The emergency department carbon footprint calculator: Design and validation.

Carbon footprint calculators could lead to positive environmental actions, raise awareness, and justify sustainable actions. Emergency departments worldwide receive a large number of patients every year, representing a high carbon footprint. Our tool aims to provide a comprehensive tool created by emergency nurses to measure the carbon footprint of emergency departments. A literature review was conducted to establish the boundaries of the calculator. The pertinence of the resulting boundary inventory was evaluated by a panel of experts. A version 1 of the calculator was designed including the experts' suggestions. The scope, accuracy of calculation and pertinence of conversion factors were assessed by the same panel of experts. Tool was also tested by a group of health professionals as potential users, in terms of clarity, ease of use, viability, and usefulness. Results: The agreement among experts was measured with the content validity index and Aiken V. The results showed good content validity (CVI = 0.74 and V = 0.87 in the first panel; CVI = 0.81 and V = 0.90 in the second panel). Three main themes emerged from the focus group: calculator overview, data collection and benefits. A validated, and comprehensive tool was obtained for carbon footprint calculation, offering a thorough analysis of scope 1, 2 and 3 emissions in the emergency department.