The purpose of this article was to describe facilitators and barriers to the implementation of a commercially available electronic medication administration record system at two pediatric hospitals. Qualitative interviews were conducted at 6 and 18 months after implementation with a convenience sample of nurses working on either the medical-surgical or ICUs. The 18-month interview reassessed barriers identified to the adoption of the electronic medication administration record system at the 6-month interview. The vast majority of respondents (85%) indicated that the implementation plan met their expectations. The most significant barrier to adoption (identified by 72% of respondents) was excessive time for logging into the system. After 18 months, respondent satisfaction increased considerably as modifications to the electronic medication administration record system were made, and adjustments to workflow resulted in streamlined nurse work processes coupled with increased productivity and enhanced patient safety. While this study confirms that nursing staff acceptance of health information technology is aided by the system's ability to improve patient safety and accessibility of patient information, we also found that factors unrelated to the actual software or the system could be important determinants of users' satisfaction.