INTRODUCTION: Patient safety is a critical competency for nursing students, highlighting the need to equip them with the knowledge and skills required to foster a culture of safety in healthcare systems. AIM: This study aimed to examine the mediating effect of patient safety confidence, moderated by campaign participation, on the relationship between nursing students' patient safety attitude and their willingness to participate in patient safety. METHODS: This study utilized a secondary data analysis approach, analyzing data from a patient safety study conducted in South Korea. The participants included 245 fourth-year undergraduate nursing students recruited using nonprobability convenience sampling. Data were collected in April 2023 through an online survey distributed to members of nursing student-focused online communities. The collected data were analyzed using SPSS PROCESS Macro (models 4 and 14) and bootstrapping method. RESULTS: The findings underscore the critical role of patient safety confidence as a mediating factor and highlight the positive impact of campaign participation in strengthening nursing students' engagement in patient safety activities. These insights emphasize the interplay between nursing students' patient safety attitudes, confidence, and experiential learning opportunities. CONCLUSION: To enhance nursing students' willingness to actively participate in patient safety, fostering positive attitudes and confidence through a well-structured educational strategy is essential. Integrating patient safety topics into the nursing curriculum and providing experiential learning opportunities can prepare students to advocate for safety and contribute to a culture of safety in healthcare.