Objective To understand the current status and influencing factors of clinical nurses′ medication safety ability and the acting paths between them, providing reference for the management and training of clinical nurses′ medication safety. Methods A total of 282 clinical nurses were selected by convenient sampling method and investigated using a general information questionnaire, the Nurses′ Sense of Organizational Support Scale, the Medication Safety Competence Scale, the Nurses′ Medication Environment Perception Scale, and the Patient Safety Culture Assessment Scale. Results The score of clinical nurses′ medication safety competence was 155.00(144.00,179.00); The score of clinical nurses′ medication safety competence were positively correlated with the scores of organizational support, patient safety culture perception and medication environment perception (all P<0.05); the results of structural equation model showed that patient safety culture perception and medication environment perception played a completely intermediary effect between organizational support and medication safety competence. Conclusion The medication safety competence of clinical nurses is at a medium to high level. Attention should be paid to enhancing organizational support for clinical nurses, creating harmonious patient safety culture atmosphere and supportive medication environment, so as to improve their medication safety competence.