Sustainable Nursing in Acute Care: Mapping the Evidence From Waste Reduction to Carbon Metrics: A Scoping Review

ABSTRACT

Introduction

This scoping review explores the environmental impact of nursing interventions in acute care settings, focusing on waste reduction, energy consumption, and carbon emissions, while identifying nurse-led sustainability practices, assessment frameworks, and implementation barriers/enablers.

Design

Guided by Arksey and O'Malley's framework and reported per PRISMA-ScR guidelines.

Methods

Data Sources: PubMed, CINAHL, Scopus, and Google Scholar were searched for peer-reviewed, English-language studies published between 2020 and 2025. Review Methods: A five-stage process was employed: (1) research question formulation, (2) comprehensive literature search, (3) study selection using the Population–Phenomenon–Context (PPC) framework, (4) data charting via a structured extraction form, and (5) thematic synthesis. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.

Results

Of 400 identified records, 25 met inclusion criteria. Findings show nurses reduce environmental impact through reusable linen use (e.g., 496 kg/year ICU waste reduction), energy-efficient equipment, and improved waste segregation. However, time constraints, limited resources, and inadequate sustainability training impede consistent implementation. Awareness among nurses and students is moderate but rarely translates into practice.

Conclusion

Nursing interventions hold significant potential to reduce healthcare's environmental footprint. Embedding sustainability competencies into curricula and reinforcing them with institutional policies and leadership support are essential.

Clinical Relevance

This review informs nurses and clinical leaders that sustainable practices—such as switching to reusable linens and optimizing energy use—are both feasible and impactful in acute care. It provides actionable evidence for reducing waste and carbon emissions while maintaining patient safety, supporting the integration of environmental stewardship into daily nursing practice. Findings from this review highlight the measurable environmental benefits of nurse-led sustainability interventions, such as waste reduction and energy conservation in ICUs. The evidence supports updating nursing curricula, clinical guidelines, and hospital policies to equip nurses with the knowledge and tools needed to lead sustainability efforts, thereby reducing healthcare's carbon footprint without compromising care quality.