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Background and Importance Medication errors are more frequent and potentially more harmful in Intensive Care Units (ICUs) due to patient complexity, the use of high-risk drugs, and the need for rapid clinical decision-making. The Spanish Institute for Safe Medication Practices (ISMP) has created a specialised self-assessment tool for ICUs to evaluate medication safety.Aim and Objectives Our hospital has chosen to implement the ISMP tool in the ICU to identify potential risks and recommend strategies for improvement. The objective was to develop a specific action plan aimed at enhancing safety and reducing the likelihood of medication-related errors.Material and Methods In September 2023, the hospital established a multidisciplinary task force that included intensive care physicians, a specialist pharmacist, nursing staff, and the Quality and Patient Safety Coordinator. This task force completed the ISMP self-assessment tool, recorded their responses, and analysed the results. Throughout 2024, the task force held six meetings to review the scores and identify priority areas that received values below 50%. They proposed several improvement strategies based on their findings.Results The overall score was 47.75%, which is below the average of 55% for comparable hospitals. The results were particularly poor in several key areas: patient and medication information (34.44%), pharmacist recruitment (29.05%), staff competency and training (38.46%), and quality and risk management programs (26.92%).To tackle these issues, several measures have been proposed, including:Implementing medication reconciliation and stockout management protocolsActively recruiting pharmacists for smart infusion pump management teamsDeveloping training and onboarding protocols that focus on medication safetyIntegrating medication safety objectives into the ICU’s strategic planCreating a program for error detection, reporting, and analysisAlthough the ICU has already begun to implement many of these actions, it is essential to introduce a new questionnaire to evaluate their effectiveness.Conclusion and Relevance The self-assessment questionnaire is an important tool for identifying gaps in medication safety within intensive care units. The interventions identified through this process can be implemented across other hospital services, thereby enhancing the culture of safety and quality of care in critical environments.References and/or Acknowledgements 1. Cuestionario de autoevaluación de la seguridad de los SMI [Internet]. [citado 6 de septiembre de 2025]. Disponible en: http://apps.ismp-espana.org/smi/Conflict of Interest No conflict of interest