Exploring the Lived Experiences and Perceived Challenges of Nurses in Enhancing Compliance with Closed-Loop Medication Administration Systems

Closed-Loop Medication Administration (CLMA) systems are increasingly used to enhance medication safety, yet nurses continue to encounter organizational, technical, personal, and workflow-related barriers that hinder consistent compliance in clinical practice. This qualitative study used a phenomenological design in Saudi Arabia. Nine registered nurses with direct CLMA experience were selected through purposive and snowball sampling. Data were gathered through a validated researcher-made structured written interview guide containing open-ended questions and were analyzed using Colaizzi’s phenomenological method to identify significant meanings, categories, and themes. Findings showed that nurses generally viewed CLMA positively because it improved verification, confidence, documentation, and error prevention. Compliance was strengthened by clear policies, supportive leadership, training, reliable equipment, competence, and teamwork, but weakened by workload, fatigue, interruptions, technical failures, equipment shortages, patient-related difficulties, and environmental barriers. The study concluded that CLMA compliance is shaped by interconnected organizational, technological, and individual conditions. Although the system supports patient safety and long-term workflow efficiency, it cannot replace clinical judgment. Consistent adherence requires dependable infrastructure, competent users, responsive leadership, and safe alternatives during emergencies or system downtime. Healthcare institutions should strengthen continuing competency training, nonpunitive reporting, technical support, staffing, equipment availability, and interdisciplinary collaboration. Clear downtime and emergency procedures, regular system evaluation, protected medication rounds, and peer-support mechanisms are recommended to reduce workarounds, preserve clinical judgment, and sustain safe, efficient medication administration across diverse practice settings. These findings provide a foundation for developing an institutional support program focused on sustainable CLMA compliance.