A controlled pilot study was performed to evaluate implementation of a medication identification device intended to reduce errors in nursing homes. Naïve observation was used for data collection of medication errors on an intervention unit using the device and a control unit, along with field notes describing observation details. Ten staff were observed administering medications to 70 residents over the study time-frame. Of the 9,099 medication administrations observed (n = 4,588 intervention; n = 4,511 control), 1,068 (12%) errors were identified. The intervention unit had fewer non-time errors versus the control unit, including dose (n = 21 vs. n = 59; p < 0.01), drug (n = 4 vs. n = 21; p <0.01), route (n = 0 vs. n = 4; p < 0.01), and given without order (n = 1 vs. n = 8; p < 0.01). However, time errors were higher on the intervention unit and were often due to late start and interruptions. Non-time errors were due to reliance on memory and nursing judgment. A combination of technology and staff dedicated solely to medication administration likely affected error rate differences. [Journal of Gerontological Nursing, 48(4), 5-11.].