Objective To construct a competency evaluation index system of nursing staff in nuclear emergency medical rescue, providing a scientific basis for the professional training and assessment for nursing staff in this field.

Methods Based on a review of literature and semi-structured interviews, preliminary competency evaluation indicators for nursing staff in nuclear emergency medical rescue were drafted. From January to March 2024, the Delphi method was used to consult experts. After multiple rounds of discussion and revision, the final version of the evaluation index system was formed, and the weights of each level of indicators were precisely calculated using the analytic hierarchy process （AHP）.

Results The competency evaluation index system for nuclear emergency medical rescue nursing staff includes 3 first-level indicators, 9 second-level indicators, and 58 third-level indicators. The first-level indicators, ranked by weight from highest to lowest, were professional ability （weight 0.490 5）, personal quality （weight 0.311 9）, and nuclear emergency knowledge （weight 0.197 6）. The second-level indicators, ranked by combined weight from highest to lowest, were emergency medical rescue ability （weight 0.162 1）, protection ability （weight 0.162 1）, ideological quality （weight 0.156 0）, physical and mental quality （weight 0.156 0）, professional knowledge （weight 0.131 7）, basic knowledge （weight 0.065 9）, decontamination and waste disposal ability （weight 0.063 9）, management ability （weight 0.054 0）, and psychological intervention ability （weight 0.048 3）. The top three third-level indicators by combined weight were obedience and responsibility awareness （weight 0.053 4）, safety awareness （weight 0.051 4）, and correct wearing of various protective items （weight 0.049 1）.

Conclusions The index system had a solid theoretical foundation, comprehensively defined the competency of nursing staff in nuclear emergency medical rescue, and had strong practicality. It could provide valuable guidance and support for the professional training and assessment for nursing staff in this field in the future.