Advocating for patients with schizophrenia

Nursing advocacy and frequent readmissions to inpatient psychiatry

Bernard Vanderhaar

DNP focus area: Psychiatric-Mental Health Nurse Practitioner


Background: Non-adherence to medications for schizophrenia relates to frequent readmissions. Long-acting injectable (LAI) medications are shown to increase adherence and reduce admissions.

Objectives: 1) Identify frequent readmissions to psychiatry. 2) Improve nursing advocacy for patients appropriate for LAIs through in-service.

Design: Chart audits were employed for data collection. Academic detailing and dashboards were used for nursing education. The chart audit spanned 90 days pre and post in-service education. All admissions to psychiatry were screened; patients with readmissions under thirty days (with the same admitting diagnosis), a schizophrenia spectrum diagnosis, and nonadherent with oral antipsychotics were included.

Results: 44 patients met criteria, and amassed 49 frequent readmissions. For inclusion criteria, the admission rate decreased by 53% and LAI prescriptions increased by 9%. Three patients from the first audit group and one from the second were initiated on LAIs.

Conclusions: Attitudes towards LAIs may improve based on RN advocacy and collaboration.