International Journal of Healthcare Simulation

Background and aim:

Climate change is considered one of the most pressing global concerns for the future and the single biggest health threat [1]. Healthcare delivery is a major contributor to the climate crisis, producing 4.4% of net carbon global emissions today [2]. One of the largest contributors to NHS carbon emissions is the use of equipment, consumables and clinical care itself [2]. Therefore, clinical staff have a significant part to play in reducing carbon emissions and achieving national carbon reduction targets. However, they must be carbon literate and understand the impact of personal practice on global carbon emissions and be able to identify ways to deliver low carbon models of care [3]. Simulation could play a significant role in educating and developing sustainable practice in healthcare students through a system thinking approach. Allowing students to examine the environmental impact of healthcare delivery and support innovative solutions to reduce carbon emissions without compromising care.

The aim was to firstly increase nursing students’ awareness of the carbon emissions from the delivery of patient care. Secondly to improve clinical decision-making in the selection and implementation of interventions to enable the delivery of low carbon care.

Activity:

Undergraduate nursing students took part in a specifically designed simulation scenario. Students completed the scenario of a patient presenting to the Emergency Department with exacerbation of Chronic Obstructive Pulmonary Disease (COPD), implementing care and interventions as clinically indicated. After completion of the simulation students then calculated the carbon emissions from the clinical resources they used, using the Centre for Sustainable Healthcare carbon emissions calculation.

Findings:

Debriefing identified that students did not consider sustainability and carbon emissions in their current clinical decision-making. Students were shocked by the amount of carbon emissions generated from interventions. Students identified areas where they could reduce carbon emissions without compromising care such as inappropriate use of gloves, using dry powdered inhalers, and reducing unnecessary cannulation.

Conclusion:

Simulation could play a pivotal role in developing sustainable clinical decision-making skills in healthcare students and staff. Actively calculating carbon emissions allows students to directly see the environmental impact of their practice, increasing carbon literacy and stimulating low carbon care practice. This use of simulation should be explored further by educators across professions to support both national and global climate change policies.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.