Purpose: This study aimed to predict the influencing factors and the consequences of near miss in nurses’ medication error based upon Salazar & Primomo’s ecological system theory. Methods: A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. Results: For the fitness of the hypothetical model, the results showed that c2 (c2=258.50, p<.001) was not fit, but standardized c2 (c2/df=2.35) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (β=-.29 p<.001), patient safety culture (β=-.20, p=.041), and work load (β=.18, p=.037) had a significant effect on the near miss experiences in nurses’ medication error, while fatigue (β=-.06, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (β=-.25, p=.001). Conclusion: These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.