Evaluation of paliperidone palmitate injection site in an acute behavioral unit

This is a quality improvement study on the administration location of paliperidone palmitate initiation doses given on an acute behavioral health unit at The University of Texas Health North Campus Tyler. Patients that received paliperidone palmitate from January 1, 2018 to June 15, 2020 were gathered from pharmacy records. Study included patients over 18 years of age who received paliperidone palmitate on the unit and received oral paliperidone palmitate prior to the injection dose. Excluded patients were those less than 18 years of age, those hospitalized on another unit, or did not receive oral paliperidone prior to injection. Using the visit number, researchers accessed the patients’ electronic medical record. For all included patients, the location of injection for each paliperidone dose was collected and recorded as either gluteal or deltoid and either left or right side onto a deidentified excel document. A total of 25 patient were included in the study. 24 patients received the 234mg dose of paliperidone palmitate and 18 patients received the 156mg dose of paliperidone palmitate. Eight of the 234mg doses were given in the gluteal muscles (33%) and 12 of the 156mg doses were given in the gluteal muscle (66%). Although initiation doses of paliperidone palmitate should be administered in the deltoid muscle to achieve therapeutic concentrations rapidly, 33% of the 234mg doses and 66% of the 156mg doses were given in the gluteal muscle on this unit. The results of this study will be used to provide nursing education on appropriate administration of paliperidone palmitate initiation doses.