Green Nursing in Healthcare: A Systematic Review of Sustainable Nursing Practices and Environmental Stewardship

Healthcare systems worldwide are increasingly challenged to reduce their environmental impact while maintaining safe, effective, and patient-centred care. Hospitals contribute substantially to greenhouse gas emissions, biomedical waste, energy consumption, and resource depletion, making sustainability an essential component of modern healthcare delivery. Nurses, as the largest group of healthcare professionals, play a vital role in promoting environmentally responsible practices through efficient resource utilisation, waste management, patient education, and leadership in sustainable healthcare initiatives. The concept of Green Nursing integrates environmental stewardship into nursing practice to support both public health and ecological sustainability. This systematic review aims to synthesize the available evidence on sustainable nursing practices implemented in healthcare settings and evaluate their impact on environmental, organizational, and clinical outcomes. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, CINAHL, and the Cochrane Library for studies published between 2015 and 2025. Peer-reviewed studies examining green nursing interventions, environmental sustainability, healthcare waste reduction, energy conservation, sustainable procurement, and climate-responsive nursing practices were considered. Following screening and quality assessment, 24 studies met the eligibility criteria and were included in the final synthesis. The findings indicate that green nursing interventions contribute to improved biomedical waste segregation, reduced use of disposable materials, enhanced recycling practices, lower energy and water consumption, and increased environmental awareness among healthcare professionals. Educational programs, supportive organisational leadership, and institutional sustainability policies were identified as major facilitators of successful implementation, whereas inadequate training, financial limitations, and resistance to organizational change remained significant barriers. Overall, the evidence suggests that integrating sustainability into nursing practice can improve environmental performance without compromising patient care quality. This review highlights the importance of strengthening sustainability education within nursing curricula, promoting environmentally responsible clinical practices, and developing healthcare policies that support sustainable nursing leadership. Future research should focus on evaluating the long-term effectiveness, cost-efficiency, and patient outcomes associated with green nursing interventions across diverse healthcare settings.