Abstract
BACKGROUND: To effectively manage seizures in emergency departments (EDs), nurses must possess adequate knowledge and skills. In Iran, however, there is limited evidence on ED nurses’ knowledge and the factors that influence it. The purpose of this study was to assess emergency nurses’ knowledge of seizure management and identify individual and organizational predictors of knowledge levels. METHODS: A cross-sectional descriptive study was conducted from August to October 2025 across hospitals affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran. The study surveyed 534 emergency nurses who met specific inclusion criteria, using a researcher-designed questionnaire that was validated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). The questionnaire evaluated knowledge in three domains: fundamental knowledge, seizure management, and documentation. Data analysis comprised descriptive statistics, correlation analyses, independent t-tests, one-way ANOVA, and a negative binomial model, all conducted using SPSS 26.0, with statistical significance set at p < 0.05. RESULTS: A total of 540 nurses were employed in the emergency departments during the study period. Among these, 534 completed the questionnaires, resulting in a response rate of 98.8%. In terms of age, participants had a mean age of 33.14 ± 3.12 years and a mean professional experience of 8.07 ± 2.34 years. The mean total knowledge score was 6.02 ± 2.64 out of 13, indicating moderate overall knowledge. Negative binomial model revealed that the counts of correct answers were 1.64 times greater in nurses attending workshops than those not attending workshops (Exp (β) = 1.64, p < 0.001). Male gender (Exp (β) = 1.47, p < 0.001) and professional experience (Exp (β) = 1.05, p = 0.025) were significant predictors of a greater number of correct answers. CONCLUSIONS: Knowledge of seizure management among ED nurses was moderate, with educational exposure and experience as the primary factors associated with. Attendance at structured, competency-based educational programs was associated with higher correct answers, suggesting these may be beneficial for future educational planning. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-026-01554-3.