Cultura

Assessing the Impact of Pharmacy–Nursing–Medical Records Integration on Reducing Medication Errors: A Systematic Review

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Duaa Saleh Mohammed, Nujood Saleh Mohammed, Najlaa Saad Nwaeyr Al-Majnoni, Samya Abdulaziz Serdar, Osama Hejab Alhejaili, Afrah Saad Damry, Samar Mohammad Majrashi
Hoda Ahmad Yahya Majrashy, Fatimah Mohammed Ali Kulibi, Areej Aqeel Mohsen Fagehi, Fatemah Abdullah Mohammad Alwani, Nuha Wali Ali Hakami, Gala Yahya Sharahily

Abstract

Background: Medication errors remain one of the most prevalent and preventable causes of patient harm in healthcare systems worldwide, accounting for billions of dollars in preventable costs and thousands of preventable deaths annually. Effective mitigation of these risks requires coordinated action across multiple healthcare disciplines, including pharmacy services, nursing practice, and medical records management.

Objective: This systematic review critically evaluates published evidence on how the integration of pharmacy services, nursing practice, and medical records systems — particularly electronic health records (EHRs) and clinical decision support systems (CDSS) — contributes to the reduction of medication errors and the improvement of patient safety outcomes.

Methods: A structured literature search was conducted across PubMed, Scopus, Web of Science, and CINAHL databases. Studies published before 2023, written in English, and addressing pharmacy, nursing, and/or medical records integration in relation to medication errors and patient safety were included. Thematic synthesis was employed to analyze and consolidate findings across studies.

Results: A total of 42 studies met the inclusion criteria. Findings consistently demonstrate that integrated, interdisciplinary approaches to medication management significantly reduce prescribing, dispensing, administration, and documentation errors. Clinical pharmacist participation in ward rounds, computerized physician order entry (CPOE), automated dispensing, and nurse-led medication reconciliation were among the most impactful interventions. Barriers to integration included fragmented health information systems, limited interoperability, workflow disruption, and resistance to change.

Conclusion: Effective integration of pharmacy, nursing, and medical records systems is strongly associated with improved medication safety outcomes. Healthcare institutions should prioritize investment in interoperable information systems, interdisciplinary training, and standardized safety protocols. Future research should focus on implementation fidelity, long-term outcomes, and cost-effectiveness across diverse healthcare settings.

Keywords : Keywords: medication errors, patient safety, pharmacy services integration, nursing practice, health information management, electronic health records (EHR), clinical decision support systems (CDSS), interdisciplinary collaboration, medication safety systems, healthcare integration..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty