Advancing Sustainable Healthcare in Obstetric and Maternity Nursing: Nurses’ Knowledge, Awareness, and Clinical Practice—A Cross-Sectional Study

Abstract

Background: Sustainable healthcare in obstetric and maternity nursing emphasizes the provision of high-quality, safe, and environmentally responsible care for women and newborns. Nurses’ knowledge, awareness, and clinical practices are central to the implementation of sustainable approaches, including efficient resource management, evidence-based interventions, and patient education. Evaluating these dimensions is essential for identifying gaps, informing targeted training, and supporting sustainable and effective maternal care aligned with global health goals. Accordingly, this study aimed to assess obstetric and maternity nurses’ knowledge, awareness, and clinical practices related to sustainable healthcare. Method: A cross-sectional study design was employed. A convenience sampling technique was used to recruit obstetric and maternity nurses working in the selected study settings during the data collection period. A total sample of 120 participants was targeted. The study was conducted at Al-Azhar University Hospital in New Damietta and selected Family Medicine Centers in Damietta Governorate, Egypt. Data were collected using a structured, self-administered questionnaire developed specifically for this study to assess eco-conscious nursing practices in obstetrics and gynecology units. The questionnaire included sections addressing demographic and professional characteristics, knowledge and awareness of sustainable healthcare, eco-conscious clinical practices in maternity settings, perceived barriers and institutional support, attitudes and advocacy toward environmental sustainability, procedure- and material-related environmental concerns, and energy and water conservation behaviors. Responses were measured using standardized 5-point Likert and frequency scales, with composite scores calculated to categorize levels of knowledge, practices, and attitudes toward sustainability; higher scores indicated greater knowledge, awareness, and engagement in sustainable practices. Results: Overall, among the 120 nurses, of whom 62 (51.7%) had reported having heard about sustainability and received training about it, whereas 58 (48.3%) had not. Most participants held a bachelor’s degree (n = 54, 45.0%), nearly half had more than 10 years of nursing experience (n = 58, 48.3%), and the largest proportion worked in delivery rooms (n = 53, 44.2%). Regarding knowledge, attitude, and practice, good knowledge was observed in 61 participants (50.8%), good practice in 46 participants (38.3%), and positive attitudes in 108 participants (90.0%). The findings also showed that trained nurses in obstetrics and gynecology units demonstrated significantly higher knowledge, more positive attitudes, and better eco-conscious practices compared to untrained nurses across all domains (p < 0.001). Conclusions: The study demonstrates that maternity nurses showed moderate to high awareness and positive attitudes toward sustainability, while environmentally sustainable practices were less consistently implemented, indicating a clear knowledge–attitude–practice gap. Nurses who received sustainability-related training consistently achieved significantly higher knowledge, attitude, and practice scores than untrained nurses.