Crisis Management Competency Among Nurses in the High-Acuity Units of a Public Tertiary Care Hospital, Lahore: A Descriptive, Cross-Sectional Study
Abstract
Nurses working in high-acuity units of resource-constrained public tertiary care hospitals routinely manage operational crises, including mass-casualty presentations, supply shortages, and infrastructure failures, that extend well beyond standard nursing training, yet the crisis management competencies nurses develop informally in such settings remain poorly documented. Objective: To identify the crisis management skills employed by nurses in their daily practice within the Emergency Department, surgical and medical wards, and intensive care units of Mayo Hospital, Lahore. Methods: A descriptive, cross-sectional study was conducted among 222 registered nurses, selected through convenience sampling from January to June 2026 at Mayo Hospital, Lahore, Pakistan. Data were collected using an adapted, validated 32-item Crisis Management Competency Questionnaire assessing four domains: technical, cognitive, behavioral, and underlying-characteristics competencies. Data were analyzed using SPSS version 26; descriptive statistics summarized demographic characteristics and domain- and total-level competency scores, and reliability was assessed using Cronbach's alpha. Results: Most nurses were female (75.7%), with a mean age of 29.8 ± 5.6 years and mean clinical experience of 5.4 ± 3.7 years. The overall crisis management competency score was 71.2% (SD = 12.55), placing the sample in the high-competency category; 50.9% of nurses were classified as having high competency and 46.4% moderate, while only 2.7% were classified as low. Behavioral Competencies were the most strongly endorsed domain (73.3%), followed by Cognitive Competencies (72.5%) and Underlying Characteristics (71.0%), while Technical Competencies were comparatively lower (68.6%). The questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.867). Conclusion: Nurses at Mayo Hospital, Lahore demonstrated substantial crisis management competency, developed largely through sustained informal clinical exposure rather than formal training, with a comparative gap in technical competencies suggesting a specific, actionable target for structured training interventions.