Additional factors cited in this article can be related to lack of training, undue time pressure, and poor perception of risk. The ICN believes that understanding these factors are the first step in preventing medication errors. This organization declares that failure to administer a prescribed medication, improper dose, and administration of drugs that are not authorized by the physician are quoted as the most frequently reported errors. The International Council of Nurses suggests that medication errors are not a result of a problem with bad professionals in health care, but of a bad system that requires change to become safer. This organization supports a system wide approach that emphasizes reporting, not blaming the care provider, and including actions that address human and system factors when medication errors occur. Problems with the health care system’s design, organization, and operation are believed to be at fault and not that of negligence or lack of training of the individual provider. This article recommends the use of a voluntary reporting system in which medication errors can be reported. When these incidents are reported, attention must be made on finding the cause of the error as a way to learn from the mistake and increase patient safety. Through exploring the circumstances surrounding the