Factors associated with disaster nursing competence among emergency department nurses: the roles of disaster preparedness, self-efficacy, and communication ability

BACKGROUND: Disasters are increasing owing to climate change and urban overcrowding, and emergency department nurses play a pivotal role in disaster response. Understanding the factors associated with disaster nursing competence is essential to enhance preparedness and response capacity. METHODS: A cross-sectional survey was conducted with emergency department nurses from one regional medical centre and three local emergency medical centres in South Korea between 15 July and 10 August 2023. Validated instruments were used to assess disaster experience, disaster preparedness, self-efficacy, communication ability, and disaster nursing competence. Data were analysed using correlation and hierarchical regression analyses. In Model 1, general characteristics (e.g. age, marital status, emergency department experience, job position) were entered; in Model 2, additional variables (disaster experience, disaster preparedness, self-efficacy, and communication ability) were added. RESULTS: The mean disaster nursing competence score was 50.65 out of 75. In Model 1, age, marital status, and emergency department experience were significantly associated with disaster nursing competence (adjusted R² = 0.30). After adding disaster preparedness, self-efficacy, and communication ability, the explanatory power increased to 62%, representing a 32% improvement (Δ adjusted R² = 0.32). In the final model, disaster preparedness (β = 0.42, P < 0.001), self-efficacy (β = 0.15, P = 0.016), and communication ability (β = 0.15, P = 0.025) remained significantly associated with disaster nursing competence. CONCLUSIONS: Given that disaster preparedness showed the strongest association, institutional investment in systematic, continuous, and practice-based disaster education and drills should be considered a central strategy for strengthening emergency department nurses' competence and overall emergency response capacity. In addition, given the demonstrated contributions of self-efficacy and communication ability, institutions should incorporate structured programmes and interprofessional exercises that enhance nurses' confidence and communication skills.