Aims: Underreporting remains a major challenge in patient safety programs, influenced by both individual and organizational factors. This study aimed to examine the effects of the nursing work environment, patient safety competence, and clinical supervision on patient safety incident reporting. Methods: A cross-sectional quantitative correlational study was conducted among nurses from three type B hospitals in Malang. A total of 224 eligible nurses completed the questionnaire. Data were collected using four validated and reliable Indonesian-translated instruments: PES-5, H-PEPSS, MCSS-26, and ROCAES. SmartPLS 4 was used to analyze the data and test the moderating role of clinical supervision. Results: The nursing work environment showed a positive but insignificant effect on patient safety incident reporting (β=0.130, p=0.106), whereas patient safety competence (β=0.109, p=0.048) and clinical supervision (β=0.373, p<0.001) had significant positive effects. Clinical supervision did not moderate the relationship between the nursing work environment and incident reporting (β=−0.007, p=0.929), but significantly strengthened the effect of patient safety competence on incident reporting (β=0.276, p<0.001).). Conclusion: Clinical supervision serves not only as a direct determinant of patient safety incident reporting but also as a mechanism that strengthens the influence of nurses' patient safety competence on reporting behavior. These findings highlight the importance of integrating structured clinical supervision with competency development initiatives to foster a stronger patient safety reporting culture.
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