A smart approach to managing medication in paediatrics

Your research looks to improve electronic prescribing of medicines — how did you get into this area of work?

I was working as a clinical pharmacist in the paediatric ICU at Crumlin [what is now Children’s Health Ireland] when they brought in a new system to move from paper to electronic prescribing. It was a great leap forward, and I was involved in building the drug file and decision-support system for the technology.

I loved that, it really appealed to me. Around the same time, we were introducing “smart” or programmable infusion pumps to the ICU, and again these needed a drug library to work from. I ended up doing a PhD on the impact of this new technology.

What did your PhD find?

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We showed that using the smart pumps, which standardise the delivery of intravenous infusions, errors were reduced and that electronic prescribing removed ambiguity with handwriting and the like. But we also found that we needed to be aware of new aspects, like the need to select the correct option from drop-down menus, and subsequently optimise the system to engineer out any new errors where we can.

What do you wish people knew more about paediatric medication management?

That it’s such a complex area, and that there can often be limited availability of medications developed specifically for children. Because of this, doctors may need to prescribe an adult medication, or a medicine may only be available in a tablet form that the child can’t easily take.

So you need to look at all available evidence to proceed safely and in a way that will work for the doctors, nurses and patients. Then when you bring in an IT system for medications, you need to also figure out how that will work in a children’s hospital.

What are you looking forward to next?

I have just been granted a Fulbright-TechImpact Scholar Award to visit St Jude’s Children’s Research Hospital in Memphis, Tennessee, and learn more about pharmacy informatics and their medication systems. I had heard Dr David Aguero from St Jude’s on the podcast Pharmacy IT and Me, and his offer to reach out to him to learn more.

So I had this germ of an idea that I could go and learn about the medication management systems at St Jude’s to help inform the digital and IT systems for our new hospital here. Thanks to the Fulbright-TechImpact award, I will spend six weeks at St Jude’s, learning about how they use and integrate and manage their informatics systems and how they ensure all the different parts of the system continue to talk to each other when new medications are introduced or changed. I will be shadowing the informatics team, engaging with nurses and doctors, learning from their experience and bringing all of that to Children’s Health Ireland.

What do you love about your work?

That you can make such a difference. For example, the Children’s Health Ireland smart pump drug library is now used in a number of neonatal units, ambulance transport services and has just been implemented into the adult ICU in Mayo. So the medication technology work we are doing is not just for Children’s Health Ireland, it’s about improving care across Ireland, and to me it’s really important to share expertise widely to do that.

How do you take a break?

With family life and children, life is busy. I love to get out and walk in the mountains when I can. And since I finished my PhD a couple of years ago I have taken up dress making and quilting, and I love cooking for family and friends.