A scoping review on critical care nurses’ perspectives on sustainability in relation to intensive care

Background and rationale Healthcare systems are in a paradoxical position, as they aim to protect and improve human health while simultaneously contributing to environmental harm. The 2024 Lancet Countdown reported that healthcare related emissions accounted for 4.6% of global greenhouse gas emissions in 2021, representing a 36% increase since 2016 and highlighting the urgency of healthcare decarbonisation (1). Within hospitals, intensive care units (ICUs) deliver resource intensive, technology dependent care that relies heavily on single use consumables, resulting in high energy use, substantial waste generation, and significant emissions documented in life cycle assessment studies (2-4). Given this context, understanding healthcare professionals’ perspectives—particularly those of critical care nurses who are centrally involved in ICU practice—is essential for identifying opportunities to promote sustainability in intensive care. Understanding critical care nurses’ experiences and perspectives is thus a necessary step in informing strategies, including educational interventions, aimed at promoting sustainable practices in intensive care. Study aim The aim is to map and synthesize the existing evidence on critical care nurses’ perspectives on sustainability in intensive care, identifying key themes, knowledge gaps, and implications for clinical practice and future research.