BACKGROUND: Enhancing patient safety involves identifying key factors and applying preventive strategies. While clinical competency, professional values and safety culture are recognised as important, the mediating role of patient-centred communication in promoting safety-care activities remains underexplored. AIM: This study aimed to identify factors influencing safety-care activities among hospital nurses, with patient-centred communication competency as a mediator. METHODS: A correlational survey design was employed, involving 308 nurses with a minimum of 6 months of clinical experience at university hospitals. Data were collected between March and December 2022 and analysed using structural equation modelling with IBM SPSS 26.0 and AMOS 26.0. RESULTS: Most participants were female (93.8%) and single (84.4%), with an average of 5 years of clinical experience. Clinical competency, professional values, awareness of safety culture and patient-centred communication competency collectively explained 36% of the variance in safety-care activities. Patient-centred communication competency demonstrated a significant indirect effect (β = 0.04, 95% CI [0.01, 0.07]), supporting its mediating role. CONCLUSIONS: Clinical competency, awareness of safety culture and patient-centred communication competency were significant predictors of safety-care activities. The mediating role of communication highlights its importance in translating values into safety-care practice. Future research should examine broader organisational and cultural influences to strengthen the model's applicability across diverse healthcare settings.