discussion response 1 philetha vulnerable populationvulnerable populations include chronically ill W r i t i n g

discussion response 1 philetha vulnerable populationvulnerable populations include chronically ill W r i t i n g

Discussion question 1

Disparities in Vulnerable Populations

Step 1

  • Identify a vulnerable population that you see in your caseload or that lives in your community.
  • Describe the effect of disparities of health services to that population on health-promotion outcomes.

Step 2 Read other students’ posts and respond to at least two of them.

In your response to each of your peers, identify something you
learned and agree with. Explain why you agree. Provide two examples from
your peer’s post to support why you agree.

Your initial post should be 2-3 paragraphs long and follow the
requirements outlined in the discussion rubric. Please add to the
discussion in your peer responses with informative responses, instead of
posts similar to “great idea! I really agree with you.” The initial
post and the peer responses have different deadlines. Make sure that
your discussion adheres to these deadlines.

APA guidelines and plagiarism prevention matter in discussion posts
just like with other scholarly assignments. Cite all references
appropriately using APA format.

Discussion response 1 Philetha

Vulnerable population

Vulnerable populations include chronically ill and disabled persons,
low income and/or homeless, the uninsured, LGBTQ+ population, people
living with human immunodeficiency virus (HIV), the very young and the
very old (World Health Organization, 2018). The vulnerability of these
persons results from ethnicity, race, age, sex, and other factors such
as insurance coverage and income. One of the vulnerable populations is
within my workplace, these population of people have learning
disabilities, described by activity limitation, impairment, and
participation restrictions (Shivayogi, 2017). Although disability is
extremely diverse and on the rise due to an increase in chronic health
conditions, all people with disabilities suffer almost the same general
health care needs thus need access to mainstream healthcare services
(Shivayogi, 2017). Further, despite the goals and efforts the United
States put forward to eliminate and reduce health care disparities by
2010, some such as access to healthcare, risk factors, mortality, and
mobility continue to affect the vulnerable population health promotion

A study by the world health organization showed that people living
with disabilities seek more health care than people without disabilities
but have more unmet needs (World Health Organization, 2018). This is
due to prohibitive costs, limited availability of services, physical
barriers, and inadequate skills and knowledge of health workers. Also,
health promotion and prevention activities rarely target disabled
persons. For example, adolescence and adults living with a disability
are likely to be excluded from sex education programs. Also, disabled
women receive less screening for breast and cervical cancer, and
individuals with intellectual impairment and diabetes rarely get their
weight checked (Shivayogi, 2017). As a result, this population may
experience greater vulnerability to age-related conditions, co-morbid
conditions, engage in health risk behaviors, secondary conditions such
as pressure ulcers, osteoporosis, pain, and urinary tract infections.


Shivayogi P. (2017). Vulnerable population and methods for their safeguard. Perspectives in clinical research, 4(1), 53–57. https://doi.org/10.4103/2229-3485.106389

World Health Organization. (2018, January 16). Disability and health. WHO | World Health Organization. https:// class=”screenreader-only”> (Links to an external site.)

Discussion response 2 Lana

vulnerable population I have seen in my profession are people with
socioeconomic disparities. Most have lived with undiagnosed diabetes,
and hypertension before their bodies began to suffer from its effects.
Then they sought medical attention finding out that they were already in
kidney failure. Most had no medical insurance and never saw a doctor.
Other’s may have had a primary care doctor but had difficulty paying for
insulin and other medications. To help this population through health
promotion they first need affordable access to a health care provider.
“High quality primary care therefore represents a key strategy through
which disparities in the incidence and progression of CKD may be
eliminated” (Greer & Boulware, 2015, par 1). Once adequate primary
care is established the heath care provider could get a baseline of the
persons health and work on physical and nutritional education
strategies. Diet and exercise are important in controlling or decreasing
the incident of disease that often leads to kidney failure. If those in
these vulnerable populations do not receive the care they need
especially those that have a predisposition to hypertension and
diabetes, they will be at risk for developing CKD in the future.

Greer. R., & Boulware. E., (2015). Reducing CKD risks among vulnerable populations in primary care. Advanced Chronic Disease. 22 (1), 74-80.

Retrieved from https:// class=”screenreader-only”> (Links to an external site.)

Discussion question 2

Confidentiality and the Protection of Patient Information

Respond to the following question based on this weeks lesson and, if it’s relevant, include your own personal experience.

  • What is confidentiality? How is confidentiality impacted by HIPAA?
  • Describe
    at least one incident when confidential information within an
    informatics system was improperly disclosed. If you have not had this
    experience, describe at least one opportunity for potential improper
    disclosure of confidential information within an informatics system.
  • What additional security measures do you feel would further protect patient information in clinical practice?

Read other students’ posts and respond to at least two of them.

Discussion response 1 Rebecca S

term confidentiality is described in this week’s lesson as,
“Confidentiality in health care is the idea that once a patient gives
private information to a provider, the provider will not disclose that
information without the patient’s consent” (Enhancing, n.d., Topic 1).
HIPPA impacts patient confidentiality as it is a comprehensive law to
protect the information patients share with their providers. “Patient
confidentiality has been a standard of medical ethics for hundreds of
years, but laws that ensure it were once patchy and incomplete. The
federal law called HIPAA was passed in 1996 to make sure that there
would be one nationwide law to protect patient privacy. The law includes
other provisions, including continuity of care, but for many
individuals, the right to confidentiality is most important. There are
certain rights that the law provides for that all people should be aware
of so that they can advocate for privacy and for the best possible
care” (Confidentiality, 2018, para. 1-2). I for one have not experienced
confidential information being exposed to my knowledge, either my own
or one of my patients. I found some great examples online, here are two;

  • A hospital employee did not observe minimum necessary requirements
    when she left a telephone message with the daughter of a patient that
    detailed both her medical condition and treatment plan. An OCR
    investigation also indicated that the confidential communications
    requirements were not followed, as the employee left the message at the
    patient’s home telephone number, despite the patient’s instructions to
    contact her through her work number. To resolve the issues in this case,
    the hospital developed and implemented several new procedures (US,
    2017, para. 1).
  • After treating a patient injured in a rather unusual sporting
    accident, the hospital released to the local media, without the
    patient’s authorization, copies of the patient’s skull x-ray as well as a
    description of the complainant’s medical condition. The local newspaper
    then featured on its front page the individual’s x-ray and an article
    that included the date of the accident, the location of the accident,
    the patient’s gender, a description of patient’s medical condition, and
    numerous quotes from the hospital about such unusual sporting accidents
    (US, 2017, para. 5).

The security measures that are taken in the hospital setting where I
work include audits, integrity, and access control, “the facility has to
effectively control access to confidential patient information by
utilizing unique identification procedures and an emergency access
procedure” (Enhancing, n.d., Topic 2). It is important that everyone
with access is properly trained in policy and procedure for the
preceding to work. Part of our ongoing training is the IT team will send
out e-mails that look real except it is .com, if one opens the e-mail a
message appears that you were just phished! It really makes one pay
attention after opening just one.


Confidentiality and HIPAA. Standards of Care. (2018, May 29). https:// the Privacy and Security of Patient Information.

US Department of Health and Human Services. (2017, June 7). All Case Examples. HHS.gov. https:// response 2 Donna

in health care is the idea that once a patient gives private
information to a provider, they will not disclose that information
without the patient’s consent (Hebda, et al., 2019). Without a
confidentiality agreement, a provider’s ability to gather the necessary
information to assess, diagnose, and treat patients properly can be
compromised. Health Insurance Portability Accountability
Act of 1996 (HIPAA) is the legal foundation for all subsequent
confidentiality considerations. HIPAA states that providers, insurers,
and facilities must keep all patient information confidential (Hebda, et
al., 2019).

A potentially serious threat to patient information is the
staff itself. Either through carelessness or neglect, staff can violate
patient confidentiality (Hebda, et al., 2019). Staff can also work to
protect patient privacy. If staff members are constantly vigilant about
the confidential information they acquire, they can help maintain
patient confidentiality better than any electronic measure (Hebda, et
al., 2019). This is why institutions should maintain strong privacy and
confidentiality training programs to remind staff of their importance in
maintaining confidentiality and privacy.

There are numerous examples of staff making mistakes or being
neglectful. If a nurse leaves his or her workstation open and visible
for any passerby to view, that would be a case of negligence (Hebda, et
al., 2019). If a physician writes a prescription and leaves it out on
top of the nurses’ station for anyone to see, that isn’t very
responsible (Hebda, et al., 2019). However, if a nurse closes down his
or her workstation and is careful never to discuss patients with anyone
other than the other practitioners involved in the patients’ care, that
nurse can help the facility maintain patient confidentiality
immeasurably (Hebda, et al., 2019).

Facilities need to ensure that adequate safeguards are in
place, like using personalized ID badges, which only grant you certain
access to parts of the building. You need to have user names and
passwords on computers so that way not just anyone can log in to your
computer and get patient information.


Hebda, T.L., Hunter, K., & Czar, P. (2019). Handbook of infromatics for nurses & healthcare professionals (6th ed.). Upper Saddle River, NJ: Pearson.

Discussion question 3

Care Transitions

Step 1 Post a response to the discussion board.

Respond to the following prompts and, if it’s relevant, include your own personal experience:

  • What are some barriers and challenges to the transition of care from
    one level to another? Describe at least two. Examples: transition from
    hospital to primary care follow-up or long-term care to home care.
  • Give an example from your experience or the literature of a
    procedure aimed at improving the process of care transitions. What
    impact do you suppose it will have on patient safety?

Step 2 Read and respond to two other students’ posts

Read other students’ posts and respond to at least two of them. Use
your personal experience, if it’s relevant, to help support or debate
other students’ posts. If differences of opinion occur, debate the
issues professionally and provide examples to support your opinions.

In addition to your original post, be sure to provide a meaningful
response to at least two of your peer’s posts by Friday night at 11:59pm
Mountain Time. Cite any sources in APA format.

Discussion response 1 Lexina

Although, one of the most promising opportunities to improve care and
lower costs is the move of care delivery to the home, there are
barriers and challenges to the transition of care from one level to
another. (Shi & Singh, 2019). An evaluation of the extent of
functional impairment often determines which services are best suited to
the individual, but personal preferences, and often the availability of
financing, also play a significant role. Home health care is consistent
with the philosophy of maintaining people in the least restrictive
environment possible (Shi & Singh, 2019). There are several
challenges that can deter clinicians from participating in home-based
care. Compared to the hospital physicians, caring for patients at home
requires longer visits to coordinate and manage care with limited
resources and a limited number of patients to care for (Pooja et al.,
2019). Another determinant is patient’s ability to self-care management
along with health literacy. Physical or mental deficits that limit a
person’s ability to do daily tasks. Patients who are older with chronic
conditions and limited knowledge about their medical condition are
associated with poorer health outcomes and face challenges to transition
of care.

Ineffective care transitions can lead to adverse events and a
hospital readmission. Elements that must be in place for a safe
transition to occur from one health setting to another include:
leadership support; multidisciplinary collaboration; early
identification of patients/clients at risk; transitional planning;
medication management; patient and family action/engagement; and the
transfer of information (DelBoccio et al., 2015). From personal
experience transitioning a patient to a skilled nursing facility, we
have to assess and document the patient’s physical, mental, and
emotional condition and past medical and social history, former
occupation, leisure activities, and cultural factors which are used to
determine which services would be most suitable for the individual (Shi
& Singh, 2019). Monitoring compliance can be used to improve safe
care transitions for patients, clinicians and family members.

DelBoccio, S., Smith, D., Hicks, M., Lowe, P., Graves-Rust, J.,
Volland, J., Fryda, S., (2015) Successes and Challenges in Patient Care
Transition Programming: One Hospital’s Journey. OJIN: The Online Journal of Issues in Nursing Vol. 20 No. 3. Manuscript 2

Pooja Chandrashekar, Sashi Moodley and Sachin H. Jain (2019). 5
Obstacles to home-based health care, and how to overcome them. Harvard
Business Review.

Shi, L., Singh, D. A. (2019). Essentials of the U.S. healthcare system(5thed.). Jones &Bartlett Learning

Discussion response 2 Elizabeth

we try to make transition of care as easy as possible sometimes it not
that easy. Transitional care encompasses a broad range of services and
environments designed to promote the safe and timely passage of patients
between levels of health care and across care settings (Naylor &
Keating, 2009). High-quality transitional care is very important for the
elderly and other patients with multiple chronic conditions and complex
regimens, as well as for their family caregivers. With patients that
have multiple condition may receive care from multiple providers and a
good hand off would be essential. Transitions within a hospital, such as
from the ED to an ICU to a step-down unit to a general medical–surgical
unit, can have devastating effects on the health of older adults and
the well-being of family caregivers (Naylor & Keating, 2009). Such
as serious medication errors are common during transition periods. When
transition from a hospital stay back home can be tricky if all
information is not given. If there are large gaps within care that
exist with patient and caregivers during the transition period can lead
to adverse events like readmission to the hospital. Case manager play an
important role when it comes to patient transitioning out of the
hospital. Case managers can play a pivotal role to ensure high-quality
transitions by assessing patients and identifying those who are at high
risk; coordinating care and services among providers and settings;
reconciling medications; and facilitating education of patients and
their support systems to improve self-management ( (Campagna, Nelson,
& Krsnak, 2019). Having all the correct information and education
the patient need to transition will impact the patient safety
significantly. Having all information regarding medication follow-up
appointment etc. is needed when transition and that is a key point and
patients not being readmitted to hospitals.


Campagna, V., Nelson, S., & Krsnak, J. (2019). Improving Care
Transitions to Drive Patient Outcomes: The Triple Aim Meets the Four
Pillars. Lippincott®Nursing Center.

Naylor, M., & Keating, S. (2009). Transitional Care: Moving patients from one care setting to another.