The hospital is a very risky organization for the occurrence of medical error because of the various actions performed in health services. Implementation of patient safety system in hospital is one of the important goals to prevent and reduce the incidence of patient safety in health service. Factors of knowledge, attitudes, spiritual intelligence, quality of work life and the impact on nurses performance support in the patient's safety system. This research is descriptive qualitative and quantitative with cross sectional research design. The sample is nurses who are on duty at X Hospital of Pemalang 40 people with sampling technique that is total sampling. Data analysis using Structural Equation Modeling (SEM) using Partial Least Square (PLS) data analysis tool. The results showed that knowledge and attitudes affect quality of work life and the impact on nurses’ performance, while spiritual intelligence does not affect quality of work life and the impact on nurses performance of patient safety systems implentation in X Pemalang Hospital.