Predicting Safe Environment Behaviors to Prevent Nosocomial Infections Among Nursing Students: A Structural Equation Modeling Study

Abstract Background Nosocomial infections pose a significant threat to patient safety and healthcare costs. Nursing students, as future healthcare professionals, play a crucial role in preventing nosocomial infections. Understanding the factors influencing their safe environment behavior is essential for designing effective intervention programs. This study aimed to investigate the relationships among knowledge, attitudes, subjective norms, perceived behavioral control (PBC), and the intention to engage in safe environment behavior among nursing students in preventing nosocomial infections. Methods A cross-sectional study was conducted with 242 nursing students from three nursing institutions in Pekanbaru Province, Indonesia. Data were collected via a self-administered questionnaire assessing knowledge, attitudes, subjective norms, PBC, and intentions. Structural equation model (SEM) was employed to analyze the relationships between the variables. Results SEM analysis revealed that attitude (β = 0.375, p < 0.001) and PBC (β = 0.224, p < 0.001) had significant positive direct effects on the intention to engage in safe environment behavior. Knowledge had a significant positive indirect effect on intention through attitude (β = 0.536, p < 0.001). Subjective norms had a significant positive indirect effect on intention through PBC (β = 0.476, p < 0.001). Conclusion Attitudes and PBC are key determinants of nursing students' intentions to engage in safe environmental behavior to prevent nosocomial infections. Knowledge indirectly influences intention through attitudes. Interventions aimed at improving nursing students' attitudes and PBC are crucial for promoting safe environmental behavior and reducing nosocomial infections.