Background Occupational Bloodborne Exposures (OBEs) are incidents where healthcare workers come into contact with blood or other potentially infectious materials, leading to risks of transmitting bloodborne pathogens. Nursing students, often in direct contact with patients, face heightened risks due to their duties. Methods First, we conducted a cross-sectional survey using a OBEs questionnaire to explore the knowledge, attitudes, practices, and needs regarding OBEs among nursing students. Subsequently, we used a randomized controlled trial (RCT) to compare the impact of the Presentation-Assimilation-Discussion (PAD) method with the traditional lecture-based learning (LBL) method on OBEs education for nursing students. Pre-test, post-test, and retention test were used to observe the teaching effectiveness, and the students' feedback on the teaching method was also observed. Results In the cross-sectional survey, we found that nursing students lacked sufficient knowledge and management skills regarding OBEs but recognized the importance of standard precautions and expressed a desire for systematic OBEs training during their education and internships. In the RCT, the total, theoretical, and practical scores of the PAD and LBL groups were comparable in the pre-test (56.70 +/- 3.47 vs. 56.40 +/- 3.95, 33.09 +/- 3.39 vs. 33.33 +/- 2.44, 23.61 +/- 4.66 vs. 23.07 +/- 4.84, p > 0.05). After training, the PAD model demonstrated an advantage over the LBL model in immediate total (84.25 +/- 4.06 vs. 78.95 +/- 4.23, p < 0.001), theoretical (54.32 +/- 2.43 vs. 51.44 +/- 2.58, p < 0.001), and practical scores (29.93 +/- 3.90 vs. 27.51 +/- 4.33, p < 0.01). It also showed superior retention of total (69.05 +/- 3.87 vs. 65.77 +/- 2.94, p < 0.001) and theoretical scores (39.05 +/- 3.05 vs. 36.23 +/- 3.18, p < 0.001). However, there was no significant difference in the retention of practical scores between the two groups (30.00 +/- 4.76 vs. 29.53 +/- 3.73, p > 0.05). The PAD group benefited more across various learning dimensions but reported a higher study load. Conclusions Our study reveals that the PAD model could be a valuable approach for teaching OBEs to nursing students.