From Sustainability to Regeneration: A Scoping Review of Nursing Practices in the Construction of Green and Healthy Hospitals

Vollständiger Abstract

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Background/Objectives: The healthcare sector accounts for an estimated 1–5% of the global environmental footprint, and hospitals concentrate a large share of that impact. As the largest professional group, nurses are pivotal to the transition toward green and regenerative hospitals. This review aimed to map the sustainable nursing practices implemented in hospitals internationally and to characterise the contribution of nursing to reducing the environmental footprint of care. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, ScienceDirect, SpringerLink, SciELO and Dialnet were searched for studies published between 2021 and 2026, complemented by grey and institutional literature, citation searching and hand-searching. Records were screened in duplicate against predefined eligibility criteria, and the evidence was charted into six thematic categories aligned with the review objectives. Results: Twenty-five sources were included—11 reviews and 14 primary studies, most of them descriptive. Waste management emerged as the domain most sensitive to nursing action, whereas energy and water use were only minimally nurse-sensitive. Education, leadership and nurse engagement were the main enablers; insufficient training, resistance to change and limited investment were the recurrent barriers. Only one study explicitly addressed the regenerative transition, from a governance perspective. Conclusions: Embedding sustainable practices in nursing can reduce the environmental impact of hospitals while preserving quality of care. Nurse-sensitive environmental indicators and the integration of sustainability competencies into curricula and hospital governance are key levers for this transition, whose regenerative dimension remains incipient and requires primary, comparative research.