OBJECTIVE： To provide reference for the medication safety in elderly patients with chronic diseases. METHODS：  Elderly inpatients with chronic diseases and nursing staff in affiliated hospital of shaoyang medical college， from Mar. 2014 to May 2015 were randomly selected for a questionnaire survey to analyze the influential factors of drug safety and health education demand， and the difficulty sources of nursing staff in developing health education was explored. RESULTS： Totally 500 questionnaire was sent out to elderly patients with chronic diseases， 500 were effectively received with effective recovery of 100％； and totally 200 were sent out to nursing staff， 200 were effectively received with effective recovery of 100％. In the 500 surveyed patients， 193 had ADR， which was affected by age， educational background， monthly income， disease course， whether received health education， etc. （P＜0.05）， patients with older age， lower educational background and monthly income， longer disease course and no receiving health education showed higher incidence of ADR； the influential factors for health education demands included educational background， occupational status， disease course， quality evaluation of nursing staff， etc. （P＜0.05）， patients with higher educational background， lower disease course， higher occupational status and quality evaluation of nursing staff showed stronger health education demands. The difficulty sources of surveyed nursing staff in developing health education were busy work， being afraid of misunderstanding， embarrassing， cognitive and skill deficits. CONCLUSIONS： The drug safety of elderly patients with chronic diseases is related to many influential factors， as well as the health education demands. Nursing staff should continuously improve their ability and quality， combined with the above influential factors， carry out health education with physicians and pharmacists to ensure the medication safety.