Objective To investigate and analyze the status of medication near-miss reporting barriers of nurses, and analyze its influencing factors.Methods In October, 2023, 285 clinical nurses were investigated and analyzed by stratified cluster sampling method with the general situation questionnaire, the reporting disorder scale of nurses′ drug approach error and the scale of nurses′ organizational climate perception.Results The total mean score of nurse medication near-miss reporting barriers was (3.80±0.51) (The average score of the scale is 1 to 6 points, the higher the score indicates the more serious the reporting disorder), and the total mean score of nurses′ organizational climate perception was (3.16±0.45) (The scale is divided into 1 to 4 points, the higher the score, the better the organizational atmosphere perceived by nurses). There were statistically significant differences in the total average score of nurses′ medication near-miss reporting barriers in terms of working years, professional title and position (P<0.05). Correlation analysis showed that there was a negative correlation between the nurses′ medication near-miss reporting barriers and the total score of organizational climate perception of nurses and its various dimensions (r=-0.558,P<0.01). Multiple linear regression analysis showed that working years, job title, position, nurses′ organizational climate perception were the main influencing factors of nurses′ medication access error reporting disorder.Conclusion The medication near-miss reporting barriers and the organizational climate perception of nurses are above medium level. The medication near-miss reporting barriers of nurses are affected by working years, professional title, position, and organizational atmosphere, so good organizational atmosphere of the department can reduce the reporting barriers of near-miss in drug administration by nurses.