<![CDATA[Background: Patient safety remains a global healthcare priority, with nurses playing a pivotal role in preventing adverse events. This study evaluated the effectiveness of a structured educational intervention in improving nurses' patient safety knowledge and explored multidimensional relationships among patient safety knowledge domains. Methods: A randomized controlled trial was conducted among 300 registered nurses from three regional hospitals in Medan, Indonesia. Participants were randomly assigned to an intervention group (n = 150) receiving structured patient safety education or a control group (n = 150) receiving conventional module-based learning. Knowledge was assessed across five domains. Within-group differences were analysed using the Wilcoxon signed-rank test, while between-group differences were evaluated using the Mann–Whitney U test. Correlation heatmaps and a 50-node correlation network were used to examine multidimensional relationships. Results: Both groups demonstrated significant improvements (p < 0.001). The intervention group improved from 11.72±1.93 to 16.44±1.46 (mean gain 4.72), whereas the control group improved from 12.21±1.74 to 14.99±1.74 (mean gain 2.79). Post-intervention scores were significantly higher in the intervention group (U = 6636.00; Z = −6.12; p < 0.001; r = 0.35). Stronger correlations were observed among patient safety knowledge domains in the intervention group (r = 0.87 - 0.96) than in the control group (r = 0.65 - 0.76). The correlation network further demonstrated dense intra- and inter-domain connectivity, indicating integrated knowledge development. Conclusions: Structured patient safety education significantly improves nurses' knowledge and strengthens multidimensional competency integration, supporting its implementation to enhance patient safety and healthcare quality.]]>
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