Nurse handover is a critical process in ensuring patient safety and the continuity of nursing care, as failures during this transition frequently lead to adverse events and medical errors. Despite growing awareness of its importance, gaps in effective communication practices, patient safety culture internalization, and structured supervision by head nurses remain prevalent challenges in hospital settings, including at Cinta Kasih Tzu Chi Cengkareng Hospital, where a preliminary study revealed that 34.4% of nurses did not always receive complete patient information during handover, 33.3% felt unable to clarify information, and 38.7% reported that supervisors did not model good communication during handover. This study aimed to analyze the simultaneous and partial effects of effective communication and patient safety culture on the quality of nurse handover, as well as the mediating role of supervision techniques in those relationships. A quantitative cross-sectional design was employed with a total sampling technique involving 110 implementing nurses in inpatient wards. Data were collected using a four-point Likert scale questionnaire and analyzed through Partial Least Square Structural Equation Modeling (PLS-SEM). The results demonstrated that effective communication, patient safety culture, and supervision techniques simultaneously had a significant effect on handover quality (F = 323.88 > F-table 2.665). Effective communication had the most dominant direct positive effect on handover quality, while patient safety culture showed a significant but negative direct effect, indicating that its impact on handover quality is optimally realized only when mediated through supervision techniques. Supervision techniques significantly mediated both pathways, confirming their role as a key structural bridge between the independent variables and handover quality outcomes.
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