Exploring Nurse-Pharmacist Collaboration for Medication Safety in Iraqi Hospitals: A Qualitative Study from the Nursing Perspective

Abstract

Background: Effective nurse-pharmacist collaboration is essential to medication safety, but evidence documenting this relationship from nurses’ viewpoints remains limited within Iraq. Objective: To explore nurses’ perspectives and experiences regarding collaborative practices with hospital pharmacists in promoting medication safety, identifying key challenges from a nursing standpoint, and providing recommendations for improvement. Methods: A qualitative study using semi-structured interviews with 30 nurses across eight public hospitals in two governorates (November 2025-January 2026). Participants were recruited using purposive and snowball sampling. The Stutsky and Laschinger Interprofessional Collaborative Practice framework guided the study, and data were analyzed using Braun and Clarke’s inductive thematic analysis. Results: A total of 30 nurses participated (17 male, 13 female), with experience ranging from 1 to 25 years. Six themes emerged: interprofessional communication, characterized by need-based consultation and pharmacist condescension deterring two-thirds of nurses; role understanding and dynamics, marked by role ambiguity and nurses assuming patient education responsibilities; collaborative practice and safety, reflecting universal error detection and nurse-reported improvements in care quality; systemic and organizational barriers, including staffing shortages (n=29), night-shift unavailability (n=25), and physician-stamp bureaucracy (n=25); institutional support and leadership, marked by the absence of formal collaborative policies; and enablers of collaboration, including mutual trust (n=23), joint education (n=22), and clinical pharmacist presence (n=10). Conclusions: Nurses acknowledge the clinical value of collaborating with pharmacists for medication safety, but structural, behavioral, and organizational barriers hinder this potential. Enhancing this collaboration requires institutionalizing joint training, expanding clinical pharmacy services, and developing clear collaborative policies.