The policy of single over double checking of medications has been adopted by many health services; however, nurses' attitudes toward single-checking medications remains unclear. The aim of this study was to explore the attitudes of nurses who single check and administer medications in a setting where single checking has been in place for over a decade.A cross-sectional survey design using the validated Single Checking Administration Medication Scale-II to registered nurses (n = 299) working in one metropolitan teaching hospital in Victoria, Australia. Descriptive analyses for participants' demographics were examined and confirmatory factor analysis (CFA) was performed on the survey items to represent the main themes of nurses' attitudes toward single checking.Nurses reported single checking allowed a greater accountability as a professional nurse and more control over drug administration. The efficiency of single checking was welcomed by nurses through reductions in administration time and workplace interruptions. Nurses were more likely to adhere to drug administration procedures when single checking and this process facilitated drug knowledge updates. There was significant variance in attitudes amongst nurses based upon current appointment and years of clinical experience. Free text responses indicated nurses' attitudes were situated in the context of the traditional double-checking system.Understanding nurses' attitudes toward single checking may assist health care services to positively address medication safety. Accountability, efficiency and knowledge are important for nurses when administering medications. Nurses' attitudes are varied when correlated with demographic characteristics.