Class of 2013 Abstract / Specific Aims: The objective of this study was to describe the failure rate of activation of medications that employ the ADD-Vantage medication delivery system in one community hospital, Tucson Medical Center (TMC). Methods: A daily, hospital-wide summary was generated identifying all patients currently receiving ADD-Vantage medications using the TMC electronic medical record system, Epic. Data collection occurred on arbitrary days and times from July 2012 to March 2013. Direct observation of a failure or a success in activation occurred by entering a patient’s room after the ADD-Vantage medication was administered by the nurse. Important data collected included: medication, frequency of administration, nursing unit, time of administration, administering nurse, the shift during which the nurse was working and whether or not the medication was or was not properly activated. Main Results: All medications utilizing the ADD-Vantage medication delivery system at TMC were analyzed. The rate of failure across 347 total samples collected on various days and times was 6.92%. Night shift had a higher rate of failure at 11.43% versus 6.41% for day shift (χ2 = 1.23). The General Surgery and Cardiac units of the hospital had the highest rates of failure with 18.18% and 15.38% respectively. Zosyn was improperly activated with greatest frequency with 12 total failures. Conclusion: No statistically significant difference was found between the rates of activation failure for those samples collected during nursing day shift versus night shift. The overall rates of activation failure suggest a significant opportunity for nursing education to improve outcomes.