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INTEGRATION OF THE QUALITY APPROACH INTO NURSING PRACTICES, CHALLENGES AND IMPROVEMENT LEVERS.: The deployment of the care quality and safety approach is integrated into the strategic policies of healthcare facilities. Despite significant investment by management and a desire on the part of caregivers to provide quality care, certain tools and practices are still not widely used. A qualitative survey carried out with nurses and healthcare managers reveals the obstacles to the long-term survival of such an approach and the levers which can be used to develop this quality culture.