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.