Impact of High Dose Medication on Patient Health: A Critical Analysis in Nursing Practice

This report critically examines the impact of high dose medication on patient health in nursing practice. It identifies the key determinants associated with the patient case study and evaluates evidence-based policy and practice recommendations related to the patient impacting determinant of health.

Critically examine the impact of one
determinant of health on the given
scenario from your field of nursing
practice
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Table of Contents
INTRODUCTION ..........................................................................................................................3
Identification determinant of health ....................................................................................3
Problem analysis framework..................................................................................................4
Key determinant associated with the field of case study .......................................................5
Selection of the determinant...................................................................................................5
Overview of the health determinant relationship with a case study ....................................6
Evaluation of evidence based policy and practice recommendation related to the patient
Impacting determinant of health. ..........................................................................................6
More broadly related policy and evidence in context to the social, economic factors...........7
CONCLUSION ...............................................................................................................................7
REFERENCES .............................................................................................................................10
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INTRODUCTION
The health conditions of the individuals get impacted and influenced by various factors of
their life and environment (Chhabra and et. al., 2019). It can be considered the health
determinants of health such as environment, physical influences, genetics behaviour, medical
care, and social factors. Patient health can be influenced by one or more than one health
determinant, and manage the health condition critical to analysing each specific health
determinant and addressing them effectively. In this report, the patient case study will evaluate
to make a critical analysis of patient health influencing health determinants along with proper
research and selection of interventions for specific health determinants. UK health policies and
regulations are also considered in context to that particular health influencing factor and patient
care.
Identification determinant of health
Health determinants of schizophrenia is can be an environmental condition, coping
support, personal system, family relationship, genetic and biochemical factors. Below is
the brief analysis and identification of the patient health determinants based on the case
scenario.
People's health can be improved or chronic due to the various factors of environment,
personal, life, and internal body changes, and collectively those health influencing factors are
considered the determinant of health. In the given patient case study, various health influencing
determinants impact patient mental health and physical health (Kyle and Henry, 2017). Sam is a
35-year-old diagnosis with schizophrenia, and this health issue is developed due to stress and
family loss as she lost her parent five years ago. Other personal and social health discriminants
are further impacting patient health. Such as family stress in context to finance and needs
fulfilment. COVID-19 is another environmental health determinant that was severely impacting
patient mental health. By increasing the development of furthermore social and economic
determinants, Such as fear, job loss, lack of family support, etc., one of the most Impacting
determinants of health is high dose medication such as antipsychotics which is causing a
furthermore bad impact on patient health. The genetic determinant of health assures the risk of
Diabetes because her mother also had Diabetes (Nine, 2021).
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Problem analysis framework
In context to the patient case study, the most appropriate framework to address social
determinants of health is (SDOH) (Russell, Coleman and Ganong 2018). This framework helps
to evaluate five major health determinants to analyse the other key effecting elements or
determinants of each group of significant determinants. Below is the illustration of framework
application in context to the patient health determinant associated problems analysis.
SDOH Framework
Health determinant Presence and impact
Economical stability
Employment
food insecurity
Housing instability
Poverty
Sam is not having employment, and she is
facing a lack of the finical security for her
family and herself.
Education
Early childhood education and development
Enrolment in higher education
High school graduation
Language and literacy
Sam is educated.
Social and community context
Civic participation
Discrimination
Incarceration
Social cohesion
Lack of social cohesion due to legal barrier of
COVID 19 prevention policy.
Health and health care
Assess to health care
Access to the primary car
Health Literacy
Sam is not getting proper health care services
due to social distancing. One-call services are
not sufficient to manage the side effects of
high-dose medication.
Neighbourhood and built environment
Access to food that supports healthy eating
patterns
Environment condition is very complicated
because COVID-19 is causing stressful
environment with lack of various facility's.
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crime and violence
Environmental condition
Quality of Housing
Key determinant associated with the field of case study
In the context of the case of Sam, the key factors are healthcare, environment, social
context, and economic stability.
Healthcare- This is the broad group of the health influencing determinants which can be
related to the health care facilities and risks associated with that. Person health gets more
complicated due to the lack of health care services accesses and medication side-effects which
further contribute to other health care issues such as constipation, dizziness, periodic tremors and
hypersalivation, and stress face by the Sam. All these health care complications are due to the
lack of access to healthcare services, high dose medication side effects, and lack of social
support due to COVID (Aladdin and et. al., 2020).
Environment- COVID is an environmental determinant that has caused several social
context determinant impacts, such as the stress of COVID risk and lack of social support.
Social context- Lack of access to family and other social support is why most of the Sam
health issues. such as in the case of Sam, due to the different social determinants, she is not
getting the proper care and due to which living environment is gating difficult for her with
schizophrenia (Hsiao 2017).
Selection of the determinant
Health care factor ( high dose medication)- In the context of the given case study, the
selected health determinant is health care factors such as high dose medication and its side
effects. Which has more impact in terms of Sam's health condition (Macias Gil and et. al.,
2020). Sam is not getting the proper care, and she is putting up the weight due to the medication
side-effects, and there are the chances of diabetes too, along with other medication side-effects
health issues such as constipation, hypersalivation periodic tremors. That is clear that improper
medical test and treatment along with inappropriate management of antipsychotics side-effects is
influencing the furthermore complex health condition for Sam.
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Overview of the health determinant relationship with a case study
Antipsychotics and medical service need is a continuous process and interconnected
because this medicine help to cop-up with the schizophrenia complexity. Due to its side effects,
patients can face health issues furthermore. Such as Cardiac Arrhythmias, sexual dysfunction,
etc. this can also increase the risk of Diabetes by causing weight gain by affecting insulin
sensitivity and secretion (Gottlieb and et. al., 2017). Sam is not getting access to the healthcare
services and side-effects management interventions due to the COVID-19 impact. Some most
essential interventions for Sam's health condition management and improvement can be
Psychosocial interventions, Physical activity programs (Baptiste and et. al., 2020).
Evaluation of evidence-based policy and practice recommendation related to the patient
Impacting determinant of health.
Nice recommends
There is a policy for the management of antipsychotics prescription and complexity or
risk management. Such as according to the NICE recommendation that is important to consider
the need for that medication which should be analysed according to the type of mental health
systems analysed in patient behaviour. Sam's mental health is not that complicated because she
is not harming herself and others, so there is not that much need for antipsychotics. High dose
these then are changed with other medication like Anticonvulsants etc. which can be less risky
for the patient (Bomboy, 2021).
The Department of Health policy paper England
This is the health care policy of England in context to the management and prevention of
inappropriate prescription of Antipsychotics. Because in context to the Antipsychotics
prescription prevention, National dementia and antipsychotic prescribing audit were developed
which result in the 17 % reduction in prescription (Glasper, 2019).
The compassion intervention manual
The SCIE guidelines cover all essential details related to managing mental health and
Non- cognitive symptoms. Such as non-pharmacological interventions, which involve the
person canter care undertaken by the MCPCRD. This involves the integrated interdisciplinary
system which can be best for Sam. As is apply person-centred care in primary, secondary, and
tertiary settings with the help of health, social care professionals, and family. Group of
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intervention of this guideline will help manage all social determinants by, most notably
addressing the complication of high dose medication (Henry, 2020).
More broadly related policy and evidence in context to the social, economic factors
According to this policy, life courses for the treatment and effective recovery of the
patient are essential to consider all social and personal determinants of health. This focuses on
emphasizing temporal and social prospects (McCormick, 2017). By evaluating Cohort's life
experiences along with the analysis of the current pattern of health and disease. Which can be
further used to address all those issues with the help of holistic care (Muntaner,2018).
Micro-finance programs- Sam is facing the stress of her daughter's responsibility and
needs fulfilment which is inhibiting the improvement of her mental health (Alderwick and et al.,
2018). So in context to these types of problems, there is the health care policy which is known as
the IM-AGE ( Intervention with micro-finance for AIDS and Gender equity) this provides the
small financial support to the patient's health betterment with reduction of poverty (Rosa and et.
al., 2020).
CONCLUSION
From the above study, it has been concluded that health conditions and social, economic,
environmental factors are interconnected and affect each other. Such as, patients with mental
illness require holistic care with all medication-al, social, emotional, and positive environment
support. But if the patient is not getting it correctly with the management of risk associated with
that, this can cause further, more severe issues. Such as in the care of Sam, the key health
influencing determinants are high dose medication and its complication along with the economic
problems related to need satisfaction and environmental condition, which prevent the patient
from getting proper access to the solution of all these determinants. So in context to the specific
higher dose antipsychotics, the UK health care and intervention policies are Nice recommends
Challenge on dementia 2020: implementation plan and SCIE guidance on The compassion
intervention manual. And in context to the other broad social, political, economic factors,
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policy's and practice recommendations are Physical activity programs, Life courses,
Psychosocial interventions.
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REFERENCES
Chhabra, M., and et. al., 2019. Screening for housing instability: providers' reflections on
addressing a social determinant of health. Journal of general internal medicine, 34(7),
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Kyle, S. and Henry, A.L., 2017. Sleep is a modifiable determinant of health: Implications and
opportunities for health psychology. British journal of health psychology, 22(4).
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after lumbar spinal fusion surgery: a multistate analysis, 2007 to 2014. Spine, 45(10),
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Macias Gil, R., and et. al., 2020. COVID-19 pandemic: disparate health impact on the
Hispanic/Latinx population in the United States. The Journal of infectious diseases,
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Baptiste, D.L., and et. al., 2020. COVID‐19: Shedding light on racial and health inequities in the
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Rosa, W.E., and et. al., 2020. Rapid investment in nursing to strengthen the global COVID-19
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McCormick, R., 2017. Does access to green space impact the mental well-being of children: A
systematic review. Journal of Pediatric Nursing, 37, pp.3-7.
Muntaner, C., 2018. Digital platforms, gig economy, precarious employment, and the invisible
hand of social class. International Journal of Health Services, 48(4), pp.597-600.
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Alderwick, H.A., and et. al., 2018. Social prescribing in the US and England: emerging
interventions to address patients' social needs. American journal of preventive medicine,
54(5), pp.715-718.
Nine, S.B., Najm, A.F., Allan, E.B. and Gronholm, P.C., 2021. Mental health stigma among
community members in Afghanistan: A cross-sectional survey. International Journal of
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Hsiao, C.Y., Lee, C.T., Lu, H.L. and Tsai, Y.F., 2017. Living with schizophrenia: Health‐related
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Bomboy, K.T., Graber, J.S. and Wallis, E.P., 2021. Improved prescriber adherence to guidelines
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Glasper, A., 2019. Enhancing the care environment for people living with dementia. British
Journal of Nursing, 28(18), pp.1216-1217.
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