NURS FPX 4905 Assessment 2 FREE DOWNLOAD
NURS FPX 4905 Assessment 2 Define and Analyze Your Healthcare Process Problem or Issue of Concern
Student name
Capella University
NURS-FPX4905 Capstone Project for Nursing
Professor Name
Submission Date
Define and Analyze Your Healthcare Process Problem or Issue of Concern
The substance use disorder (SUD) is an unresolved, multidimensional public health issue, especially in inpatient detoxification and residential rehabilitation institutions. In the context of Immersion Residential Center, where drug and alcohol detox and long-term recovery are prioritized, the issue of missing consistent and individualized post-detox care planning has become a serious healthcare process problem and one of the reasons behind high relapse rates and lack of treatment adherence (The Immersion Program, 2024).
The lack of continuity of care hinders recovery and exposes a client to recurrence of detoxes. To examine this problem, it is necessary to comprehend the multidimensional character of an addiction, obstacles to a long-term recovery, and gaps in the discharge planning, follow-up care, and patient interaction on the system level in the initial phases of rehabilitation.
Description of Practicum Site
| Key Point | Details |
|---|---|
| Practicum Site | The site of my practicum is the Immersion Residential Center, which is a private for-profit healthcare facility in Boynton Beach, Florida. |
| Services Provided | The facility specializes in the treatment of substance use, and medical detoxification and residential rehabilitation are the main types of services provided there (The Immersion Program, 2024). |
| Treatment Methods | It provides numerous treatment methods that encompass cognitive behavior therapy, motivational interviewing, relapse prevention methods, and facilitation of the 12-step process (American Addiction Centers, 2025). |
| Accreditation & Registration | The facility is accredited and registered by The Joint Commission, the Drug Enforcement Agency (DEA), the state Substance Abuse Agency, and the state Department of Health so that it meets standards of high-quality care (American Addiction Centers, 2025). |
| Medication-Assisted Treatment | Immersion Residential Center is authorized to prescribe and administer alcohol and opioid use disorder medication, such as buprenorphine, naltrexone, disulfiram, and acamprosate, within a full Medication-Assisted Treatment (MAT) program. |
| Patient Population | The population of patients in the Immersion Residential Center is mainly young adults of both sexes who have substance use disorders such as alcohol, opioids, methamphetamines, and benzodiazepines. Most of them also come with comorbid mental health issues or traumatic backgrounds, or social instability. |
| Patient Care | The center helps the patients by providing them with personalized detox programmes, counseling, group therapy, and case management (The Immersion Program, 2024). |
| Ancillary Services | There are also ancillary services, i.e., domestic violence support, social skills development, and recovery coaching (American Addiction Centers, 2025). |
| Staff | Although the number of full-time staff can fluctuate, the facility is estimated to have around 40-60 full-time healthcare workers, such as nurses, physicians, licensed therapists, case managers, and recovery support staff, among others, and strives to offer collaboration with other workers to deliver holistic patient-centered care. |
Clinical and Operational Decisions at the Practicum Site
The psychiatrists, nurse practitioners, therapists, and addiction specialists make a multidisciplinary decision that guides clinical and operational decisions at Immersion Residential Center. Such decisions include the degree of care needed by the given client (detox, partial hospitalization, or outpatient), the choice of a suitable MAT, buprenorphine or naltrexone, and the adjustment of therapeutic interventions to the requirements of a specific client (The Immersion Program, 2024). Operational decisions are concerned with the smooth transfer of treatment phases, group and individual therapy schedules, the caseloads, and compliance with the licensing regulators, such as The Joint Commission and the DEA (The Immersion Program, 2024). The recovery process within the center has a systematic, three-step recovery, which begins with stabilization and detox, then therapy and reintegration, which have to involve combined planning and constant review to provide the best results.
As part of the practicum, I have actively participated in the contribution of both clinical and operational decision-making through the supervision of licensed professionals. I also attend interdisciplinary team meetings during which I help to evaluate client progress, review the responses to treatments, and propose a change to the care plan based on observations and feedback from the clients. I have also been involved in the discharge planning, where I assist in identifying discharge needs and the right after-care services. Moreover, I am engaged in therapeutic session preparation, client education materials preparation, and assisting in the implementation of trauma-informed practices. The position I am in enables me to combine academic knowledge and practical experience, provide a significant voice in the decision-making process, and support the necessity of individualized evidence-based care.
The key patient health outcomes at Immersion Residential Center are successful detoxification, stabilization of comorbid mental health symptoms, better coping mechanisms, and sustained recovery participation. The facility focuses on measuring the outcomes by relapse prevention planning, continuous mental health service, and follow-up care. The combination of 12-step facilitation, trauma-informed counseling, and pharmacological support based on the substance use history of a particular client also leads to positive results (The Immersion Program, 2024). My practicum participation is also involved in client progress monitoring and documentation, detection of possible risks of relapse, and support of health education, as it helps people who have been overcoming substance use disorders to recover and have a better quality of life in the long run.
Process Issue Identification
Among the most urgent healthcare process challenges at Immersion Residential Center, there is the lack of continuity of care after detoxification, specifically, in patients with the diagnosis of SUD and comorbid mental health issues (American Addiction Centers, 2025). Although the initial detox and the initial stabilization are crucial steps to take, most of the patients experience difficulties in the transition to long-term care because of the incoherent follow-up planning, absence of customized aftercare, or absence of accompanying support during reintegration.
This disparity has great effects on patient outcomes that usually lead to relapse, readmission, and interrupted recovery progress (David et al., 2022). Since the Immersion Center is located in a three-phase framework with strict structure, a failure in this cycle, and particularly in the transition of the residential treatment to the outpatient treatment, may undermine the long-term recovery pattern and result in poorer treatment outcomes. The concern is especially high in comparison with national information. An analysis of Americans aged 12 and above shows that 48.5 million have fought with substance use disorder within the last year, and more than 20.4 million adults have co-occurring mental health and substance use disorder (American Addiction Centers, 2024). These statistics indicate how difficult the treatment of SUD is and the significance of comprehensive, long-term care beyond the detox stage. It is found that people with SUD and mental health issues have an increased risk of relapse when their treatment does not continue (Sweileh, 2024).
At Immersion Center, it is very important to make sure that every patient is provided with a detailed discharge plan and the subsequent provision of outpatient therapy, medication management, and community-related support to ensure a low level of relapse and enhanced recovery rates. Closing this gap in the healthcare process can result in more stable, empowered, and long-term patient recovery from addiction and mental health-related issues.
Impact Analysis
Continuous coverage following the process of detoxification is a serious area of concern with regard to the nature of the result of the patient and the overall performance of the organization as a whole. Quality-wise, patients not getting customized and continuous treatment plans will have higher chances of relapse, thus causing readmission cycles to intervene between long-term recovery (Owusu et al., 2022).
This interferes with the quality of care and the mission of a residential facility such as Immersion Residential Center, whose mission is to offer a holistic healing environment. Clients with co-occurring disorders are also put at risk of suicide without sufficient follow-up care, including psychiatric counseling, medication management, and peer support (Aadnes et al., 2020). They are more susceptible to an overdose or self-harm, or even a worsening mental condition, particularly during the initial weeks of post-detox recovery.
This organizational level also causes financial strain and inefficiencies in this process gap. The situation of readmission of clients leads to higher healthcare usage with no subsequent improvement in the treatment outcomes (Birhan et al., 2025). This increases the overall cost of operation to the facility, imposes repetitive crisis intervention on the staff, and limits the number of beds available to new admissions. Furthermore, insurance reimbursement models are becoming outcome-based; therefore, the lack of continuity of care may trigger a bad provision of funds, accreditation, or relations with the payer (Wagenschieber and Blunck, 2024). Lack of systematic follow-up programs also has reputational risks in society and might not be able to retain the clients or program completion rates, which are critical indicators of organizational success.
The causative factors of this issue are poor coordination in residential and outpatient care, inadequate staffing of aftercare planning, and structural failure of investments in transitional care programs. One of the factors is the lack of sufficient integration of treatment pathways that will be able to support clients holistically throughout the recovery process. The study by Sweileh (2024) indicates that people with co-occurring mental disorders must be subjected to continuous and coordinated care to attain and sustain recovery. Nevertheless, a great number of programs continue to address addiction and mental health problems separately. In the absence of effective communication and collaboration between the stages of treatment, patients will fall through the cracks and jeopardize their health as well as the cost-effectiveness of care delivery.
Conclusion
The process problem in the Immersion Residential Center that has been identified, and that is the absence of effective continuity of care after detoxification, is rather problematic to both the success of the client’s recovery and the organizational efficiency. Through the practicum experience that I had in this facility as a graduate nursing student, I have noted that inadequate aftercare planning and a lack of effective integration between inpatient and outpatient services are some of the factors that lead to relapse, high healthcare expenditure, and safety risks among co-occurring disorder clients.
The proposed measures to address this problem, based on coordinated treatment pathways, individualized discharge planning, and follow-ups, will not only improve the quality and safety but will also decrease readmissions and increase the success of long-term recovery. In my practice in this environment, I will establish myself as part of a significant change by promoting evidence-based practices that are sustainable and client-focused.
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References For NURS FPX 4905 Assessment 2
Ådnanes, M., Cresswell-Smith, J., Melby, L., Westerlund, H., Šprah, L., Sfetcu, R., Straßmayr, C., & Donisi, V. (2020). Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective. Patient Education and Counseling, 103(5), 1033–1040. https://doi.org/10.1016/j.pec.2019.12.002
American Addiction Centers. (2024, December 31). Alcohol and Drug Abuse Statistics (Facts About Addiction). Americanaddictioncenters.org. https://americanaddictioncenters.org/rehab-guide/addiction-statistics-demographics
American Addiction Centers. (2025). Immersion Residential. Recovery.org. https://recovery.org/providers/immersion-residential-2300904361/
Birhan, B., Rtbey, G., & Gelaw, K. A. (2025). Relapse and associated factors among psychiatric patients in Africa: A systematic review and meta-analysis. BioMed Central Psychiatry, 25(1), 333. https://doi.org/10.1186/s12888-025-06759-7
David, A. R., Sian, C. R., Gebel, C. M., Linas, B. P., Samet, J. H., Sprague Martinez, L. S., Muroff, J., Bernstein, J. A., & Assoumou, S. A. (2022). Barriers to accessing treatment for substance use after inpatient managed withdrawal (Detox): A qualitative study. Journal of Substance Abuse Treatment, 142(1). 108870. https://doi.org/10.1016/j.jsat.2022.108870
Owusu, E., Oluwasina, F., Nkire, N., Lawal, M. A., & Agyapong, V. I. O. (2022). Readmission of patients to acute psychiatric hospitals: Influential factors and interventions to reduce psychiatric readmission rates. Healthcare, 10(9), 1808. https://doi.org/10.3390/healthcare10091808
Sweileh, W. M. (2024). Research landscape analysis on dual diagnosis of substance use and mental health disorders: Key contributors, research hotspots, and emerging research topics. Annals of General Psychiatry, 23(1). https://doi.org/10.1186/s12991-024-00517-x
The Immersion Program. (2024, December 6). About Us – The Immersion Program. Immersionrecovery.com. https://www.immersionrecovery.com/about/
Wagenschieber, E., & Blunck, D. (2024). Impact of reimbursement systems on patient care – a systematic review of systematic reviews. Health Economics Review, 14(1), 1–12. https://doi.org/10.1186/s13561-024-00487-6
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