Abstract
Background: Hospital-acquired infections (HAIs) pose significant safety risks, making nursing students' behavioural intention during clinical rotations vital for prevention. Objective: To analyze the influence of Perceived Behavioural Control (PBC) and knowledge on students' intention to maintain a safe clinical environment. Methods: A cross-sectional design was conducted with 242 nursing students at a Type A referral hospital in Pekanbaru, Indonesia. Participants were selected via simple random sampling. Data were collected using validated questionnaires measuring PBC (six indicators), knowledge (three subscales), and behavioural intention. Statistical analysis involved Chi-square tests for unadjusted Odds Ratios (OR) and binary logistic regression to calculate adjusted Odds Ratios (AOR) by entering all variables into the model simultaneously. Results: The majority of participants demonstrated high intention (66.5%) and high PBC (83.9%). In the univariate analysis, all six PBC indicators and general nosocomial knowledge were significantly associated with high intention (p < 0.05), with staff direction (OR = 5.96) and specific training (OR = 4.94) showing the strongest independent effects. However, when all environmental and cognitive variables were entered into the regression model simultaneously, only knowledge of personal protective equipment (PPE) use remained a significant independent factor (AOR = 2.66; 95% CI: 1.40-5.06, p = 0.003). The unadjusted OR emphasized the isolated influence of each factor, whereas the adjusted OR showed that technical knowledge was the only variable to retain significance after controlling for other factors. Conclusions: Technical knowledge regarding PPE use is the primary independent driver of nursing students' intention to maintain a safe clinical environment. While environmental support and general knowledge are important foundational elements, clinical education should prioritize practical, technical training in protective measures to translate knowledge into behavioural intention effectively.