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Objective: To examine adverse events in nursing care from the perspective of patients and families.Methods: A retrospective mixed-methods study was conducted, analyzing patient and family-reported adverse events related to nursing care. Qualitative content analysis was used to categorize the types of adverse events, while descriptive statistics summarized patient characteristics and event frequency.Results: Four main categories of adverse events emerged: participation, clinical judgment, nursing interventions, and essentials of care. Over a third of reports related to lack of patient and family participation. Adverse events were reported across settings, with some differences in patterns between long-term care and acute care.Conclusion: Partnering with patients and families, ensuring their participation in care, and consistently delivering high-quality essential nursing care are key strategies to improve patient safety. The patient and family perspective should inform ongoing efforts to reduce adverse events.