The setting was somewhat comparable to Houston Methodist. Most participants worked in regional hospitals, while about one-third worked in primary care or nursing homes. The sample consisted of 76.4% females and 23.6% males, with experience levels evenly split: one-third had over 20 years of experience, one-third had between five and 20 years, and one-third had less than five years of experience.

Phase I:

• NAS: 70.4% reported moderate environmental awareness.
• PEB: 57.3% followed environmental guidelines at home; 63.1% found home-based environmental tasks easier than workplace tasks.
• NPEB: 52.2% rarely performed environmental activities at work; 35% cited difficulty implementing them. Recycling was considered easy (57.6%), yet over half engaged less often than desired.

Phase II:

• Green Teams are essential for leading sustainability efforts.
• Green Team activities positively influenced nurses.
• Leadership involvement is critical for building a culture of environmental awareness.
• Barriers include time constraints and a lack of resources.
• Reducing the burden on nurses would improve sustainability.

Yes, the findings are consistent with the population and regional context studied.

No immediate changes resulted from this study; however, its findings can guide nurses, leaders and health systems in creating and sustaining effective environmental practices and programs.

Nurses and nurse leaders play a crucial role in developing and maintaining environmentally responsible health care systems.