Environmental responsibility in nursing in hospitals: A modified Delphi study of nurses' views

Abstract

Objectives: To identify nurses' views on environmentally responsible clinical practices, and to examine their consensus regarding the stakeholders and their roles and tools needed to promote, and enable, environmental responsibility in clinical practice. Background: Using materials and energy in hospitals has a negative impact on the environment and people's environmental health. Research on decreasing this burden in clinical practice is sparse. Design: A modified Delphi method with two rounds. Methods: Data were collected from 35 nursing staff in five Finnish university hospitals in 2019. The first-round data were collected with semi-structured interviews in small groups and subjected to content analysis. The second-round data were collected with an Internet-based questionnaire from 27 of those participants and statistically analysed. The CREDES checklist was used. Results: According to nurses, environmentally responsible clinical practices focus on effective material and energy use. Material use focused on sustainable and cooperative purchasing, considerate use of products and minimising waste and idle electricity and reducing water and transport use. The tools needed to promote, and enable, environmental responsibility in clinical practice were staff inducements and training and certain resources and guidance. All the hospital health and support service staff needed to commit to collaboration. Conclusions: It is important to address stakeholders' roles in environmental responsibility in hospitals. Environmental aims should be firm and visible, and nurses should have the relevant competencies. They also need sufficient time to develop environmental initiatives and proper facilities to carry out their work with a minimal environmental burden. Providing staff feedback and rewards for their environmental efforts is beneficial for engagement. Relevance to clinical practice: This study will help nurses to identify their needs and opportunities to realise and develop environmental responsibility in their practice. It can also inform hospital leaders to develop corporate environmental responsibility, including in-service training.

Healthcare Workers’ Experiences and Views of Using Surgical Masks and Respirators, and Their Attitudes on the Sustainability: A Semi-Structured Survey Study during COVID-19

“…Indeed, environmental awareness among healthcare workers remains a fairly unfamiliar concern according to, e.g., Anåker et al [ 36 ], Dunphy [ 37 ] and Sherman et al [ 38 ]. However, this survey’s respondents indicate that understanding environmental issues was important, which aligns with the most recent results for nurses [ 39 ].…”

Registered nurses' perceptions of their career—An interview study

“…However, previous research has shown that high competency and training opportunities are important for nurses' experience of meaningful careers and ability to provide high‐quality care (Hariyati et al, 2017 ) in a burdensome, constantly changing health care environment (Price & Reichert, 2017 ). Research has also addressed the fact that nurses value autonomy in their work (Rakhab et al, 2021 ) and that, as they work closely with patients, they play a vital role in developing care practices (Kallio et al, 2018 ). Furthermore, it is notable that younger generations have been shown more likely to base their career choices on financial comfort rather than living a calling with poor pay (Carter, 2014 ).…”

Past, present, and future of sustainable intensive care: narrative review and a large hospital system experience

“…Accordingly, healthcare systems around the world have strived to integrate sustainability into ICU operations. Indeed, the intersection of sustainability and critical care (including surgical, medical, pediatric, and cardiac intensive care, burn care, and neonatal intensive care [ 13 ]) is well-studied with Europe [ 21 , 28 ], the United Kingdom [ 8 , 9 , 32 ], Canada [ 22 , 27 , 29 ], and Australia and New Zealand [ 7 , 33 ] at the forefront of such movement, including educational and advocacy materials [ 15 , 19 , 23 , 34 , 35 ]. European countries have made strides in adopting renewable energy sources and implementing energy-efficient technologies within healthcare facilities.…”

“…Nurses participating in semi-structured interviews viewed environmentally sustainable practices to be at odds with both patient care priorities (e.g., patient care workload did not leave bandwidth to consider the environment) and with the organization’s priorities, support, and culture for strategic and operational management (e.g., when their organization puts budget as the top priority). On the other hand, Kallio et al [ 28 ] and Yu and Baharmand [ 27 ] emphasized the utilization of functional facilities for waste sorting, training, and visible internal communications and reporting related to environmental sustainability.…”