Evaluating nurses’ adherence to the seven rights of medication administration in an Indonesian hospital: A cross-sectional study

Abstract

Background: Patient safety is a critical focus in Indonesia, particularly in medication administration, where adherence to the “seven rights”—the right patient, drug, dose, route, time, documentation, and information—is essential. Despite established protocols, medication errors remain a challenge, highlighting the need for improved adherence among nurses, who are key players in ensuring safety. Objective: This study aimed to assess nurses' adherence to the “seven rights” of medication administration and explore its relationship with nurse characteristics such as age, education, and career level at Bogor Hospital, Indonesia. Methods: A cross-sectional descriptive study was conducted in May 2024 with 35 nurses selected via purposive sampling. Data were collected through non-disclosed observations using a questionnaire of “seven rights of medication administration” based on Bogor Hospital’s Standard Operating Procedures. Adherence was evaluated using the Gudman scale. Statistical analyses included descriptive and bivariate (chi-square) tests using SPSS version 23. Results: The majority (57.1%) of nurses partially adhered to the “seven rights,” 25.7% fully adhered, and 17.1% did not adhere. All nurses consistently performed key practices such as patient identity verification and medication checking (100%). However, only 57% provided patient education. Career level significantly influenced adherence (p = 0.009), with higher-level nurses showing better adherence. Age, gender, and education level showed no significant correlation. Conclusion: While adherence to core protocols was high, gaps in patient education highlight areas for improvement. Targeted training and educational advancements, especially for entry-level nurses, are essential to enhance patient safety and medication administration practices. However, further studies are needed to validate the findings.