Knowledge and Practice of Nurses Regarding Safe Medication Administration in Tertiary Care Hospitals, Bannu

Abstract

Background: Medication administration errors remain a major threat to patient safety worldwide, particularly in hospital settings where nurses administer the majority of prescribed medications. As the final checkpoint in the medication-use process, nurses play a critical role in ensuring medications are delivered safely, accurately, and in accordance with established patient safety principles. However, gaps in knowledge, inconsistent adherence to safe medication practices, and limited access to technological safety systems may increase the risk of medication-related harm, especially in resource-limited healthcare settings. Objective: This study aimed to assess the knowledge and self-reported practice of registered nurses regarding safe medication administration in tertiary care hospitals in Bannu District, Khyber Pakhtunkhwa, Pakistan, and to examine the association between nurses’ knowledge and their medication administration practices. Methods: A descriptive cross-sectional study was conducted among 157 registered nurses working in inpatient wards of tertiary care hospitals in Bannu between January and June 2026. Participants were selected using simple random sampling. Data were collected using a structured self-administered questionnaire assessing socio-demographic characteristics, medication administration knowledge, and self-reported practices. Descriptive statistics summarized participant characteristics and knowledge/practice scores. Chi-square tests examined associations between demographic variables and knowledge/practice levels, and Pearson correlation assessed the relationship between knowledge and practice scores using SPSS version 25.0. Results: Overall, 68.2% of nurses demonstrated adequate knowledge of safe medication administration, while 72.6% reported adequate practice adherence. Knowledge was highest for identification of the five rights of medication administration (83.4%) and recognition of high-alert medications (78.3%). However, lower knowledge levels were observed for medication error management (37.6%) and technology-supported medication administration systems (47.1%). Education level was significantly associated with knowledge adequacy (p=0.004), whereas no demographic factors were significantly associated with practice levels. A moderate positive correlation was observed between knowledge and practice scores (r=0.54, p<0.001). Conclusion: Although most nurses demonstrated adequate knowledge and practice related to safe medication administration, important gaps remain in medication error management, post-administration monitoring, and technology utilization. Targeted continuing education programs strengthened institutional policies, and improved access to medication safety technologies are recommended to enhance patient safety in tertiary healthcare settings.