Purpose
This qualitative study aimed to explore clinical nurses’ experiences in managing high-alert medications (HAMs) and their educational needs. Methods: Two focus group interviews were conducted with 10 hospital nurses at the proficient level or higher who had experience administering HAMs and managing or encountering related medication errors. Data were analyzed using Graneheim and Lundman’s qualitative content analysis approach. Results: The analysis generated four themes: strengthening competency in HAM management; developing a multilayered education system for HAMs; fostering a supportive patient safety culture; and strengthening system- and organization-based HAM management. Conclusion: HAM safety cannot rely solely on individual vigilance or one-time didactic training. Competency-based nursing education, combined with team-based training and robust organizational safety systems, is needed to reduce medication errors involving HAMs and enhance patient safety in acute care settings.