Construction of a postoperative cervical collar use and nursing guidance protocol for single-level anterior cervical discectomy and fusion patients in cold northern China (Heilongjiang Province): A modified Delphi study.

AIM: Guided by the Enhanced Recovery After Surgery (ERAS) concept, this study aimed to establish a postoperative nursing guidance protocol focusing on cervical collar management for patients receiving single-level anterior cervical discectomy and fusion (ACDF), to strengthen patients' self-management of cervical collar application and lower the incidence of postoperative complications.

METHODS

From August to December 2024, Chinese and English databases were systematically searched. After quality appraisal, evidence was synthesized to develop an initial protocol draft. Three rounds of modified Delphi expert consultation were performed with 16 specialists from tertiary hospitals to review, revise and refine the protocol.

RESULTS

The final protocol consisted of a three-tier structural framework, including 4 Level 1 core functional modules, 10 Level 2 secondary classification dimensions and 29 Level 3 specific executable nursing operation items. The expert response rate was 100% across all three rounds. Expert authority coefficients were 0.796, 0.862, and 0.925, respectively. Kendall's W values were 0.171, 0.301, and 0.415 (P < 0.001).

CONCLUSIONS

The protocol shows good scientific rigor and clinical applicability. Future research will focus on clinical validation to provide a theoretical basis for standardizing postoperative care for single-level ACDF patients.