Hospital pharmacists' perceptions of collaboration with nurses for medication safety: A qualitative study in public hospitals
Abstract
Background Ensuring medication safety requires effective interprofessional collaborative practice (ICP) between pharmacists and nurses. However, this collaboration faces substantial obstacles across healthcare systems. Objective To explore hospital pharmacists' perceptions and experiences of interprofessional collaboration with nurses in relation to medication safety, including perceived facilitators, barriers, and recommendations for improvement. Method This qualitative study used purposive and snowball sampling through face-to-face, semi-structured interviews with hospital pharmacists, conducted between November 2025 and January 2026. The Stutsky and Laschinger ICP Conceptual Framework informed the development of the interview guide; thematic analysis proceeded inductively, following Braun and Clarke's (2006) six-phase approach, with emerging themes interpreted in relation to the framework's constructs. Results The study involved 36 hospital pharmacists (27 women and 9 men) from eight public hospitals, with an average experience of 5.3 years. Three interpretive insights emerged from the study. First, interpersonal facilitators (particularly trust, respectful communication, and proactive information sharing) were found to support collaboration. Second, structural and organizational barriers, including resource constraints, professional hierarchy, and limited legal recognition of pharmacists' clinical authority, were identified as factors that constrained collaboration. Finally, participants linked collaboration to perceived improvements in medication safety and proposed infrastructural, organizational, and joint-training strategies to strengthen it further. Conclusion These findings suggest that, in resource-constrained settings, pharmacist-nurse collaboration may rely more heavily on individual initiative than on institutional support structures. From pharmacists' perspectives, this was evident in Iraqi public hospitals, where structural, hierarchical, and legal barriers shaped both professions' practice. Strengthening role policies, communication structures, and interprofessional training may support pharmacists' ability to contribute to safer collaborative practice.