Background and Objective: Adverse events, defined as errors occurring during nursing care, have become one of the most serious threats to patient safety and quality of care in hospitals. This study aimed to investigate the role of various factors influencing adverse events among nurses.

Methods: An analytical epidemiological study was conducted on 360 nurses working in public hospitals in Ahvaz. Data were collected using a personal information questionnaire, an environmental factors checklist, the standardized Patient Safety Culture questionnaire, the NEO Personality Inventory, the Copenhagen Psychosocial Questionnaire assessing psychosocial work factors, and a standardized adverse events checklist. Data analysis was performed using SPSS and SMART PLS software.

Results: The most frequently reported adverse events were complaints from patients or their families, while surgical wound infections were reported less frequently. Additionally, 31 nurses (8.6%) reported more than 20 adverse incidents in the past 12 months. The developed model indicated that environmental noise significantly affects both patient safety culture and adverse events, and psychosocial factors influence patient safety culture; however, patient safety culture alone did not have a significant effect on the occurrence of adverse events.

Conclusion: Overall, the prevalence of adverse events among the studied nurses was high. Exposure to environmental noise and psychosocial factors substantially impacts patient safety culture. These findings can inform strategies to improve adverse event management and enhance patient safety culture.