The goal of this descriptive observational study was to develop and test a method for assessing the nursing effort required in the medicine administration process and to better understand nursing work flow. This study of nursing effort (time and motion) was conducted at three institutions; a rural community hospital, an urban community hospital, and an academic health center.  Data were collected in each hospital in medical/ surgical units over 72 hour periods (Total N=850 unique medication passes by over 100 nurses). For this study, the medication administration process was divided into four distinct time periods; medication preparation, retrieval, administration, and documentation. Inter rater reliability for data collectors was assessed at 99.6%.  Nurses also wore pedometers during the study. The results of the study to be reported include: timing of each phase of the medication administration process, frequency and sources of interruptions/distractions during the medication administration process, nursing effort (number of steps), identified workflow issues and recommendations for changes. This study will be the largest identified nursing time and motion research conducted to date, and will provide improved understanding of the medication administration process.