Abstract
OBJECTIVE: To construct a preventive nursing protocol for eye complications in critically ill patients in prone position ventilation (PPV). BACKGROUND: Eye complications are common complications of PPV. However, there is a lack of prevention and nursing programs for eye complications associated with PPV in China. DESIGN: A Delphi study. METHODS: Through literature review and semi-structured interviews, a preliminary draft of a preventive nursing protocol for eye complications related to PPV was developed. The Delphi method was used to select experts for two rounds of correspondence inquiry. A 5-point Likert scale was used to rate the importance and feasibility of each item. The coefficient of variation (CV), mean score, and level of agreement were calculated to evaluate the consensus among expert opinions. RESULTS: A total of 19 experts participated in the two rounds of expert consultation. The effective questionnaire response rate was 100% in both rounds, and the expert authority coefficient was 0.91 for each. The Kendall’s harmony coefficients for item importance were 0.09 and 0.27, respectively, and those for item feasibility were 0.11 and 0.21, respectively, with p < 0.05. After two rounds of consultation, all items had a mean score ≥4, and achieved ≥75% agreement, and CV < 0.25. The final protocol consisted of four Level I indicators, 11 Level II indicators, and 33 Level III indicators, encompassing the domains of organizational management, risk assessment, prevention measures, and effect evaluation. CONCLUSION: Consensus was reached on the preventive nursing protocol for eye complications in patients undergoing PPV. The protocol can serve as a valuable reference for clinical practice. Further research is needed to validate its effectiveness and feasibility. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-025-04246-8.