Many hospitals have systems of checks and balances in place to prevent errors, but what happens when the systems don't work? Today in the United States, medical errors represent the fifth leading cause of death. In 2000, the Institute of Medicine published a study, “To Err is Human,” which revealed approximately 98,000 deaths each year due to medical errors. Even if this figure is assumed to be lower than the actual figure, each death carries an intrinsic cost to the healthcare system. Nowadays this figure is underestimated, however the estimated cost is between 17 and 29 billion dollars per year. According to Grober and Bohnen (2005), “medical error can be defined as “a contributing act of omission or commission in planning or execution. Nurses are expected to provide a competent level of care that is indicative of their education, experience, skills, and ability to act upon agency policies or procedures. In a study of 1,116 hospitals, Bond, Raehl, and Franke (2001) found that “medication errors occurred in 5.07% of patients admitted to these hospitals each year. Each hospital experienced a medication error every 22.7 hours (every 19.73 hospitalizations). Medication errors that adversely affected patient care outcomes occurred in 0.25% of all patients admitted to these hospitals/year” (p. 4). This means that at least one medication error occurs every 24 hours in the facilities studied, and these are preventable errors. The main responsibilities of nurses during medication administration are to prevent or detect errors and report them. Even if the prescribing doctor or healthcare provider made an error in the order, it is the nurse's job to question the doctor. With medical errors increasing length of stay and cost of care, hospitals are facing even tighter margins. Struggling to make a profit, the only way hospitals can grow is by improving the quality of care and reducing errors. Only with recent legislation were hospitals reimbursed for poor quality of care that led to longer patient stays or more hospital-acquired infections. Recent healthcare reform legislation, the Patient Protection and Accountable Care Act, prevented hospitals from receiving reimbursement for readmissions due to hospital-acquired errors or infections. Not only does this law prevent reimbursement for poor-quality care, but hospitals that provide lower standards of care will also be ineligible to participate in the Medicare and Medicaid programs (Andel et al..,