How to Decarbonize Your OR

Drive Environmental Sustainability in the OR

Periop Nurses Can Make Real Change

Healthcare’s collective carbon footprint is not sustainable. Yet, experts suggest we have the power to change this.

“Nurses are uniquely positioned to drive environmental sustainability. AORN is here to help you lead this conversation.” That’s according to AORN CEO Linda Groah, MSN, RN, CNOR, NEA-BC, FAA and AORN Guidelines Editor-in-Chief Erin Kyle, DNP, RN, CNOR, NEA-BC.

“Perioperative nurses and teams have the power to make real change,” Kyle stresses. That’s why AORN is committed to environmental sustainability. You can commit, too.

Here are some stark facts and tangible actions, as well as specific projects nurses can champion environmentally healthier ORs.

Facts on Healthcare and Climate Change

Healthcare is Harming the Environment

Healthcare is responsible for 8.5% of carbon emissions in the US. And 5% globally. Of this 8.5%, hospitals are responsible for 35% of carbon emissions driving climate change.

The largest generators of waste and emissions in healthcare are surgery and sterile processing. The very places where perioperative nurses practice and can influence change.

Climate Change is Hurting People

Record temperatures are increasing heat-related injuries and death. Extreme weather events are disrupting utilities, communications, and the supply chain. Drought is driving food scarcity and poor air quality is increasing respiratory conditions such as asthma.

Climate-Related Health Effects Impact Populations Disproportionately

Climate-sensitive health risks are felt differently by demographics like gender, age, race-ethnicity, and lower-income. That’s according to the World Health Organization. This impact influences social determinants of health, such as access to care and worsening of underlying health conditions such as respiratory health.

Actions to Decarbonize Health Care

Voice the Research

Nurses are in a unique position to influence and lead positive environmental change in healthcare. But they may have questions on where to start. Step one is understanding and sharing the facts. Start with The AORN Position Statement on Environmental Responsibility. It provides a list of environmentally responsible actions to take. From conserving natural resources to reducing waste including hazardous waste.

Build a Team

Engaging an interdisciplinary team is essential. You need individuals committed to the initiative. They must have the passion, expertise, and authority to make changes, Kyle says. “I have heard so many stories about recycling programs or waste reduction programs falling flat. The necessary support from leadership and team education just weren’t there.”

Use What Works

Kyle recommends leveraging the Model for Improvement. This is a framework for making changes that can help teams chart a clear path and plan. It provides structure to help an interdisciplinary team in their collaborative work. “Having a structured plan and strategy that everyone can see and participate in can make all the difference.” You can also look to AORN Journal articles about teams who have succeeded with environmental initiatives.

Start Small

Choose simpler projects like separating the trash from recycling in the OR when setting up for a procedure. This seemingly small action has significant value, Kyle stresses. “Just one coordinated activity for the environment can influence and inspire others to do the same. Then sustainability becomes culture. This is where the magic really happens. Especially in practice settings where everything we do is as a team.”

Celebrate Successes

Measure your impact, such as how much waste you diverted to recycling. Then quantify these actions and share your results. Tell everyone you can, whether it’s your CNO, an industry rep, or your patients.

Keep improving

Build on your successes to generate more interest in environmental sustainability programs. Such as adding to what gets recycled from OR waste. “Or consider how evacuating surgical smoke creates safer, cleaner air for human health and the environment,” Groah suggests.

Speaking in Terms of ESG [Environmental, Social, Governance]

Healthcare organizations are taking a much closer look at their part in environmental health and justice. Because it makes no sense to harm the environment in the provision of health care. “This is where ESG comes in,” Groah says. "It’s why healthcare leaders are talking about environmental sustainability. Because ESG encompasses the environment, as well as social aspects of DEI such as preventing health disparities. And it’s centered around governance to make sustainability standard practice.

“Periop nurses can speak in terms of ESG to frame their sustainability work,” Groah suggests. “Remember that surgical areas in the hospital generate up to 70% of the facilities total waste. Hospital leaders are eager to listen and collaborate on strategies to change this.”

Groah also encourages periop nurses to be more engaged in the global dialogue around the environment. For example, AORN has signed onto the White House/HHS Health Sector Climate Pledge. A number of healthcare organizations have also signed the pledge.   

Explore More on This Topic

Check out these evidence-based resources from AORN to lead environmental sustainability in your workplace.

Sustainability in the Perioperative Practice Setting

Reducing the Environmental Impact of the OR

AORN Environment, Social and Governance