Background <p>Literature describing nurse practitioners’ (NPs) experiences with point-of-care ultrasound (PoCUS) training and clinical use remains limited. This study aims to assess the effect of PoCUS training for NPs across different hospital levels.</p> Methods <p>A prospective cohort study was conducted. The curriculum comprised 1-hour didactics followed by a 3-hour hands-on training session. Written examinations and objective structured clinical examinations (OSCEs) were administered immediately after training and at 3 months. Self-reported monthly PoCUS examination volumes during clinical practice after training were also collected.</p> Results <p>One hundred and nineteen NPs across different hospital levels were recruited. They had better performance in both the written test and OSCE at the 3-month assessment compared to the immediate assessment. Following the curriculum, a greater proportion of NPs incorporated PoCUS into clinical practice, with abdominal ultrasound becoming the most used. Additionally, NPs working in settings without resident staff were significantly more likely to perform clinical PoCUS examinations (OR 4.43, 95% CI 1.57–12.47) after adjusting for covariates such as age, sex, postgraduate year, hospital level, department, prior experience, and the initial assessment.</p> Conclusions <p>This focused PoCUS curriculum was associated with improved knowledge, skills and increased clinical use among NPs across different hospital levels, with greater uptake in teams without resident staff. However, interpretation is limited by short follow-up and self-reported use. Further studies with longer follow-up and direct assessment of clinical PoCUS performance are needed to better define training durability and the role of PoCUS in NP-led care.</p> Trial registration <p>Registered at the ClinicalTrials.gov. (NCT 06543693).</p>