproducibility and image trueness considering repetitive experience [J]. Journal of Prosthetic Dentistry, 2018, 119(2): 225-232. Akl MA, Mansour DE, Zheng F. The Role of Intraoral Scanners in the Shade Matching Process: A Systematic Review [J]. Journal of Prosthodontics, 2023, 32(3): 196-203. Rotar RN, Faur AB, Pop D, Jivanescu A. Scanning Distance Influence on the Intraoral Scanning Accuracy-An In Vitro Study [J]. Materials, 2022, 15(9): 3061. Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans. Part 1: Operator factors [J]. Journal of Esthetic and Restorative Dentistry, 2023, 35(1): 230-240. Mehl A, Reich S, Beuer F, Güth JF. Accuracy, trueness, and precision - a guideline for the evaluation of these basic values in digital dentistry [J]. International Journal of Computerized Dentistry, 2021, 24(4): 341-352. Amornvit P, Sanohkan S, Peampring C. Studying the Optical 3D Accuracy of Intraoral Scans: An In Vitro Study [J]. Journal of Healthcare Engineering, 2020, 2020: 5739312. Chen Y, Zhai Z, Li H, et al. Influence of liquid on the tooth surface on the accuracy of intraoral scanners: an in vitro study [J]. Journal of Prosthodontics, 2022, 31(1): 59-64. Liu JX, Hu YQ, Zhong MY, et al. Application of digital technology in anterior aesthetic restoration from the perspective of dental technicians [J]. China Medical Engineering, 2021, 29(12): 47-51. Li P, Chi H, Sun Z, Song X. Application of FOCUS-PDCA modular hierarchical training model in nursing management and influence on improving nursing quality and satisfaction [J]. Minerva Medica, 2023, DOI: 10.23736/S0026-4806.23.08898-5. Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterialTable1QualitativeInterview.doc supplementarymaterialtable2SummaryTableofEvaluationIndicators.xlsx supplementarymaterialtable3PatientSatisfactionEvaluationForm.xlsx SupplementaryMaterialTable4OralScanningOperationScoringSheet.docx SupplementaryMaterialTable5OralCavityScanningQualityInspectionSheet.xls SupplementaryMaterialtable6PatientSatisfactionQuestionnaire.doc Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 21 Dec, 2025 Reviews received at journal 19 Dec, 2025 Reviews received at journal 18 Dec, 2025 Reviews received at journal 15 Dec, 2025 Reviewers agreed at journal 14 Dec, 2025 Reviewers agreed at journal 13 Dec, 2025 Reviews received at journal 11 Dec, 2025 Reviewers agreed at journal 10 Dec, 2025 Reviewers agreed at journal 10 Dec, 2025 Reviewers agreed at journal 09 Dec, 2025 Reviews received at journal 09 Dec, 2025 Reviewers agreed at journal 08 Dec, 2025 Reviewers agreed at journal 08 Dec, 2025 Reviewers agreed at journal 27 Nov, 2025 Editor invited by journal 06 Nov, 2025 Reviewers invited by journal 14 Jul, 2025 Editor assigned by journal 21 Jun, 2025 Submission checks completed at journal 21 Jun, 2025 First submitted to journal 16 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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scanning","fulltext":[{"header":"Introduction","content":"\u003cp\u003e With the deepening implementation of the \u0026ldquo;Healthy China 2030\u0026rdquo; Plan Outline, oral health, as a vital part of national health, has gained increasing attention. The \u0026ldquo;Healthy Oral Action Plan (2019\u0026ndash;2025)\u0026rdquo; emphasizes that strengthening the construction of oral professional talent teams is a strategic priority for improving oral medical service quality [1]. In the context of rapid development in digital oral diagnosis and treatment, digital impression technology has become a core technique due to its efficiency and precision [2]. Notably, approximately 78% of digital impression scanning operations in clinical practice are performed by nursing staff [3], posing new challenges to their professional technical capabilities. Studies have shown that scanning quality is significantly \u0026ldquo;operator-dependent\u0026rdquo; with experienced operators reducing scanning time by 40% and increasing data accuracy by 25% [4]. However, existing quality control research has three limitations: (1)excessive focus on equipment performance parameters (83.4% of existing literature), neglecting standardized operation process research [5]; (2)lack of a systematic quality evaluation framework, especially for nursing operations; (3)insufficient clinical evidence, with only 12% of studies using RCT or clinical validation designs [6]. These limitations lead to inconsistent training standards and variable scanning quality across institutions [7].\u003c/p\u003e\u003cp\u003eThis study, based on Donabedian's classic \u0026ldquo;Structure-Process-Outcome\u0026rdquo; quality model [8], innovatively constructed the first quality evaluation index system for nursing-led digital impression scanning. Through two rounds of Delphi expert consensus (n\u0026thinsp;=\u0026thinsp;22, Cr\u0026thinsp;=\u0026thinsp;0.98), the system researches and determines 3 first-level, 12 second-level and 35 third-level indicators, covering key elements such as personnel qualifications, equipment management, operational norms and humanistic care. The subsequent clinical validation (n\u0026thinsp;=\u0026thinsp;200) confirmed that the system reduced scanning time by 39.1%, improved data qualification rate by 8.3%, and increased patient satisfaction by 4.1%.\u003c/p\u003e\u003cp\u003eThis study firstly applies the medical quality evaluation model systematically to the field of oral digital nursing. It has established quantifiable evaluation criteria for nursing operations, provided a scientific framework for the cultivation of oral digital nursing talents, and laid an evaluation foundation for the research and development of \u0026ldquo;human-machine collaboration\u0026rdquo; operation modes and AI quality control systems. These achievements respond to the national strategic needs for the digital transformation of oral health services, and play an important role in promoting the improvement of oral medical nursing service quality.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003ePhase 1:Construction of the quality evaluation index system\u003c/h2\u003e\u003cp\u003e\u003cb\u003eEstablishment of the research team.\u003c/b\u003e the research team composed of 7 members, including 1 PhD(team-leader), 4 master's degree holders, and 2 undergraduates; 1 chief physician, 2 associate chief physicians, 1 attending physician, 2 senior nurses and 1 technician. The team covered fields of oral management, clinical dentistry, oral nursing and oral scanning, responsible for literature retrieval, interview outline development, index draft construction, expert selection and data analysis.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLiterature retrieval.\u003c/b\u003e Chinese and English databases (CNKI, VIP, Wanfang Data, CBM, PubMed, Web of Science) were searched using terms like\u0026ldquo;digital oral care\u0026rdquo; \u0026ldquo;digital impression\u0026rdquo; \u0026ldquo;Delphi method\u0026rdquo; and so on. Two researchers used \u0026ldquo;Mendeley one\u0026rdquo; software for Initial screening, then all members of team, with solving issues and breaking through bottlenecks in clinical practice, review full-text and thematic analysis to identify relevant indicators and draft interview outlines.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSemi-structured interviews.\u003c/b\u003e Nineteen participants from a tertiary hospital's department of stomatology (including two directors, two charge-nurses,two tooth-reparative dentists, three technicians, five oral-scanning nurses and five patients) were purposively sampled. Based on a pre-prepared interview outline which include the characteristics and requirements of oral management, oral treatment, oral scanning and patient experience, etc, Interviews explored multi-dimensional aspects of digital impression scanning, with content analyzed using Colaizzi's 7-step method [9], yielding 13 themes (staffing, environmental layout, equipment configuration, regulations and standards, training and assessment, oral scanning evaluation, oral scanning operations, health education, communication skills, hospital infections, adverse event occurrence, humanistic care and satisfaction), then draft of an initial evaluation index system for the quality of oral digital impression scans. The interview content is detailed in Supplementary Table\u0026nbsp;1.\u003c/p\u003e\u003cp\u003e\u003cb\u003eDraft an expert consultation questionnaire.\u003c/b\u003e Taking the three-dimensional quality structure model as the theoretical framework, based on the initial draft of the evaluation index system and combined with clinical nursing routines, after two rounds of group discussions, 3 first-level indicators, 13 second-level indicators, and 51 third-level indicators have been preliminarily formulated and compiled into an expert consultation questionnaire. The questionnaire consists of three parts: ① Instructions of the questionnaire, which expound the research purpose and content; ②The main body of the questionnaire, including the consultation form for the evaluation index system of the scanning quality of oral digital impressions (using the Likert 5-point scale [10] to evaluate the importance of each item) and modification suggestions; ③The questionnaire on the basic information of experts, the basis for index judgment, and the degree of familiarity.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSelect expert consultants.\u003c/b\u003e According to the principles of rationality of knowledge structure and professional complementarity, we use the purposive sampling method to select oral experts. The selection criteria are as follows: ① Oral management experts, oral nursing experts, or oral clinical experts from Grade III Class A general hospitals or stomatological specialized hospitals in Yunnan Province; ② Bachelor's degree or above; ③ Intermediate professional title or above, and have been engaged in oral-related work for more than 10 years; ④ Willing to participate in the Delphi expert consultation.\u003c/p\u003e\u003cp\u003e\u003cb\u003eImplement expert consultation.\u003c/b\u003e According to the Delphi principles [11, 12, 13, 14], 22 oral experts were selected in March 2025 to conduct two rounds of consultation through Wenjuanxing (an online questionnaire platform). Each round of consultation was completed within two weeks. After each round of consultation, the indicators with an average importance score of equal or above 4.0 and a coefficient of variation of less than 0.25 were retained [15]. Combined with the suggestions of experts and group discussions, modified the indicators, then the next round of consultation was carried out. After two rounds of consultation, the opinions of experts tended to be consistent, and the quality evaluation index system was settled down. See Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e for details.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003ePhase 2:Clinical application\u003c/h3\u003e\n\u003cp\u003e\u003cb\u003eParticipants.\u003c/b\u003e A total of 200 patients who underwent intraoral scanning of digital impressions for single crown restoration of posterior teeth in the Dental Department of a tertiary hospital in Yunnan Province from May to June 2025 were selected. They were divided into a control group and an experimental group according to the treatment time, with 100 cases in each group. Among them, there were 107 females and 93 males, aged from 20 to 78 years old, with an average age of 44.3 years old. The restored tooth positions included 59 maxillary molars, 69 mandibular molars, 34 maxillary premolars and 38 mandibular premolars. Inclusion criteria: ① Age equal or above 18 years old; ② Good periodontal condition; ③ The adjacent teeth and the opposite teeth are intact or the filling/restoration treatment has been completed; ④ The patient gives informed consent. Withdrawal criteria:Patients who request to withdraw during the intervention period; ② Participants who fail to complete the study for various reasons. This study has been approved by the Medical Research Ethics Committee of the 920th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army (Review No.: 920IEC/AF/71\u0026thinsp;\u0026minus;\u0026thinsp;02/2024\u0026thinsp;\u0026minus;\u0026thinsp;02.1).\u003c/p\u003e\u003cp\u003e\u003cb\u003eGrouping.\u003c/b\u003e Control group: The scanning nursing staff were trained through the master-apprentice teaching method. Conventional intraoral scanning operations were carried out, including preparations before the operation, quality control during the operation, and health education after the operation. Oral specialty nursing was implemented throughout the scanning process. Experimental group: According to the constructed quality evaluation index system for oral digital impression scanning, a quality evaluation and nursing implementation plan for oral impression scanning was formulated. The plan was strictly implemented, and intraoral scanning and nursing were carried out for the patients. It included forming a special intraoral scanning team, perfecting the scanning specifications and systems, optimizing the training plan and implementing it [4, 16, 17], strictly assessing the admission qualifications, and implementing quality control and personalized intraoral scanning nursing [18]. The specific implementation plan is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStandardized Impression Scanning Nursing Intervention Program Based on Donabedian's Three-Dimensional Quality Model\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eStandardized Impression Scanning Nursing Intervention Program\u003c/p\u003e\u003cp\u003eBased on Donabedian's Three-Dimensional Quality Model\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStructure Optimization\u003c/p\u003e\u003cp\u003e(Basic Support)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEstablish a Special Oral Scanning Team\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Establish a three-level quality control framework:Oral Scanning Operation Group (clinical execution layer);Data Quality Control Group (technical supervision layer)༛Nursing Management Group (decision-making layer). 2.Configure a standardized oral scanning room (including environmental control, equipment segmentation, and privacy protection)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStandardization of Systems and Processes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Formulate the Digital Oral Scanning Operation Specifications Manual (including standard procedures for equipment operation, oral scanning, emergency handling, etc.). 2.Establish an oral scanning admission and dynamic reward-punishment mechanism:Link scanning quality with nursing performance;Reward teams that meet standards, and require non-compliant teams to receive intensive training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDynamic Training and Assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Optimize the training program:Clarify training duration, frequency, content, and methods (e.g., peer role-playing) to enhance nurses' operational proficiency. 2.Implement hierarchical modular training:Junior nurses: Focus on basic theories and practical operations (e.g., equipment calibration, single-tooth scanning);Senior nurses: Strengthen complex case management (e.g., full-mouth scan stitching, management of patients with hypersensitive gag reflex). 3.Assessment criteria:Nurses must score\u0026thinsp;\u0026ge;\u0026thinsp;85 points in both theoretical and practical exams to qualify for duty.Those who fail to meet the standards will receive one-on-one intensive training.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eProcess Management (Operational Specifications)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStage-Based Quality Control\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Pre-scanning assessment:Comprehensively evaluate the patient's physiological characteristics (age, mouth opening degree, pharyngeal reflex sensitivity) and psychological state, and formulate a personalized nursing pathway. 2.Equipment pre-inspection:Ensure sufficient battery power, clean lens, and compliant software parameter settings. 3.Material preparation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eDynamic Adjustment During Scanning: Follow standardized procedures and proficiently apply scanning techniques.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Post-scanning data verification:Instantly validate and evaluate data (five dimensions), and rescan unqualified data. 2.On-site feedback on patient satisfaction (Likert 5-point scale), with immediate rectification of issues. 3.Statistics on oral scanning time and patient recommendation rate for oral scanning\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePersonalized \u003c/p\u003e\u003cp\u003eIntervention Measures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.For patients with limited mouth opening:Provide preoperative guidance on mouth opening exercises;Use vaseline lubrication assistance during the scan. 2.For anxious patients:Offer 3D animation operation demonstrations;Implement empathic communication during the scan (e.g.,\u0026ldquo;We can pause and adjust the pace at any time\u0026rdquo;) and progressive relaxation training. 3.Real-time scanning progress broadcasting:Adopt dynamic progress updates (e.g.,\u0026ldquo;Maxillary scanning completed; approximately 2 minutes remaining\u0026rdquo;)༛Incorporate progressive relaxation training with 4-second inhalation-6-second exhalation guidance.4.Positive feedback mechanism:Provide specific encouragement for patient cooperative behaviors (e.g., maintaining stable posture), such as \u0026ldquo;You're cooperating very well\u0026mdash;the images are extremely clear!\u0026rdquo; to enhance confidence.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eResult-Oriented (Quality Enhancement)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eQuantified Evaluation Indicators\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e1.Key indicators:Scanning time (target\u0026thinsp;\u0026le;\u0026thinsp;10 minutes/single crown);Data qualification rate (target\u0026thinsp;\u0026ge;\u0026thinsp;90%);Patient satisfaction (target\u0026thinsp;\u0026ge;\u0026thinsp;98%);Patient oral scanning recommendation rate (target\u0026thinsp;\u0026ge;\u0026thinsp;80%). 2.Data feedback mechanism:Summarize and analyze unqualified data monthly;Use quality control tools to identify and analyze causes;Implement improvements through the PDCA cycle.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePatient Experience Optimization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eHumanistic care:Strengthen communication during the operation;Assist patients in oral cleaning and facial tidying after the operation;Distribute the Oral Health Maintenance Guide to enhance health education.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003ePatient satisfaction tracking:Collect patient satisfaction with oral scanning, recommendation rate for oral scanning operations, feedback on scanning experience, and improvement suggestions for communication effectiveness.\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eEvaluation indicators.\u003c/b\u003e ① Intraoral scanning time: The entire process from the entry of patient information to the successful submission of intraoral scanning data [19, 20, 21]. ② Qualification rate of intraoral scanning data: Technicians conduct professional evaluations of the submitted data from five dimensions [22, 23, 24], which are classified into two categories: \u0026ldquo;qualified\u0026rdquo; and \u0026ldquo;unqualified\u0026rdquo;. Subsequently, the corresponding qualification rate is calculated. The higher the qualification rate, the better the scanning quality.③ Patient satisfaction: After the scanning is completed, patients use a self-made satisfaction evaluation form to conduct on-site scoring of the scanning situation from five dimensions [4, 25, 26, 27, 28, 29, 30]. The satisfaction score was calculated using the Likert 5-point scale and weighted average. The higher the satisfaction, the more satisfied the patients are. The evaluation indicators are detailed in Supplementary Material Table\u0026nbsp;2.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStatistical analysis.\u003c/b\u003eThe SPSS 27.0 software was used for data analysis. Measurement data conforming to the normal distribution are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{x}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s), and qualitative data are expressed as frequency and percentage (%). The weights of each index were calculated by the Analytic Hierarchy Process [31]. The importance of the indicators is expressed as༈\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{x}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s༉. The basic situation of the experts is described by frequency and constituent ratio. The enthusiasm of the experts is expressed by the questionnaire recovery rate. The authority degree of the experts is expressed by the authority coefficient (Cr). The coordination degree of the experts' opinions is evaluated by the coefficient of variation and Kendall's W. For the inter-group comparison of the intraoral scanning time and patient satisfaction (expressed as a percentage), an independent samples T-test was used (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). For the inter-group comparison of the qualification rate of intraoral scanning data (expressed as a percentage), a chi-square test was used (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Result","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003ethe basic information of the expert\u003c/h2\u003e\u003cp\u003e22 experts aged between 36 and 55 (average 41.09\u0026thinsp;\u0026plusmn;\u0026thinsp;4.72 years); their work experience ranged from 10 to 35 years (average 21.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.23 years). The basic information of the experts is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExperts general information form(n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProject\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClassification\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003enumber of people\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003epercent(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003egender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eman\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e22.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ewoman\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e77.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eage\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e30\u0026thinsp;~\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e59.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e41\u0026thinsp;~\u0026thinsp;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e31.82\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e50 or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eeducational background\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eDoctor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e18.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMaster's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e22.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ebachelor's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e59.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eprofessional title\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eSenior\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eAssociate Senior\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eIntermediate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e63.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eYears of experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e10\u0026thinsp;~\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e72.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e21\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e22.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e30 or more\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e4.55\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eProfessional field\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eoral care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e18.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOral healthcare\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e27.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOral care\u003c/p\u003e\u003cp\u003emanagement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e45.45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOral clinical\u003c/p\u003e\u003cp\u003emanagement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eA supervisor or not\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003epostgraduate supervisor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e13.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePhD supervisor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e77.27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eExperts' enthusiasm, authority, and alignment of opinions\u003c/h2\u003e\u003cp\u003eAccording to the criterion that an expert questionnaire recovery rate of above 60% indicates a high level of enthusiasm [32], the recovery rate of the questionnaires in both rounds of this study reached 100%, suggesting that the experts showed a high level of enthusiasm. The acceptable reliability is defined as an expert authority coefficient Cr\u0026thinsp;\u0026ge;\u0026thinsp;0.70 [33]. In this study, the Cr values in the two rounds of Delphi consultations were 0.972 and 0.982 respectively, indicating a high level of authority. The authority coefficients are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. The degree of coordination reflects the consistency of experts' judgments, which is evaluated through the coefficient of variation and Kendall's coefficient of concordance. In the two rounds of Delphi consultations, the coefficient of variation of each indicator was 0.000\u0026thinsp;~\u0026thinsp;0.111 and 0.000\u0026thinsp;~\u0026thinsp;0.104 respectively, and Kendall's coefficients of concordance were 0.625 and 0.687 respectively, indicating that the experts' opinions were consistent. Kendall's coefficients of concordance are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExperts' activity coefficient and authority coefficient\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eletter of inquiry\u003c/p\u003e\u003cp\u003e(round)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ehand out questionnaires\u003c/p\u003e\u003cp\u003e(copys)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCollect valid questionnaires\u003c/p\u003e\u003cp\u003e(copys)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEffective recovery rate\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ecriterion for judgment\u003c/p\u003e\u003cp\u003e(Ca)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003elevel of familiarity\u003c/p\u003e\u003cp\u003e(Cs)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCoefficient of Authority\u003c/p\u003e\u003cp\u003e(Cr)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe first round\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.961\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.972\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe second round\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.974\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.989\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe degree of coordination of experts' opinions\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003etimes of inquiry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of indicators\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eKendall's W\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ2 value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe first round\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.625\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e714.854\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe second round\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.687\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e786.483\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eExpert consultation results\u003c/h3\u003e\n\u003cp\u003eAfter two rounds of expert Delphi consultations, discussions and revisions were carried out by integrating the experts' opinions respectively. Eventually, 3 first-level indicators, 12 second-level indicators, and 38 third-level indicators were formed. The results of the Delphi consultations are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe results of the Delphi consultations\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003efirst-level\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003esecond-level\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ethird-level\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eImportance score(\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{x}}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;σ)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCV\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeight\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003cp\u003eStructural indicator\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30.7692\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;1\u003c/p\u003e\u003cp\u003estaffing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.7912\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-1-1\u003c/p\u003e\u003cp\u003eThe ratio of chairs to caregivers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.8791\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-1-2\u003c/p\u003e\u003cp\u003eThe ratio of medical staff to nursing staff\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.5165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-1-3\u003c/p\u003e\u003cp\u003eThe ratio of nurses' professional levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.5165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-1-4\u003c/p\u003e\u003cp\u003eThe ratio of specialized nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.8791\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 Environmental layout and equipment configuration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.7912\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-2-1\u003c/p\u003e\u003cp\u003eThe cleanliness of the oral scanning room and the oral scanning chair position\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.7582\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-2-2\u003c/p\u003e\u003cp\u003eThe compliance rate of disinfection implementation on the surface of environmental objects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.3442\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-2-3\u003c/p\u003e\u003cp\u003eThe completeness rate of items used for oral scanning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.3442\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-2-4\u003c/p\u003e\u003cp\u003eThe availability rate of oral scanning equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.3442\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;3\u003c/p\u003e\u003cp\u003erules and regulations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.5934\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-3-1\u003c/p\u003e\u003cp\u003eThe improvement rate of the oral scanning system, process, operation specifications, quality supervision structure and the relevant solution plans.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.2747\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-3-2\u003c/p\u003e\u003cp\u003eThe implementation rate of the post responsibilities for oral scanning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.3187\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;4\u003c/p\u003e\u003cp\u003eTraining and assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.5934\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-4-1\u003c/p\u003e\u003cp\u003eThe implementation rate of the oral scanning training plan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.6374\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-4-2\u003c/p\u003e\u003cp\u003eThe coverage rate of oral scanning training\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.6593\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-4-3\u003c/p\u003e\u003cp\u003eThe pass rate of the theoretical and practical operation examinations for oral scanning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2967\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e\u003cp\u003eProcess indicator\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e38.4615\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026thinsp;\u0026minus;\u0026thinsp;1\u003c/p\u003e\u003cp\u003eOral scanning assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12.8205\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-1-1\u003c/p\u003e\u003cp\u003eThe implementation rate of the pre-oral scanning assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.6153\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-1-2\u003c/p\u003e\u003cp\u003eThe accuracy rate of personalized assessment for patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;2\u003c/p\u003e\u003cp\u003eOral scanning operation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.0256\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-1\u003c/p\u003e\u003cp\u003eThe timeliness rate of oral scanning operation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.4687\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-2\u003c/p\u003e\u003cp\u003eThe accuracy rate of oral scanning chair position adjustment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.4687\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-3\u003c/p\u003e\u003cp\u003eThe accuracy rate of oral scanning information entry\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.955\u0026thinsp;\u0026plusmn;\u0026thinsp;0.213\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.043\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.9620\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-4\u003c/p\u003e\u003cp\u003eThe accuracy rate of oral scanning equipment usage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.4687\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-5\u003c/p\u003e\u003cp\u003ePatient cooperation degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.4191\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-6\u003c/p\u003e\u003cp\u003eThe accuracy rate of oral scanning process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.9441\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-7\u003c/p\u003e\u003cp\u003eThe qualified rate of oral scanning quality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.4191\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-8\u003c/p\u003e\u003cp\u003eThe implementation rate of preventive measures for oral scanning complications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.091\u0026thinsp;\u0026plusmn;\u0026thinsp;0.249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.9720\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-2-9\u003c/p\u003e\u003cp\u003eOral scanning proficiency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.9033\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;3\u003c/p\u003e\u003cp\u003eCommunication ability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.6154\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-3-1\u003c/p\u003e\u003cp\u003eThe effective rate of communication with patients or their families\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-3-2\u003c/p\u003e\u003cp\u003eThe effective communication methods tailored for special patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-3-3\u003c/p\u003e\u003cp\u003eaccept or adopt the constructive suggestions from patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e\u003cp\u003eOutcome indicator\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30.7692\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026thinsp;\u0026minus;\u0026thinsp;1\u003c/p\u003e\u003cp\u003eHospital-acquired infection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-1-1\u003c/p\u003e\u003cp\u003eHand - hygiene compliance rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.9837\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-1-2\u003c/p\u003e\u003cp\u003eThe qualified rate of personal protective equipment wearing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.818\u0026thinsp;\u0026plusmn;\u0026thinsp;0.501\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.2378\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-1-3\u003c/p\u003e\u003cp\u003eThe implementation rate of cross - infection prevention measures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.9837\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026thinsp;\u0026minus;\u0026thinsp;2\u003c/p\u003e\u003cp\u003eIncidence rate of adverse events\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-2-1\u003c/p\u003e\u003cp\u003eIncidence rate of adverse events such as mandibular dislocation and aspiration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.864\u0026thinsp;\u0026plusmn;\u0026thinsp;0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.2051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;3\u003c/p\u003e\u003cp\u003eHumanistic care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.0513\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-3-1\u003c/p\u003e\u003cp\u003eImplementation rate of humanistic care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.0513\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;4\u003c/p\u003e\u003cp\u003eSatisfaction degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10.2564\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-4-1\u003c/p\u003e\u003cp\u003eSatisfaction degree of patients and their families\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.5641\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-4-2\u003c/p\u003e\u003cp\u003eSatisfaction degree of doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.5641\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-4-3\u003c/p\u003e\u003cp\u003eSatisfaction degree of technicians\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.5641\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-4-4\u003c/p\u003e\u003cp\u003eSatisfaction degree of intra - oral scanner operators\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.909\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.5641\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;5\u003c/p\u003e\u003cp\u003eHealth education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.0513\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-5-1\u003c/p\u003e\u003cp\u003eThe rate of health education implementation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.6838\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-5-2\u003c/p\u003e\u003cp\u003eThe awareness rate of patients about intra - oral scanning and oral health care knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.091\u0026thinsp;\u0026plusmn;\u0026thinsp;0.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.3675\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eComparison between two group indicators\u003c/h3\u003e\n\u003cp\u003e After performing oral scanning and nursing using the constructed evaluation index system for the scanning quality of oral digital impressions, the oral scanning time of the experimental group was (9.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.79) minutes, which was shorter than that of the control group [(14.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56) minutes]. The patient satisfaction rate of the experimental group was 98.24%, higher than 94.35% of the control group. Both of these two indicators showed statistical significance after analysis (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). After chi-square test, the qualified rate of oral scanning data in the experimental group did not show significant difference (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), but the qualified rate of 91% in the experimental group was significantly higher than 84% in the control group, reflecting the comparative advantage of the quality of oral scanning data in the experimental group. It indicates that the constructed evaluation index system for the scanning quality of oral digital impressions has high clinical application value.The evaluation indicators of the two groups are shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe evaluation indicators of the two groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ecategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of cases (cases)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIntra-oral scanning time (min,\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\mathbf{x}}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s )\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eQualified rate of intraoral scanning data(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePatient satisfaction degree(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003econtrol group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e94.35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eexperimental group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2. 79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e98.24\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eX\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003cb\u003e/t\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-15.315\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.44\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eP value\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eScientific validity and clinical applicability\u003c/h2\u003e\u003cp\u003eWith the rapid development of oral digital technology, the quality evaluation of digital impression scanning has become a research focus. However, Alkadi's [34] systematic review shows that approximately 80% of related studies overly focus on technical parameters such as equipment accuracy and seriously neglect the crucial dimension of standardization of nursing operations. Among them, standardized training processes account for only 12% of the total number of studies, and infection control standards account for 9% [5].\u003c/p\u003e\u003cp\u003eIn this study, innovative methodological integration was adopted. Through systematic literature review, in-depth qualitative interviews, and rigorous Delphi expert consultations, the first quality evaluation index system for digital impression scanning from the perspective of nursing management was constructed. After two rounds of strict consultations, the questionnaire recovery rate of 22 senior experts in the field of stomatology reached 100%. The expert authority coefficients (Cr values) were 0.972 and 0.982, and the Kendall's coefficients of concordance (W values) were 0.625 and 0.687 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), fully demonstrating the scientific nature of this system.\u003c/p\u003e\u003cp\u003eBased on the three-dimensional quality model of \u0026ldquo;structure-process-result\u0026rdquo;, this system covers 12 dimensions and 38 specific indicators. It innovatively incorporates clinically practical indicators such as \u0026ldquo;proficiency in oral scanning operation\u0026rdquo; (weight 1.90%), \u0026ldquo;patient cooperation degree\u0026rdquo; (weight 2.42%) and \u0026ldquo;technician satisfaction\u0026rdquo; (weight 2.56%). Clinical application has confirmed that the application of this system can significantly improve clinical efficacy. The operation time is shortened by 39.1%, quality and safety are ensured, the qualified rate of data is increased by 8.3%, the service experience is optimized, and the satisfaction is increased by 4.1%, strongly confirming the clinical applicability of this index system.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eKey steps in practical application\u003c/h2\u003e\u003cp\u003eFirstly, patient cooperation is the foundation for ensuring the quality of scanning. It is necessary to comprehensively evaluate factors such as the patient's age, educational level, sensitivity of the pharyngeal reflex, and mouth opening degree, and formulate a personalized oral scanning nursing intervention measures. Studies have shown that combining cognitive education with progressive relaxation training can effectively relieve patients' nervousness and improve their cooperation ability [35, 36, 37], thus helping patients better adapt to the scanning process and giving full play to the advantages of digital scanning in terms of comfort and convenience.\u003c/p\u003e\u003cp\u003eSecondly, the scanning quality is the core of the evaluation index system. Before scanning: It is necessary to strictly control the quality control links, including ensuring that all the items for oral scanning are complete, the equipment has sufficient power supply and is in good performance, and completing the calibration and debugging of the equipment [38] and parameter settings [39, 40, 41] to make the equipment in the best working state. During scanning: The operator needs to follow the standardized process and skillfully apply scanning techniques [42, 43, 44]. An in vitro study by Resende et al. [4] shows that an experienced operator can not only shorten the scanning time but also improve the accuracy of the data. After scanning: It is necessary to optimize and repair the data to further improve the data quality [42, 45, 46].\u003c/p\u003e\u003cp\u003eThirdly, the qualified rate and satisfaction are the key points for optimizing the scanning work. The feedback mechanism of the \"qualified rate of scanning data\" should be strengthened. The digital oral scanning work should be continuously optimized through the quality evaluation system, with a focus on studying the accuracy, integrity, and clarity of the scanning data, as well as reducing errors and the number of rework, so as to improve the work efficiency and production quality of technicians [47]. At the same time, the feedback function of \"patient satisfaction\" should be strengthened. In-depth research should be carried out in aspects such as the improvement of nursing techniques, the optimization of operation processes, the implementation of infection control, the communication between nurses and patients, humanistic care, and the patient experience, so as to comprehensively improve the level of digital oral nursing service.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eThe significance of an evaluation index system\u003c/h2\u003e\u003cp\u003e\u003cb\u003eGuiding modular training\u003c/b\u003e. The quality evaluation index system constructed in this study provides a data-driven scientific basis for the training of oral digital scanning. Based on the systematic analysis of key quality indicators such as scanning integrity, accuracy, clarity, and scanning efficiency, a hierarchical modular training model is established. For newly admitted scanning nurses, the focus is on basic operation specifications, while for skilled scanning nurses, the emphasis is on the optimization of scanning for complex cases. At the same time, special training courses are developed for common clinical problems (such as blurriness in the posterior tooth area, gingival bleeding, splicing errors, etc.). The study by Li P et al. [48] shows that hierarchical modular training can increase the speed of mastering operation skills and significantly reduce the operation error rate.By combining the quality evaluation index system for digital impression scanning with modular hierarchical training, targeted courses are designed according to different clinical needs (such as implantation, orthodontics, etc.); the training requirements for different scanning technologies (such as full-mouth scanning and local fine scanning) are met; and the personalized learning needs of personnel at different levels are satisfied. This data-driven training system significantly improves the pertinence and efficiency of training, and provides a standardized solution for the cultivation of digital talents in oral nursing.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEstablish a standardized system for evaluating job competencies\u003c/b\u003e.This system solves the problem of the lack of a unified standard for the assessment of oral digital scanning personnel by means of quantitative scoring, covering multi-dimensional evaluations such as technical ability, operation processes, infection control, and humanistic care. Based on the weak points identified in the assessment results, personalized training and development suggestions are provided for oral scanning nurses to help them continuously improve their professional skills and comprehensive qualities.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStandardize the access criteria for the digital scanning position.\u003c/b\u003e The access to the oral digital scanning position is the first \"threshold\" to ensure the quality of oral medical services. By constructing the quality evaluation index system for digital impression scanning, specific standard requirements are provided for the professional knowledge, skill level, and practical experience required for the position, offering a scientific basis for position access. These standards can include the operation specifications for digital scanning work, the evaluation criteria for scanning quality, the requirements for the scanning position, etc. Only when scanning personnel meet or exceed these standards can they be allowed to enter the oral digital scanning position.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResearch limitations.\u003c/b\u003e All the experts consulted in this study are stomatological experts within Yunnan Province, and the constructed evaluation index system has only been applied in a Class III Grade A general hospital in the province, so its applicability is limited. In the follow-up, the scope of the consulted experts and the scope of medical institutions using the index will be expanded, and the index system will be continuously improved in combination with clinical practice to make it more valuable for clinical application.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003e This study takes the three-dimensional quality structure model as its theoretical foundation, focuses on the existing problems in the field of oral digital impression scanning, and systematically constructs a quality evaluation index system for oral digital impression scanning by comprehensively applying literature review, qualitative interviews, and the Delphi expert consensus method. Through clinical verification via RCT, research data shows that this evaluation index system can significantly shorten the operation time of impression scanning, improve the qualification rate of scanning data, and enhance patient satisfaction, achieving a complete closed loop from theoretical construction to clinical practice verification. Adopting a mixed research approach, this study aligns with international academic frontier trends, providing an innovative methodology for research on oral digital nursing quality. It not only offers an evaluation benchmark and theoretical framework for the construction of standardized training systems for digital impression scanning, qualification certification for scanning positions, and the research and development of human-machine collaborative operation modes and AI quality-controlled scanning systems, but also pioneers a new application model for theories of oral nursing quality management in the context of digital transformation. Follow-up research will focus on developing a hierarchical modular training system based on this evaluation index system, continuously promoting the standardized development of oral digital diagnosis and treatment technologies.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCNKI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eChina National Knowledge Infrastructure\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eVIP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eChongqing VIP Information Co., Ltd\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCBM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eChina Biology Medicine Database\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCr\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCredibility Coefficient\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ep-value\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eProbability value\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eKendall's W\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eKendall's coefficient of concordance\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are deeply grateful to all who contributed to this study. Thanks to the 22 experts for their expertise in the Delphi consultations and the 19 interviewees for their valuable insights. The patients in the clinical trial are also greatly appreciated for their cooperation. Our sincere gratitude goes to the research team for their dedicated work. We also thank the Stomatology Department of the Yunnan tertiary hospital for its support. Their help was crucial to the success of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was funded by the Yunnan Provincial Health Commission and the 920th Hospital, grant number: 017102.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.Department of Stomatology, 920th Hospital of Joint Logistics Support Force, PLA, Kunming 650032, China\u003c/p\u003e\n\u003cp\u003eFali Zhang, Shunyi Wu, Leilei Zhang, Lijia He, Jianmei Guo, Zhuzhu Tian, Min Wang, Wenyun Zhang\u0026nbsp;\u0026amp;\u0026nbsp;Jun Su\u003c/p\u003e\n\u003cp\u003e2.Department of Infection Management, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, China\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Xinchun Zou\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch plan conception:WYZ, XCZ, JS, LLZ, LJH. Interviews and questionnaires conduction: JMG, FLZ, ZZT, MW. Data collection: ZZT, MW, \u0026nbsp;FLZ. Data analysis: LLZ and SYW. Writing the first and final versions of the manuscript: FLZ. revising the manuscript: WYZ. making the figures and tables: SYW. All authors have approved the final version of the manuscript for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data-set used and/or analyzed during the current study is available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Review Committee of the 920th Hospital of the Joint Logistic Support Force of the Chinese People\u0026apos;s Liberation Army, in accordance with Document 920IEC/AF/71-02/2024-02.1. The approval number is:\u0026nbsp;伦审2025-075(科)-01. Informed consent was obtained from all study participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNational Health Commission of the People\u0026rsquo;s Republic of China. Healthy Oral Action Plan (2019\u0026ndash;2025) [EB/OL]. (2022-05-20) [2023-10-11].\u003c/li\u003e\n\u003cli\u003eXu H, Xu XQ, Shi Y, et al. The mediating role of psychological capital in the relationship between job competency and work engagement among dental nurses [J]. Evidence-Based Nursing, 2024, 10(14): 2644-2647.\u003c/li\u003e\n\u003cli\u003eChen L, Chen C, Li ZY, et al. 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Evaluation Study on the Use of Non-Contact Prevention and Protection Products in the Context of COVID-19: A Comprehensive Evaluation Method from AHP and Entropy Weight Method [J]. International Journal of Environmental Research and Public Health, 2022, 19: 16857.\u003c/li\u003e\n\u003cli\u003eQabool H, Sukhia RH, Fida M. Assessment of cooperation and compliance in adult patients at three stages of orthodontic treatment at a tertiary care hospital: A cross-sectional study [J]. International Orthodontics, 2020, 18(4): 794-800.\u003c/li\u003e\n\u003cli\u003eAlkadi L. A Comprehensive Review of Factors That Influence the Accuracy of Intraoral Scanners [J]. Diagnostics, 2023, 13(21): 3291.\u003c/li\u003e\n\u003cli\u003eRay CD, Floyd K, Mongeau PA, Randall AK. Success Bias and Inflation Bias After Planning and Communicating Emotional Support [J]. Journal of Cancer Education, 2020, 35(5): 972-976.\u003c/li\u003e\n\u003cli\u003eBowers EM, Woolley MG, Mu\u0026ntilde;oz K, et al. Acceptance and commitment therapy versus progressive relaxation training for misophonia: Randomized controlled trial protocol, interventions, and audiological assessments [J]. Contemporary Clinical Trials, 2024, 145: 107671.\u003c/li\u003e\n\u003cli\u003eRichert R, Goujat A, Venet L, et al. Intraoral scanner technologies: a review to make a successful impression [J]. Journal of Healthcare Engineering, 2017, 2017: 8427595.\u003c/li\u003e\n\u003cli\u003eKim MK, Kim JM, Lee YM, et al. The effect of scanning distance on the accuracy of intra-oral scanners used in dentistry [J]. Clinical Anatomy, 2019, 32(3): 430-438.\u003c/li\u003e\n\u003cli\u003eCamcı H, Salmanpour F. Effect of saliva isolation and intraoral light levels on performance of intraoral scanners [J]. American Journal of Orthodontics and Dentofacial Orthopedics, 2020, 158(5): 759-766.\u003c/li\u003e\n\u003cli\u003eLim JH, Park JM, Kim M, et al. 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Minerva Medica, 2023, DOI: 10.23736/S0026-4806.23.08898-5.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Digital stomatology, Digital impression, Digital intraoral scanning, Oral nursing quality, Delphi method","lastPublishedDoi":"10.21203/rs.3.rs-6903044/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6903044/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e With the popularization of digital intraoral impression scanning technology, the lack of standardized quality evaluation criteria has increasingly affected the development of the industry, especially in nursing-led scanning procedures. Therefore, exploring the construction of a scientific quality evaluation index system for digital intraoral impression scanning is a matter of great significance.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e Based on Donabedian's \u0026ldquo;Structure-Process-Outcome\u0026rdquo; model, this study constructed an index system through literature review, semi-structured interviews (n\u0026thinsp;=\u0026thinsp;19), and two rounds of Delphi expert consultations (n\u0026thinsp;=\u0026thinsp;22), and conducts clinical verification via RCT from May to June 2025. from January to March 2025. A total of 200 patients requiring posterior single crown restoration-impression scanning were randomly divided into a control group and an experimental group. The control group received routine impression scanning and nursing, while The experimental group performed scanning and nursing according to the standardized impression scanning nursing intervention program formulated based on the evaluation index system of Donabedian's three-dimensional quality model. The primary outcomes included scanning time, data qualification rate (assessed by 5 dimensions), and patient satisfaction (measured by a 5-item Likert scale).\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e The constructed index system comprised 3 first-level indicators, 12 second-level indicators, and 35 third-level indicators, with an expert authority coefficient (Cr\u0026thinsp;=\u0026thinsp;0.982) and Kendall's W coefficient (W\u0026thinsp;=\u0026thinsp;0.687, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), that All met the screening criteria of the Delphi method. Clinical application showed that the experimental group had significantly shorter scanning time (9.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.79 min vs. 14.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56 min), higher patient satisfaction (98.24% vs. 94.35%) with statistically significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in t-tests for time and satisfaction, and improved data qualification rate (91% vs. 84%) although non-statistically significant differences but positive trend in qualification rate.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e The evaluation index system significantly enhances scanning efficiency, scanning quality and patient satisfaction, providing an effective and standardized practical model for clinical standardization of digital intraoral impression scanning, with high clinical application value.\u003c/p\u003e\u003cp\u003eClinical trial number\u003c/p\u003e\u003cp\u003eThis trial has been registered with the Chinese Clinical Trial Registry.12/05/2025 with identifier: ChiCTR2500102285.\u003c/p\u003e","manuscriptTitle":"Construction and clinical application of a quality evaluation index system for digital intraoral impression scanning","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-22 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