Assessing the Impact of Pharmacy–Nursing–Medical Records Integration on Reducing Medication Errors: A Systematic Review
Published 2024-08-15
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.
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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.