School of Nursing Climate Commitment: Nursing Faculty Bring Climate to the Classroom.

In 2021, the American Association of Colleges of Nursing (AACN) added "the impact of climate change on environmental and population health" into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC)-a campaign to educate 50,000 health professionals about health impacts of climate change-launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty (1) integrated resources into didactic and clinical settings, such as population or organ-system content, leadership, and policy; and (2) used resources to support assignments. In four years, faculty reported educating over 37,700 students, using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.

Climate, Health, and Nursing Tool (CHANT): A confirmatory factor analysis.

OBJECTIVE: To confirm the factor structure of the Climate, Health, and Nursing Tool (CHANT) tool via confirmatory factor analysis. DESIGN AND SAMPLE: This is a cross-sectional analysis of voluntary, anonymous responses collected online in 2019, from a non-representative sample of 489 nurses from 12 nations with 95% of the respondents from the United States. MEASUREMENTS: A confirmatory factor analysis (CFA) was conducted to test a five-factor measurement model of the 22-item CHANT. Reliability was examined via Cronbach's α coefficient. RESULTS: The five CHANT subscales demonstrated acceptable reliability with Cronbach's α ranging from 0.67 to 0.91. The five-factor model of CHANT demonstrated good fit, x2 (199) = 582.747, p < .001, CFI = 0.94, RMSEA = 0.06, and SRMR = 0.04 with statistically significant item-factor loadings. CONCLUSION: CHANT is a reliable and robust instrument to measure nurses' awareness, concern, motivation, and home and work behaviors regarding climate change and health, and is ready to be utilized in research, policy, professional settings, and among educators.

How Should Clinicians and Health Care Organizations Respond When Civic Planning Concentrates Waste Processing in Minoritized Communities?

US health care is responsible for 8.5% of the country's greenhouse gas emissions, contributes to nearly 30 pounds of waste per patient per day, and uses a vast array of toxic chemicals and pharmaceuticals that pollute our air and water. Communities are not affected equally by the volume and location of this waste: historically marginalized populations are hurt first and worst. This commentary on a case considers the irony that the health sector simultaneously responds to and produces environmental damage and argues that health professionals are ethically bound to protect patients' and communities' health.

How Should We Respond to Health Care Generating Environmental Harm?

Clinicians and organizations in the health sector have healing missions, and physicians, specifically, take oaths to "do no harm." Yet, paradoxically, health care operations contribute to pollution and exacerbate environmental disease burden. This article offers a view of how health sector actions exacerbate climate warming and iatrogenically harm global public health and argues that clinicians and organizations have ethical responsibilities to respond.

Climate, Health, and Nursing Tool (CHANT): Initial survey results.

OBJECTIVES: This study measured nurses' awareness, motivation, concern, self-reported behaviors at work, and self-reported behaviors at home regarding climate change and health. DESIGN: Descriptive study using an anonymous and voluntary web-based survey. SAMPLE: A nonrepresentative sample recruited from nurses. MEASUREMENTS: The CHANT (Climate, Health and Nursing Tool) with five psychometrically evaluated scales used to measure awareness, motivation, concern, behaviors at work, and behaviors at home. RESULTS: The 489 respondents reported moderate levels of awareness (2.97 mean score of 0-4) and high levels of concern (3.43) about health impacts of climate change. They were motivated to reduce greenhouse gas emissions (3.27), yet few did at home (2.28), and even fewer at work (1.81). They were motivated by clean air and water and concern about the future. Barriers to action included not knowing what to do and feeling overwhelmed. Respondents reported discussing climate and health with friends or family more frequently than they did with their colleagues. A majority (63%) never contacted elected officials. CONCLUSION: The respondents were aware of climate and health impacts and motivated to act. However, they reported lower frequencies of changing behaviors at work, and communicating about climate and health professionally and with elected officials.

The Nurses Climate Challenge: A National Campaign to Engage 5,000 Health Professionals Around Climate Change.

Climate change poses significant threats to human health and worsens existing inequities. The health sector is a significant contributor to climate change, making up approximately 10% of U.S. greenhouse gas emissions. Yet most nurses do not learn about the health dangers of climate change in their education or in practice, and therefore are ill-equipped to lead action on climate change. When educated about climate change, nurses can effectively lead climate adaptation and mitigation strategies aimed at creating healthier populations. As the most trusted professionals and making up 40% of the health-care workforce, nurses have the potential to impact behavior change and launch a movement around climate solutions. Health Care Without Harm and the Alliance of Nurses for Healthy Environments partnered on the "Nurses Climate Challenge" with the aim of nurses educating 5,000 health professionals on climate and health. In the Nurses Climate Challenge, nurses register as Nurse Climate Champions and gain access to online resources to plan and host educational sessions about climate change. After educating, Nurse Climate Champions return to the online platform to track their progress. Within 10 months, over 540 Nurse Climate Champions from 6 continents, 16 countries, and 42 U.S. states registered for access to the resources. To date, the champions have educated over 5,250 colleagues and students about climate and health. Based on early metrics, this model of education and engagement around climate action may be applicable for other disciplines in health care and beyond.

Mitigating a Nursing School's Impact on Climate Change: A Quality Improvement Project.

BACKGROUND: Mitigation is one approach to addressing climate change, which focuses on reducing carbon dioxide and greenhouse gas emissions. Nurses play a critical role in mitigation to prevent the health impacts of climate change. Recommendations to mitigate climate change in higher education institutions reflect four themes: policy, people, process, and practice. This quality improvement project aimed to mitigate a metropolitan nursing school's impacts on climate change. METHODS: A Sustainability Champion Workgroup was formed to address gaps identified in the organizational needs assessment. A No Waste November (NWN) campaign and a sustainability dashboard were created to engage participants and increase awareness about climate change and environmentally sustainable behaviors. A pre- and post-NWN survey, adapted from the Nurses' Environmental Awareness Tool, and waste disposal measurements over 6 weeks were used to assess the impact of these interventions. RESULTS: The post-NWN survey showed the greatest increases in mean scores for the following environmentally sustainable behaviors: biking, walking, carpooling, or taking public transportation to work; leading or participating in recycling initiatives; serving on committees that purchase sustainable supplies; and composting. Waste disposal measurements revealed a higher proportion of recycling to landfill waste during 5 out of the 6 weeks of measurement. CONCLUSION: Nurses and higher education institutions play an important role in mitigating the human impacts on climate change through environmental sustainability initiatives. Barriers to adopting environmentally sustainable behaviors and incentives to support these behaviors also need to be examined and addressed in future projects.

CHANT: Climate, Health, and Nursing Tool: Item Development and Exploratory Factor Analysis.

Climate change poses significant health risks. Nurses assess, treat, and educate patients about health risks. However, nurses' level of awareness, motivation, and behaviors related to climate change and health is not known. This study developed and tested a novel tool measuring these elements. Three hundred fifty-seven nurses responded to the overall survey. Exploratory factor analysis (EFA) assessed the factor structure of the 22-item CHANT survey and Cronbach's alpha estimated internal consistency. A five-factor model was retained through the EFA, demonstrating good model fit (comparative fit index [CFI] = .95, root mean square error of approximation [RMSEA] = .04, standardized root mean square residual [SRMR] = .09), and items were internally consistent (Cronbach's alpha for each subscale >.70). CHANT has been developed and psychometrically examined and is ready for further use and study.

Testing a modified perceived exertion scale for Alzheimer's disease.

Standardized methods for prescribing and monitoring exercise intensity are needed to advance exercise research in Alzheimer's disease (AD). The purpose of this study was to evaluate the concurrent validity of a modified 1-10 Rating of Perceived Exertion (RPE) scale against heart rate (HR) in older adults with mild-to-moderate AD (N = 8, age 77-87 years). RPE and HR were assessed every 5 min during each exercise session with 3,988 data pairs. Pearson and Spearman correlations and mixed models for correlated data were used for analysis. Results show the correlation between RPE and HR and between RPE and change in HR from resting was -.11 (SE = .15) and -.31 (SE = .17), respectively. The proportions of variance explained by RPE overall, RPE within participant, and RPE within session were only 4.0, 5.3, and 6.7%, respectively. We conclude that the modified 1-10 RPE scale did not show concurrent validity to HR, with large between-individual variability.