Date of Award

Spring 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Semira Semino-Asaro, PhD, APRN


Background: Serious mental illness including schizophrenia and bipolar disorder affects 1 in 24 adults in California. These chronic disorders are difficult to treat and often sabotaged by medication nonadherence. Long-acting injectable (LAI) medications are one strategy to combat medication nonadherence. Effectively providing treatment with LAI medications can be challenging at the clinic level.

Objectives: Reduce the number of days without medication by reducing the number of days between injection due date and injection administration for patients receiving LAI medications.

Design: Establish appointments for all injection visits. Standardize visit protocol for injection encounters to optimize provider time. Arrange immediate follow-up and prompt rescheduling of missed injections.

Results: Number of patients receiving an injection more than one week late decreased by 20%. Average number of days late decreased from 10 to 6.

Conclusions: Appointments and reminders reduced number days without medication in patients receiving LAI medications. Standardization of injection visits improved clinic productivity.