Disaster preparedness knowledge and training needs among emergency department nurses in two tertiary care hospitals in Peshawar evaluated through a cross-sectional study

Emergency department nurses are the primary clinical responders during mass-casualty incidents and sudden catastrophic events, yet their baseline disaster preparedness is rarely documented in resource-constrained settings. This study assessed the disaster preparedness knowledge, training exposure, and triage competencies of emergency nurses in two tertiary care hospitals in Peshawar, Pakistan. A comparative cross-sectional survey was conducted with \\(102\\) emergency department nurses ( \\(60\\) from Lady Reading Hospital, \\(42\\) from Khyber Teaching Hospital). Data were collected using the Revised Public Health Nurses’ Knowledge Regarding Disaster Management Questionnaire (PHNK-DMQ-R), an instrument adapted from the validated original. The tool evaluated behavioural preparedness practices, acute triage accuracy under the START protocol, and post-disaster recovery knowledge. Between-hospital comparisons used \\(\\chi^2\\) tests for binary items and independent-sample \\(t\\) -tests for domain scores, with effect sizes (Cramér’s \\(V\\) and Cohen’s \\(d\\) ). Only \\(29.4\\%\\) of participants had ever assisted disaster victims, and \\(40.2\\%\\) lacked any formal disaster training. The preparedness practice score did not differ significantly between hospitals. However, formal START protocol training was more frequent at Lady Reading Hospital ( \\(53.3\\%\\) vs. \\(33.3\\%\\) ; \\(p = 0.046\\) ). Acute triage accuracy was significantly higher at Lady Reading Hospital (mean score \\(2.13\\) vs. \\(1.76\\) ; \\(p = 0.006\\) , Cohen’s \\(d = 0.57\\) ), driven by superior classification of green and yellow tags, whereas Khyber Teaching Hospital nurses performed better on black-tag classification ( \\(78.6\\%\\) vs. \\(53.3\\%\\) ; \\(p = 0.012\\) ). Recovery-phase knowledge was uniformly low across both institutions (mean score \\(1.83\\) out of \\(5\\) ), with correct-answer rates below \\(30\\%\\) for all items. Marked gaps in disaster preparedness, particularly in post-disaster recovery competencies, persist among these emergency nurses. The observed inter-hospital differences highlight the need for institution-specific, simulation-based training programmes. As a baseline assessment, these findings provide a foundation for nursing curriculum reform and prospective longitudinal research.