The Institute of Medicine (IOM), in a report on the future of nursing, recommends nurses to be innovative in research, education, and practice in order "to lead and diffuse collaborative improvement efforts" (2010a, pp. S-9). Government agencies, healthcare groups, policymakers, researchers, and administrators emphasize the importance of innovation, research utilization, and the quality and safety of patient care. However, little is known about the individual innovative behaviors of registered nurses and the relationships between individual innovative behavior, research utilization, and the quality and safety of patient care are poorly understood. This study described acute care registered nurse individual innovative behavior using a descriptive, cross-sectional research design. Questionnaires, available both in paper and on-line formats, were distributed to registered nurses. In addition, this study explored the relationships of antecedent variables (autonomy, leader-member exchange, support for innovation), individual innovative behavior, and research utilization. It was found that nurses had, on average, moderate individual innovative behavior as well as moderate commitment to research utilization. Individual innovative behavior was predicted by autonomy, specialty certification, and belief suspension. Research utilization was predicted by individual innovative behavior, attitude towards research, and in-services and continuing education. Perceived high quality of patient care was predicted by support for innovation and working in critical care areas. Perceived high safety of patient care was predicted by autonomy, support for innovation, and age. Individual innovative behavior and research utilization were not significant predictors of the perceived quality or safety of patient care but may be mediating variables between some of the antecedent variables and the quality and safety of patient care.