Environmental Sustainability Perspectives Among Critical Care Professionals: A Qualitative Systematic Review and Meta‐Synthesis

BACKGROUND: Intensive care units (ICUs) generate substantial emissions and waste, yet qualitative evidence on ICU professionals' perspectives on environmental sustainability remains limited. AIMS: To examine and synthesise qualitative evidence on intensive care professionals' perspectives and views regarding environmental sustainability. STUDY DESIGN: A qualitative meta-synthesis. A systematic search of English and Chinese databases (PubMed, Web of Science, CINAHL, Embase, Cochrane Library, Scopus, CNKI, Wanfang Data, VIP Information and CBM) was conducted from inception to 15 October 2025. Methodological quality was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative findings were extracted and synthesised using meta-aggregation. FINDINGS: Seven studies met the inclusion criteria. Three themes were identified: (a) the inherent characteristics of the ICU setting, (b) barriers to implementing sustainable practices in intensive care units and (c) strategies for implementing sustainable practices in intensive care units. CONCLUSION: The ICU environment presents distinctive challenges to advancing sustainable critical care, and professionals face multiple, interrelated barriers in everyday practice. Targeted, systematic and context-sensitive strategies are needed to reduce the environmental impact of ICUs while supporting safe, sustainable ('green') intensive care. RELEVANCE TO CLINICAL PRACTICE: This review supports integrating sustainability into ICU education and routine workflows, strengthening multidisciplinary collaboration and implementing practical unit-level protocols (e.g., greener procurement and standardised waste segregation) to advance a 'green ICU' without compromising patient safety.