| Sumario: | Background: Medical error reporting serves as a crucial indicator of healthcare professionals' commitment, accountability, and reliability, which ensures patient rights, and also functions as a mirror of organizational culture, reflecting staff attitudes and practices regarding patient safety. This study was conducted to predict factors affecting nurses' medical error reporting behavior using the theory of planned behavior (TPB) at Shiraz University of Medical Sciences, Iran, in 2024. Methods: This applied, cross-sectional study examined 280 nurses working in teaching hospitals. The required samples were selected using stratified random sampling proportional to size and simple random sampling methods. Data were collected using the Persian version of the medical error reporting questionnaire developed by Seyedin et al based on the theory of planned behavior and were analyzed and modeled through structural equation modeling (SEM) using Smart PLS 3.0. Results: The results showed that the model demonstrated a relatively strong overall fit (GOF = 0.342, SRMR <0.08, RSM Theta <0.12), and all its constructs were associated with and demonstrated predictive power for behavior, so that both direct and indirect paths on behavior were statistically significant (P <.001). However, perceived behavioral control (β =.385; f 2 = 0.161) and behavioral intention (β =.378; f 2 = 0.155) showed the strongest direct associations, and control beliefs (β =.175; f 2 = 0.730) exhibited the greatest indirect association on behavior. Conclusion: The findings indicated that improving medical error reporting requires comprehensive attention to both behavioral and cognitive characteristics of nursing staff and providing a supportive environment that reinforces positive beliefs and attitudes toward error reporting. Practical recommendations include facilitating access to reporting systems, giving continuous feedback about reported errors to nurses and providing them with positive consequences, considering various rewards for timely and accurate reporting of medical errors, and creating continuous supportive mechanisms.
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