This project examined the accuracy of medication administration by nurses at a large tertiary hospital. Registered nurses were prepared to directly observe medication administration. Observations were made of 1514 doses administered by 30 nurses on 3 units, on day and evening shifts. Few (5%) medication errors were found. The most frequent errors were wrong technique, wrong time, and omission. Results suggest examination of medication policies, assessment of medication administration competency, and targeted in-service education.