Table 4 Results—Sustainability habits in surgical practice

[My hospital/institution recommends ensuring only appropriate contents in sharps bins (sharps/drugs).]

3.68

1.27

[My hospital/institution recommends opening only those sets that are needed and, when they are needed, by integrating supplementary items into sets]

3.38

1.26

[My hospital/institution recommends that damaged reusable equipment is repaired, encouraging active maintenance.]

3.34

1.25

[My hospital/institution recommends avoiding clinically unnecessary interventions (e.g., antibiotics, catheterization, histological examinations).]

3.33

1.26

[My hospital/institution recommends arranging metals/battery collection where possible.]

3.27

1.30

[My hospital/institution recommends powering off lights, computers, ventilation, AGSS, and temperature control when the theatre is empty.]

3.14

1.33

[My hospital/institution recommends using non-infectious offensive waste (yellow/black tiger), unless clear risk of infection.]

3.10

1.28

[My hospital/institution installed several automatic or pedal-controlled water taps.]

3.05

1.47

[My hospital/institution recommends avoiding all unnecessary equipment (e.g., swabs, single-use gloves).]

2.99

1.28

[My hospital/institution recommends the creation of surgeon preference lists for each operation—separate essential vs. optional items to have ready on side.]

2.98

1.32

[I have a clear understanding and picture about greener clinical practices adopted by my hospital/institution.]

2.90

1.17

[My hospital/institution recommends opting for reusables, hybrid, or remanufactured equipment instead of single-use (e.g., diathermy, gallipots, kidney-dishes, light handles, quivers, staplers, energy devices)].

2.88

1.29

[My hospital/institution accurately measures operating room sterile supply waste.]

2.83

1.29

[My hospital/institution uses reusable textiles (including theatre hats, sterile gowns, patient drapes, and trolley covers).]

2.81

1.35

[My hospital/institution is supplied by firms adopting sustainable practices]

2.77

1.21

[My hospital/institution recommends using domestic or recycling waste streams for all packaging.]

2.71

1.27

[After the first water scrub of the day, I use alcohol rub for the subsequent cases.]

2.68

1.48

[My hospital/institution endorses the reduction in water and energy consumption.]

2.68

1.23

[My hospital/institution employs sustainable inputs (e.g., from renewable sources, and/or made of biodegradable materials, and/or coming from recycling processes)]

2.66

1.20

[My hospital/institution recommends avoiding the use of single-use surgical packs.]

2.61

1.29

[My hospital/institution promotes greener clinical practices in general terms.]

2.57

1.14

[My hospital/institution recommends switching to low-carbon alternatives (e.g., skin sutures vs. clips, loose prep in gallipots).]

2.57

1.28

[My hospital/institution recommends recycling or using lowest carbon-appropriate waste streams as appropriate.]

2.56

1.20