Background: Poorly organized health systems with inadequate leadership limit the devel-opment of the robust safety cultures capable of preventing consequential adverse events. Althoughsafety culture has been studied in hospitals worldwide, the relationship between clinician perceptionsabout patient safety and their actual clinical practices has received little attention. Despite the needfor mixed methods studies to achieve a deeper understanding of safety culture, there are few studiesproviding comparisons of hospitals in different countries. Purpose: This study compared the safetyculture of hospitals from the perspective of nurses in four European countries, including Croatia,Hungary, Spain, and Sweden. Design: A comparative mixed methods study with a convergentparallel design. Methods: Data collection included a survey, participant interviews, and workplaceobservations. The sample was ...