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Medication error reporting (MER) is an effective way to prevent their repetition in the future. The present study aimed to determine the frequency and factors associated with the causes of MEs and to identify barriers to and facilitators of MER. This descriptive-analytical cross- sectional study was conducted with proportional random sampling on 220 midwives or nurses working in public and private hospitals in Tabriz, Iran. In this study, data were collected using Haddon's matrix. Data were analyzed using descriptive and inferential statistics. The prevalence of MEs in this study was 36.2%. The most common causes of MEs related to weakness of nurses, wards, management and physicians were nursing staff shortage (30.5%), ward work density (51.8%), low ratio of nurses and midwives per patient (70.7%), and illegible prescriptions (76.4%), respectively. Major barriers to MER reported by nurses and midwives were blaming the individual rather than the system (67.7%). Facilitators of MER were anonymous MRE system and feeling safe about working environment. Staff also reported that if reporting is beneficial (preventing future errors, correcting practice, increasing accountability), the odds of reporting MER will increase (54.5%). Given the underlying cause of MEs from the participants' point of view (staff shortage, fear of reprisal and reprimand), it is suggested that the system and health managers adopt appropriate strategies to reduce these important factors (reducing work density and creating a friendly environment). [ABSTRACT FROM AUTHOR]