Background <p>Medication administration is a fundamental component of nursing practices, with direct implications for patient safety, health outcomes, and healthcare quality. Despite its importance, however, the literature lacks a comprehensive understanding of how individual and systemic factors are associated in medication administration, thus prompting this study.</p> Methods <p>A web-based survey was administered to 3,829 nursing staff members across seven hospitals in a Hong Kong cluster. The survey aimed to examine the associations between hospital context, professional ranking, and working experience on nurses’ knowledge, attitudes, and role perception in medication administration. The final count of usable responses was 1,393, yielding a response rate of 36.4%.</p> Results <p>The study’s findings suggest that nurses’ knowledge, attitudes, and role perception in the medication administration process vary significantly according to the hospital context and the nurses’ work experience and professional rank.</p> Limitations <p>This study relies on self-reported data and a sample limited to Hong Kong, which may affect generalizability. The lack of formal psychometric validation is also an important methodological consideration.</p> Conclusions <p>This study highlights the importance of considering individual and systemic factors, including hospital context and nurses’ professional ranking and nursing experience, in strategies aimed at enhancing medication administration and reducing errors. The findings also reveal the need for further research to untangle the complex relationships between these factors and their influence on patient safety and healthcare quality.</p>