The Vital Role of Pediatric Clinical Pharmacists: Insights from Nicklaus Children’s Hospital

January 9, 2025

Gaby Philipson, PharmD, BCPPS
Pediatric Clinical Pharmacy Specialist
Nicklaus Children’s Hospital

As a pediatric clinical pharmacist and one of the medication safety officers at Nicklaus Children’s Hospital, my passion for helping patients through medicine drives everything I do. From the earliest days of my pharmacy training, I found a deep love for working with children. There’s something truly unique about helping young patients overcome illnesses—whether acute or chronic. Their resilience and bravery inspire me daily, making this work as fulfilling as it is challenging.

A Collaborative Effort in Patient Care

One of the most rewarding aspects of my role is the opportunity to collaborate with a diverse team of healthcare professionals, including physicians, nurse practitioners, bedside nurses, and fellow pharmacists. These partnerships are instrumental in honing my clinical skills and ensuring we collectively provide the best possible care for our patients. The dynamic and multidisciplinary nature of our work keeps me constantly learning and growing.

The Unique Role of Pediatric Pharmacists

Pediatric pharmacists are specialists who undergo extensive training—often an additional one to three years beyond pharmacy school—to gain expertise in caring for young patients. While much of our work happens behind the scenes, our impact on patient care is profound.

Our primary focus is medication safety, ensuring that therapies are age-appropriate and optimized for efficacy while minimizing risks. For instance, because young children cannot always swallow tablets, we often rely on liquid formulations. When these aren’t commercially available, we engage in complex compounding procedures to create patient-specific solutions. Additionally, we determine when adult dosage forms need manipulation—such as splitting or crushing tablets, or modifying transdermal patches—to achieve accurate dosing without compromising safety.

Beyond Medication Management: Advancing Systems and Protocols

In a hospital setting, our responsibilities extend far beyond preparing and dispensing medications. We are integral to developing protocols and policies designed to enhance medication safety and efficacy. This includes contributing to the development of treatment pathways, implementing error-prevention systems, and leveraging advanced technologies to improve patient outcomes. Our role is collaborative, technology-driven, and essential for safeguarding the well-being of pediatric patients.

Challenges in Non-Pediatric Settings

While many pediatric pharmacists work in dedicated children’s hospitals, the reality is that a significant number of children receive care in facilities primarily designed for adult patients. This introduces unique challenges and risks, including:

• Dosing vulnerabilities: Pediatric patients require precise, weight-and age-specific dosing adjustments that can be overlooked in adult-focused systems.
  
• Formulation challenges: The lack of pediatric-specific drug formulations often necessitates error-prone manipulations, such as splitting tablets or compounding solutions.
  
• Specialized care gaps: Management of complex pediatric conditions and those not commonly experienced in non-pediatric hospitals is a challenge seen and experienced today. The resulting consults and extended assessments risk delays or even errors in treatment

These challenges underscore the importance of having dedicated pediatric pharmacists and infrastructure to support the unique needs of young patients.

Looking Ahead: Embracing Innovation and Change

The role of pharmacists is evolving rapidly, and technology is at the forefront of this transformation. From telehealth to advanced clinical decision-support systems, pharmacists are finding new ways to connect with patients and healthcare teams. These advancements are opening doors to specialized roles in clinical pharmacy, managed care, and even industry, broadening the impact we can have on healthcare.

While new technologies can sometimes feel overwhelming, they are essential to our growth as professionals. By embracing innovation, we can ensure that our work remains relevant and impactful, making a lasting difference in patient care and safety.

Final Thoughts

As a pediatric pharmacist, I am privileged to play a pivotal role in the healthcare journey of children and their families. The challenges and triumphs of this field are what fuel my commitment to continuous learning and collaboration. Together with my colleagues, I strive to make a meaningful impact on the lives of our youngest patients, ensuring they receive the safest and most effective care possible.

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