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

OBJECTIVES This study identified nurses' views on environmentally responsible clinical practices. It also examined consensus regarding the stakeholders, 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 analyzed. 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 minimizing 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 realize and develop environmental responsibility in their practice. It can also inform hospital leaders to develop corporate environmental responsibility, including in-service training.