my $items_sth   = $dbh->prepare('SELECT * FROM Items');
my $actions_sth = $dbh->prepare('SELECT * FROM Actions WHERE item_key = ?');

my @items;
$items_sth->execute($item_row->{item_key});
while (my $item_row = $items_sth->fetch_hashref()) {
   my $item = {
      item_key         => $item_row->{item_key},
      item_description => $item_row->{item_description},
      item_summary     => $item_row->{item_summary},
      actions          => [],
   };

   my $actions = $item->{actions};
   $actions_sth->execute($item_row->{item_key});
   while (my $action_row = $actions_sth->fetch_hashref()) {
      push @$actions, {
         key     => $action_row->{action_key},
         summary => $action_row->{action_summary},
      };
   }

   push @items, $item;
}