ANSWER
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Every day, millions of Americans with complex medical problems face rising healthcare costs, a complex health insurance market, and a shrinking pool of medical professionals. These at-risk populations across the country — the working poor, the elderly, the homeless, racial and ethnic minorities, and the uninsured — are at a higher risk of developing severe medical problems due to poor healthcare, low health literacy, and a higher rate of infectious diseases.
Despite nationwide efforts to address health disparities, healthcare providers, medical researchers, and government agencies are still looking for solutions. Doctors of Nursing Practice (DNPs), nursing specialists who focus on improving outcomes for patient care and population health, are at the forefront of driving change to help the medically vulnerable.
DNPs are advanced practice registered nurses (APRNs) who use clinical expertise, data-driven decision-making, and interprofessional collaboration to lead and change policy. Duquesne University’s online DNP degree program graduates learn how to turn clinical research into real-world practice and make a difference as healthcare policy leaders.
Across the United States, Vulnerable Populations
At-risk populations live in urban and rural areas, frequently in impoverished communities with neighbors in similar circumstances. They lack access to stable healthcare because it is either unavailable or prohibitively expensive.
They may have untreated chronic medical conditions, such as diabetes or high blood pressure, or infectious and communicable diseases, such as the human immunodeficiency virus (HIV), which causes AIDS. In other cases, they have untreated mental health issues like bipolar disorder or major depression that harm themselves and their families.
They struggle to maintain independence due to a lack of reliable transportation and poor communication skills. Their health issues are intertwined with social issues such as illiteracy, homelessness, and poverty.
Reducing the Risks to Vulnerable Populations
The United States Department of Health and Human Services launched the Healthy People 2020 initiative in 2010, a 10-year project to improve health outcomes. Among the objectives is to improve access to high-quality healthcare services across the country. Simultaneously, an American Hospital Association (AHA) task force investigated how hospitals frequently used as healthcare access points can better assist patients. The two organizations devised the following strategies to achieve policy-level changes toward the goal of health equality:
1. Enhance social factors to promote healthy living
Healthy living is determined by factors that occur throughout a lifetime. The most common health-related social challenges are lack of employment, food and housing insecurity, social support, and illiteracy. According to the AHA, healthcare providers must address these social determinants of health through a series of steps, including screening patients and providing proactive services.
2. Implement a national healthcare system with global budgeting.
According to the AHA, replacing the current fee-for-service healthcare system with a global budget system would allow the federal government to determine the total amount available to reimburse all medical facilities over a set period. A global budgeting system’s proponents claimed it would control healthcare costs.
3. Make virtual healthcare available.
Virtual healthcare gives you immediate, 24-hour access to medical advice and treatment. Providers can examine, diagnose, and monitor patients using cutting-edge technology. Proponents claimed virtual healthcare could improve chronic disease management, treat minor illnesses, support primary care access, and improve referrals to specialists for more effective treatment.
4. Align hospitalization requirements with surrounding communities
Medical facilities must look for ways to reduce inpatient bed capacity as outpatient medical services become more common. According to the AHA, fewer hospital beds could lower medical costs in local communities.
5. Encourage community-based healthcare access
Targeted medical assistance is provided by rural hospital health clinics, frontier-area health services, and partnerships with Indian Health Services (IHS). For rural communities, targeted services imply integrating medical, behavioral, and oral health care from rural hospitals and local health centers. Frontier-area health services must address healthcare access challenges for those living in extreme geographic isolation. Partnerships with non-IHS providers for specialized services to Native Americans and Alaska Natives are among the IHS strategies.
Challenges in Serving Vulnerable Populations
The high cost of medical services and medical insurance is the most significant barrier to access to healthcare. Despite regulations to lower healthcare costs, many people still cannot afford insurance. According to a Gallup poll, the percentage of U.S. adults without health insurance was 11.3 percent in the first quarter of 2017, up from 10.9 percent the previous quarter.
The federal Office of Disease Prevention and Health Promotion discovered a nationwide shortage of medical services, and factors such as age, race, gender, and ethnicity all harm access to health care. A lack of health literacy, or the ability to comprehend and apply basic healthcare information, has also harmed vulnerable populations.
The projected nationwide shortage of more than one million nurses by 2022 and 43,000 primary-care physicians by 2030, primarily due to retirement, exacerbates the problem.
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The Role of the DNP in Serving Vulnerable Populations
A Doctor of Nursing Practice degree equips APRNs with the knowledge and skills to implement evidence-based interventions and improve health outcomes for vulnerable populations. Healthcare policy, changes in the healthcare framework, social justice, and global health perspectives are all covered in DNP coursework. Duquesne University’s DNP program aims to develop leaders who will improve healthcare for the general population through policy changes and clinical practice.
DNPs collaborate with communities to promote prevention and health. They are “ready to design, influence, and implement health care policies that frame healthcare financing, practice regulation, access, safety, quality, and efficacy,” according to the American Association of Colleges of Nursing (AACN).
“Moreover, the DNP graduate can design, implement, and advocate for a healthcare policy that addresses issues of social justice and equity in healthcare. “The DNP graduate’s powerful practice experiences can become potent policy influencers,” the AACN stated.
The DNP degree has been designated as a terminal degree by the AACN, which means it is the highest academic track for clinical nursing. The DNP program of study was designed to prepare APRNs for administrative and leadership roles.
QUESTION
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What is an example of a vulnerable population? Why is this group considered vulnerable?