From Paper to Pixels: Evaluating the Impact of Digital Transformation on Sustainability in Nursing Education

Background: As the largest workforce in health, it is critically important that the principles of planetary health are incorporated into nursing education to have a significant influence on reducing the environmental impacts of health practices and address health inequities. Despite the adoption of sustainability principles by the higher education sector, the translation into nursing curriculum has been challenging. The increased integration of digital technologies in health contributes towards both sustainability in health and the United Nations Sustainable Development Goals (SDG). Electronic health records (EHRs) are well documented in reducing the reliance on paper-based records and improve the efficiency of health delivery, including accessibility to health where information sharing barriers are reduced. The incorporation of digital health training, and specifically the use of simulated EHRs, into nursing curriculum will increase the application of the principles of planetary health into graduate practice. Aims: This study explored if the use of an EHR in a simulated learning environment (SLE) in a Bachelor of Nursing (BN) program can lead to tangible reduction in paper consumption. Methods: A nonexperimental, pre- and postdesign was used to audit the paper consumption, specifically paper-based manuals, within the SLE pre- and postimplementation of the HealthiERSim®, an in house developed simulated EHR system. The study was held across multiple campuses with different BN cohorts. Results: The study reported an overall reduction paper consumption by 12.59% post-implementation of HealthiERSim® and a reduction in pages per SLE manual, with a significant (p < 0.001) difference in paper consumption between the subjects. Conclusion: The results of this study indicate an effective implementation of an EHR solution can decrease paperconsumption within an SLE, contributing to reducing the environmental footprint of an educational institution. Where adopted with curriculum content about sustainable practices, this will increase graduate awareness and practice of planetary health principles and the SDGs.