The “1 + X” certificate system is an important direction for vocational education reform in China, aiming to promote the deep integration of academic education and vocational skills training, and enhance learners’ job adaptability and employment competitiveness. University-affiliated hospitals, as the core carriers of practical teaching in nursing, play a crucial role in integrating education and training in implementing the “1 + X” certificate system. This article analyzes the core challenges currently facing the construction of nursing practical teaching bases in university-affiliated hospitals from three dimensions: system integration, resource allocation, and faculty development. Based on the development of the nursing industry and the requirements of education and training, it proposes targeted countermeasures, providing a reference for improving the nursing practical education and training system and enhancing the quality of nursing talent training.