This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model, James Reason's Error Theory and the Toyota Production Systems quality management approach. Data were collected from professional nurses in the mid-Atlantic United States, through exploratory interviews, an online survey and post-survey follow-up interviews. The findings indicate that advances in the medication administration process and the use of technology have provided the potential to improve the quality of patient care while reducing errors associated with the medication administration process. Several process and work environment issues remain however. These include frequent distractions and interruptions during the process; the inability to take breaks during work-shifts, and the potentially negative impact of technology systems on the duration and flow of work. In addition, the findings indicate that nurses may still not be reporting medication errors. The main contributions of this study are to highlight the mechanisms that lead to medication errors and to demonstrate the key rationale for integrating standardized procedures with effective support for nurses at the point of care. This study provides an important point of reference, indicating how medication administration has changed since the findings of earlier studies. Changes to management policy in the area of medication administration are indicated, to make the process safer and more reliable. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]