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Knowledge, Attitudes, and Behaviors of Critical Care Nurses Regarding Environmentally Sustainable Clinical Practice: A Longitudinal Study Protocol and Framework

Author

Listed:
  • Luciano Midolo

    (Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy)

  • Davide Bartoli

    (Department of Well-being, Health and Environmental Sustainability—BeSSA Department, Sapienza University of Rome, 00185 Rome, Italy)

  • Francesco Petrosino

    (Department of Health Management, Local Health Authority of Salerno, 84124 Salerno, Italy)

  • Mariachiara Figura

    (Department of Maternal and Child Health Promotion, Internal Medicine & Specialties of Excellence “G. D’Alessandro” (PROMISE), University of Palermo, 90127 Palermo, Italy)

  • Marco Di Muzio

    (Department of Well-being, Health and Environmental Sustainability—BeSSA Department, Sapienza University of Rome, 00185 Rome, Italy)

  • Ercole Vellone

    (Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
    Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wrocław, Poland)

  • Rosaria Alvaro

    (Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy)

  • Francesca Trotta

    (Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy)

  • Gianluca Pucciarelli

    (Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
    Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wrocław, Poland)

Abstract

Intensive care units (ICUs) are among the most resource-intensive healthcare settings and represent a strategic priority for environmental sustainability policies. While technological solutions are increasingly promoted, sustainable practice in ICUs also depends on nurses’ knowledge, attitudes, and behaviors, which remain insufficiently studied using validated, context-specific tools and longitudinal designs. This research protocol describes a multi-phase, theory-driven study aimed at developing and validating the Knowledge, Attitudes, and Behaviors Questionnaire on Environmental Sustainability in Intensive Care Units (KABQES-ICU) and at evaluating the longitudinal impact of a structured sustainability training program. Phase 1 focuses on instrument development and psychometric validation, grounded in a conceptual framework integrating individual, psychological, and organizational determinants and informed by qualitative evidence from ICU nurses. Phase 2 consists of a longitudinal intervention study assessing changes in sustainability-related competencies and their effects on nurse, patient, caregiver, organizational, and environmental outcomes. This protocol is designed to generate robust evidence to support the integration of sustainability into ICU quality improvement strategies and health policy frameworks without compromising patient safety.

Suggested Citation

  • Luciano Midolo & Davide Bartoli & Francesco Petrosino & Mariachiara Figura & Marco Di Muzio & Ercole Vellone & Rosaria Alvaro & Francesca Trotta & Gianluca Pucciarelli, 2026. "Knowledge, Attitudes, and Behaviors of Critical Care Nurses Regarding Environmentally Sustainable Clinical Practice: A Longitudinal Study Protocol and Framework," Sustainability, MDPI, vol. 18(3), pages 1-19, January.
    • Handle: RePEc:gam:jsusta:v:18:y:2026:i:3:p:1346-:d:1851671
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