“The way children face adversity can be very humiliating”

Unique environment

Pharmacy is unique in the hospital setting because of the different and complex roles it plays. This is even more evident in pediatrics, where the risk of an adverse drug event or medication error may be significantly (i.e., three to nine times) greater than in the adult environment. We are a clinical department made up of highly qualified people who provide pharmaceutical care to our inpatients and specialized outpatient services.

Clinical pharmacists are an integral part of the hospital’s multidisciplinary teams. We are also involved in the aseptic manufacture and distribution of highly specialized intravenous drugs, including cancer treatments.

I also have to make sure that medications are prescribed and used correctly, and regularly counsel patients and their caregivers on the correct use of medications. My service provides advice and information on medicines, both within OLCHC and nationally, including the development of forms, patient information brochures, electronic prescribing solutions, drug policies and clinical guidelines.

Testing and evaluations

We participate in clinical trials and continuous evaluation of medicines for children, as well as educational, training and research activities related to pharmacy, medicines and therapeutics. The pharmacy also retains the traditional and important role in cost-effective procurement, quality testing, safe storage and distribution of drugs.

We are also constantly studying new technologies and the positive impact they can have on patient care, including electronic prescribing, robotics and automated dispensing technologies, application development, and more.

I manage all of these activities on behalf of OLCHC to ensure that our patients receive pharmaceutical care of a quality comparable to that of international pediatric centers of excellence.

There is a huge amount of operational demands and pharmacy related issues to be dealt with all the time. Crumlin is so dynamic that you often don’t know what’s coming next and you may need to rearrange your priorities in a very short time.

This week started unexpectedly as I was called to work late Sunday night in response to an unusual drug request. Normally I get up just before 7 a.m. and am at work at 8 a.m. I check emails and deal with anything urgent. I then deal with resource issues to make sure the service is running properly.

I provide clinical pharmacy coverage to the burn unit and while very gratifying it made me paranoid about hot liquids around young children. My current postgraduate research is related to pediatric burns and it occupies an element of every day. Financial monitoring is very important with the ever increasing cost of new drugs and it also takes me more and more time.

We deal with requests for drugs and new products on a daily basis. And ensuring a smooth transition of patients to primary care is a long but extremely important part of our pharmacy business. I am currently involved in several projects related to prescription and drug safety, and that involves meetings and a lot of in-depth reading.

From a managerial point of view, I deal with operational issues on a daily basis to ensure the proper functioning of the dispensary and the allocation of clinical and technical staff to the services and hospital services. I also review and sign the patient information brochures and the documents produced by the pharmacy on a daily basis. I also make sure the department respects Hiqa and PSI [pharmacy regulator] standards.

Security and systems

In addition to all of these aspects, there are always other things that crop up. For example, on Monday morning, I participated in a teleconference regarding an upgrade of the national pharmacy computer system. In the afternoon, I met the management team of the company, to whom I gave a presentation on drug safety and ICT issues.

Tuesday afternoon, I chaired an internal meeting on drug safety and prepared reports and information analyzes on drug use and cost within the hospital. This is an ever increasing demand.

I attended a quit meeting Wednesday morning as part of the hospital committee’s preparations for a smoke-free campus starting this month. The pharmacy offers advice and discount nicotine replacement products to help staff who want to take the opportunity to quit smoking. That afternoon I met other pharmacists about our intensive care clinical pharmacy service and e-prescribing issues. We also looked at a project for a new medicine cart that we are creating with our colleagues on Temple Street.

Thursday morning I had a meeting in cardiology about a new electronic patient record that they are installing, as there is an important drug component in this software that the pharmacy department can get involved with.

Friday noon I attended a medical conference. It happens every week at the same time. I also participated in the strategic development of the hospital by being a member of the drugs and therapeutics and clinical governance committees.

Children’s quality of life

Every week is busy, but we provide a vital service that improves the quality of life for patients. Medication management of a child is very complex, and pharmacy is an integral part of it. I feel privileged to work with my fellow pharmacists and technicians and the extended family of healthcare professionals, management and support staff.

Their commitment and willingness to go the extra mile for our patients makes OLCHC the incredible and unique place it is. Working for the kids is definitely the best part of the job; the way they approach adversity with such positivity can be very humbling. However, there can also be some difficulties. For example, trying to manage a complex service with limited resources can be very frustrating. OLCHC leadership is very supportive of the pharmacy and recognizes what it can offer in terms of safety and costs. But that said, there are budget cuts across the public health department and I have to function as best I can within that.

Michael Fitzpatrick expresses his personal opinions in this article and does not speak for his colleagues or for his employer.

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