This study was done to identify the factors affecting the perception of patient-safety-culture and the level of safety-care-activity among nurses in small-medium sized general hospitals.

Data were collected during April and May 2011, from 241 nurses of five hospitals. A hospital survey questionnaire on patient-safety-culture and safety-care-activity was used. Collected data were analyzed using descriptive statistics, Pearson correlation, t-test, ANOVA, Scheffe test and multiple-regression.

There were significant differences in the level of perception of patient-safety-culture according to the nurses' age, type of hospital, position, work department, and knowing whether there was a Patient-Safety committee in their hospitals. Nurses with higher perceived level of the patient-safety-culture performed more safety-care-activities. Factors influencing on the safety-care-activities were general patient safety, having had safety-education, patient-to-nurse ratio, employment status, and the level of reporting medical errors. These factors explained 22.9% of the safety-care-activity.

The study findings suggest that in order to improve the nurses' perceived level of patient-safety-culture and safety-care-activity, the hospitals need to establish patient-safety committees and communication systems, and openness to reporting medical errors are needed. Better work conditions to ensure appropriate work time, regulate patient-to-nurse ratio, and nursing education standards and criteria, are also required.