Background: Reporting a near-miss event has been associated with better patient safety culture. Purpose: To examine the relationship between patient safety culture and nurses' intention to report a nearmiss event during COVID-19, and factors predicting that intention. Methods: This mixed-methods study was conducted in a tertiary medical center during the fourth COVID-19 waves in 2020-2021 among 199 nurses working in COVID-19-dedicated departments. Results: Mean perception of patient safety culture was low overall. Although 77.4% of nurses intended to report a near-miss event, only 20.1% actually did. Five factors predicted nurses' intention to report a nearmiss event; the model explains 20% of the variance. Poor departmental organization can adversely affect the intention to report a near-miss event. Conclusions: Organizational learning, teamwork between hospital departments, transfers between departments, and departmental disorganization can affect intention to report a near-miss event and adversely affect patient safety culture during a health crisis.