Building Sustainability Competencies in Future Nurses

Official title

Developing Sustainability Competencies in Nursing Students: A Randomized Controlled Study

Overview

Global warming and social justice issues are increasing the complexity of global healthcare delivery. Health systems significantly contribute to environmental harm through carbon emissions, medical waste, and resource overuse. Nurses, as the largest group in healthcare, face workplace hazards and environmental challenges, highlighting the need for institutions to promote sustainable practices and workplace safety. The United Nations' Sustainable Development Goals (SDGs) emphasize integrated social, economic, and environmental sustainability, with health and universal health coverage as key themes. The International Council of Nurses (ICN) underscores nurses' vital role in achieving these goals by linking nursing care to public health, sustainability, climate action, and education. Developing sustainability competencies in nursing education requires practical training in environmentally responsible behaviors within healthcare settings, beyond theoretical knowledge.

Detailed description

Global warming and the integration of the concepts of equality and social justice into diseases and care are making healthcare delivery more complex and challenging at a global level today. Health systems contribute significantly to environmental degradation through considerable carbon emissions, medical waste production, and excessive resource use.

Nurses, the largest group within the health system, not only face a high rate of workplace accidents but also encounter a range of challenges such as increased medical waste production and carbon emissions. Therefore, it is important for healthcare institutions to support environmentally friendly behaviors and to ensure workplace safety and sustainable performance by achieving sustainable development .

The Sustainable Development Goals (SDGs), also known as the Global Goals, were adopted by the United Nations in 2015 as a universal call to action to end poverty, protect the planet, and ensure all people enjoy peace and prosperity by 2030. The 17 Sustainable Development Goals are integrated and indivisible; they acknowledge that action in one area will affect outcomes in others, and that development must balance social, economic, and environmental sustainability. Health holds a significant place in the 2030 Agenda for Sustainable Development, which sets universal health coverage as a central theme and attaches even greater importance to the interplay of the social, economic, and environmental aspects of sustainable development. The 2017 report by the ICN also highlighted the role of nurses in the SDGs by providing case studies that exemplify the link between individual and public health in nursing care. In subsequent years, ICN reports addressed the relationships between sustainability, climate change, and planetary health, emphasizing the active role of nurses in improving community health and influencing policy. Furthermore, they underscored the importance of integrating the concept of sustainability into nursing practice and education and expressed concerns over students' impact on planetary health.

To adopt a sustainability mindset in nursing education, it is necessary to impart knowledge, attitudes, and skills during training. The literature emphasizes the need to develop competencies through behaviors such as adopting waste reduction, energy conservation, and environmentally friendly practices, especially those that are specific to hospital environments, within the context of sustainable healthcare services. In this context, sustainability competencies should not remain at the theoretical knowledge level only but should also be supported by concrete practices that students can observe and interpret in the hospital environment.

Interventions

• Behavioral Sustainability Training
  A \[1 week\] training program focusing on environmental, social, and economic sustainability competencies in nursing care.
• Other Standard Nursing Curriculum
  Nursing students do not receive the sustainability training
• Other No Training
  Nursing students do not receive the sustainability training
• Behavioral Clinical Practice
  Participate in their scheduled clinical hospital rotations and also assessment the clinic throughout sustainability (up to 3 weeks)
• Other Standard Clinical Practice
  They participate in their scheduled clinical hospital rotations up to 3 weeks (standard curriculum).
• Other No Clinical Practice
  Nursing students do not participate in clinical hospital rotations during the study period

Primary outcome measures

• The Sustainability Attitudes in Nursing Survey (SANS-2) [Time frame: Baseline (Pre-test) and 4 weeks after the intervention (Post-test).]
• Clinical Sustainability Practice [Time frame: Throughout the clinical rotation period (up to 3 weeks)]

Eligibility criteria

Inclusion criteria

• Being a nursing student currently enrolled in the "HEM304 Nursing Management" course.
• Volunteering to participate in the research and providing informed consent.

Exclusion criteria

• Having participated in a similar sustainability training program previously.
• Being on medical or academic leave during the study period.
• Withdrawing from the study voluntarily at any stage.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Other

Study locations

Turkey (Türkiye) · 1 center

• Cankiri Karatekin University — Çankırı

Identifiers

NCT: NCT07512544 · 2026/17

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗