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Ahmed Husni Maabreh,1 Ahmad R Al-Qudimat,2,3 Emad Mustafa,1 Adham Aljariri,4 Kalpana Singh5 1Nursing & Midwifery Department, Hamad Medical Corporation, Doha, Qatar; 2Surgical Research Department, Hamad Medical Corporation, Doha, Qatar; 3Public Health College, HQ Health, Qatar University, Doha, Qatar; 4Otolaryngology-Head and Neck Surgery Department, Hamad Medical Corporation, Doha, Qatar; 5Nursing & Midwifery Research Department, Hamad Medical Corporation, Doha, QatarCorrespondence: Ahmed Husni Maabreh, Nursing & Midwifery Department, Hamad Medical Corporation, Doha, Qatar, Email amaabreh@hamada.qa; a.maabreh@ymail.comBackground: Nurses need proper care skills for tracheostomy care and to handle airway emergencies and prevent complications because nursing preparedness and experience in these situations vary among healthcare facilities which shows that competency evaluations are essential for improving patient safety and care quality.Objective: The study measures nurses’ self-assessed proficiency in tracheostomy care management and emergency readiness while pinpointing nursing competency gaps to develop targeted educational and strategic interventions.Methods: A total of 1109 nurses from critical care, surgical, trauma, home care, emergency and outpatient units provided the study data. A structured questionnaire assessed participant confidence levels as well as their knowledge and preparedness, The survey instrument was adapted from a previously validated questionnaire and further reviewed by experts and pilot tested to ensure suitability for the local context. Multiple linear regression and ANOVA, along with t test enabled the study to explore the relationships between participants’ demographic traits and their educational and workplace experiences in relation to competency levels, this study was reported in accordance with the STROBE guidelines.Results: Female participants comprised 79.1% of the total group, and mean age of 36.6 ± 7.4 years, while most participants came from South Asia (45.9%) followed by Southeast Asia (35.1%) and staff nurses formed 93.4% of the sample with an average professional experience of 12 years, the participants achieved moderate assessment scores measuring confidence at 21.0 out of 30 and knowledge at 8.3 out of 16, nurses from critical care units demonstrated significantly higher levels of both confidence and knowledge registering 23.2 and 9.6 respectively compared to their emergency unit nurses who scored 18.4 and 6.6 and outpatient nurses who scored 19.3 and 5.8 with these differences being statistically significant (p < 0.001).Conclusion: The research concludes that nurses require structured training programs combined with practical experience and detailed competency evaluations to improve their tracheostomy care abilities and self-confidence which healthcare organizations should standardize to ensure enhanced patient care results across all clinical settings.Keywords: tracheostomy care, nursing confidence, tracheostomy complications, tracheostomy emergencies, nursing education