<p> Aim To identify Maltese nurses’ perceptions of medication errors, including factors that may contribute to errors, barriers to reporting them and possible preventive measures.</p> <p> Method Between December 2004 and January 2005 a survey was conducted of nurses (n=43) working on medical wards at a state general hospital in Malta. Data were collected by means of a self-administered questionnaire. Thirty-eight nurses responded.</p> <p> Results The most frequently identified causative factors of medication errors were doctors’ illegible handwriting, nurses’ tiredness, and distraction or interruption while administering drugs. Participants said barriers to reporting errors were the administration system and fear of blame.</p> <p> Conclusion The introduction of hospital policies and the development of structured protocols on drug administration may decrease medication errors. The hospital administration system needs to stress the importance of reporting errors and adopt a non-punitive approach to safeguard patient safety. Other preventive strategies include increasing staff, avoiding distraction from patients and co-workers when medications are administered, and introducing regular education sessions in pharmacology and numeracy.</p>