Association Between Nursing Work Environment and Patient Safety Events in Selected Hospitals in Akwa Ibom State

Background: The nursing work environment is a structural determinant of patient safety, influencing nurse performance, communication, and error prevention. Evidence from South South Nigerian hospitals is currently absent from the literature. Aim: This study examined the association between nursing work environment characteristics and patient safety events at selected hospitals in Akwa Ibom State. Methods: A descriptive correlational design recruited 140 registered nurses from four hospitals through stratified sampling. The Practice Environment Scale of the Nursing Work Index and hospital patient safety event records were used. Spearman's correlation and negative binomial regression were applied. Results: Nurse staffing and resource adequacy subscale scores were significantly negatively correlated with medication errors (r = -0.58), patient falls (r = -0.51), and healthcare-associated infections (r = -0.47). Collegial nurse-physician relations were positively associated with lower safety event rates. Conclusion: Improving the nursing work environment, particularly staffing adequacy and interdisciplinary relationships, is an evidence-based strategy for reducing patient safety events. These findings provide local evidence for nursing work environment reform advocacy in South South Nigeria. Keywords: nursing work environment, patient safety, Akwa Ibom, hospital quality, nursing index.