By Jaana Perttunen, President, EORNA

Sustainability in the operating room is often framed as a simple choice: reusable or single-use. In reality, safe and sustainable perioperative care depends on something far more powerful — how the whole system works.

Sustainability is rising fast on the healthcare agenda, and rightly so. Operating rooms are among the most resource-intensive areas in any hospital, generating significant waste and consuming large amounts of energy and materials.

But the conversation risks becoming too narrow.

Focusing only on whether an item is reusable or disposable oversimplifies a much more complex issue. Evidence from journals such as The Lancet Planetary Health and BMJ shows that the environmental impact of medical products depends on full life cycle considerations — including manufacturing, transport, sterilisation, and disposal. The answer is rarely straightforward.

Sustainable practice is not defined by a single product choice. It is defined by systems.

In the operating room, those systems are shaped every day through procurement decisions, workflow design, and team behaviours — all areas where perioperative nurses play a central role.

Procurement is one of the most powerful levers. Supply chains account for a large proportion of healthcare emissions, and involving clinicians in product selection leads to more balanced, evidence-based decisions that protect both patients and resources.

Workflows matter just as much. Inefficient processes result in opened but unused items, unnecessary waste, and avoidable costs. Simple measures — such as optimising instrument sets or improving communication — can make an immediate difference without compromising care.

And then there is behaviour.

Sustainability ultimately depends on what happens in practice: how waste is segregated, how materials are used, and how consistently teams follow evidence-based processes. Research shows that lasting change only happens when education, leadership, and culture align.

Crucially, sustainability and patient safety are not in competition. Well-designed systems reduce waste and reduce risk. Better organisation, standardisation, and teamwork benefit both patients and the environment — a principle reinforced by the World Health Organization.

For EORNA, this is a natural progression. Safe surgery has always been our priority. Sustainable surgery is part of that same responsibility.

Moving from “reusable versus disposable” to “responsible systems” is where real progress lies — and perioperative nurses are key to making it happen.

Call to action

As we look ahead to the EORNA Congress 2026, the conversation must move beyond simple choices to smarter systems. The question is no longer what should we use? — but how should we work?

References

Safety Is a Team Sport, but Perioperative Nurses Are the Playmakers

Ólafur Guðbjörn Skúlason, EORNA Vice-President

Safe surgery depends on teamwork, but effective teams require coordination. In the operating room, perioperative nurses are often the professionals who make that coordination possible.

Modern surgery is inherently multidisciplinary. Surgeons, anaesthetists, nurses, and technologists must function as a coherent unit under pressure. Research into human factors and patient safety consistently shows that poor communication and unclear roles are major contributors to adverse events.

Perioperative nurses are uniquely positioned to mitigate these risks. Their role spans the entire surgical pathway, from preparation to recovery. This continuity enables them to identify gaps, anticipate needs, and facilitate communication between team members.

Studies in perioperative practice demonstrate that teams with strong nursing leadership and clear role clarity perform better during crises. This is not about hierarchy, but about ensuring that someone is actively maintaining situational awareness.

EORNA advocates for recognising perioperative nurses as safety leaders within teams. Acknowledging this role strengthens collaboration rather than undermining it.

Call to action Recognise and empower perioperative nurses as coordinators of surgical safety. By supporting their role in guiding communication and situational awareness, every team member benefits—and every patient gains.

References WHO. Human Factors in Patient Safety. AORN. Team Communication and Patient Safety. Lingard et al. Communication failures in the operating room. Quality & Safety in Health Care.