• Hanna Kallio, Anna-Maija Pietilä, and Mari Kangasniemi.
• Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
• J Clin Nurs. 2020 Nov 1; 29 (21-22): 4045-4056.

ObjectivesTo 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.BackgroundUsing 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.DesignA modified Delphi method with two rounds.MethodsData 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.ResultsAccording 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.ConclusionsIt 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 PracticeThis 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.© 2020 John Wiley & Sons Ltd.

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