Trends and Core Competence Shifts in Nurses’ Infectious Disease Emergency Response Competence Across COVID-19 Pandemic Phases: Repeated Cross-Sectional Survey and Network Analysis

Despite accumulated pandemic experience, nurses' infectious disease response competence declined substantially, indicating systemic fragility during prolonged crises. However, this experience reshaped competence architecture, evolving from technical infection prevention toward higher-order competence in information integration and clinical decision-making under uncertainty. To rebuild resilience, phase-specific training programs are essential: early-phase training emphasizes infection prevention, whereas prolonged outbreaks focus on information identification and decision support. Additionally, standardized information platforms and psychological support are essential to manage ongoing pandemic pressures.