Healthcare professionals are expected to know their role in patient safety. In a rural hospital, they may have different roles along with their professional role. Staff and services are fewer and the community is often part of the hospital. This can influence patient safety culture. Researchers and governing bodies have focused on developing processes to assist healthcare leaders developing their patient safety culture. Researchers and governing bodies have tended to focus on urban hospitals and then implement the same processes in rural hospitals. This strategy has not always been successful. The purpose of this study is to explore the roles and responsibilities in patient safety culture of health care professionals in rural hospitals. A systematic review, using the Joanna Briggs Institute (JBI) review process, was completed to discover how patient safety culture and rural hospitals are described and measured. Some common elements in the literature were unique characteristics of rural hospitals, leadership, error reporting and the use of patient safety culture surveys. Ethnographic methods were used to explore healthcare professional’s roles in patient safety culture in a rural hospital. Healthcare professionals describe their roles differently than described in the literature. A patient safety culture model was developed from the literature and refined with the study findings. The affinity model was developed based on the study findings from the small rural hospital and the literature. Everything they do is how rural hospital practitioners described their role in patient safety. / Thesis (Ph.D, Nursing) -- Queen's University, 2014-02-20 09:15:25.007