Development and Validation of a Nursing Care Protocol for Laser Therapy in Pressure Injuries: Methodological Study

Abstract

Pressure injuries remain highly prevalent in hospital and home settings, particularly among elderly patients, intensive care unit patients, and individuals with impaired mobility, generating significant healthcare and economic impacts. Although low-level laser therapy has been explored as an adjunctive therapy to accelerate healing, few validated protocols exist to guide its systematic application in clinical nursing practice. This methodological study aimed to develop and validate a nursing care protocol for low-level laser therapy in stage 1 pressure injuries, conducted in three stages: integrative literature review, protocol development, and content validation using the Delphi technique with specialist nurses selected via the Lattes Platform. Judges evaluated the protocol using a five-point Likert scale, and validity was assessed by the Content Validity Index (CVI) and Cronbach’s alpha, both with minimum acceptable values of 0.80. The integrative review identified four studies supporting low-level laser therapy efficacy, informing the protocol’s technical parameters. Thirty-one specialists participated in the first Delphi round and 25 in the second, achieving a Global CVI of 0.915 and Cronbach’s alpha of 0.91, with all items reaching consensus. The validated protocol demonstrated satisfactory content validity and internal consistency, supporting its clinical applicability and potential to standardize nursing practice and reinforce patient safety. Although the protocol demonstrated satisfactory methodological validity, further clinical studies are needed to assess feasibility, implementation, and effectiveness in routine nursing care.