Safety and quality improvement are core focuses of the nursing profession. As a nursing student, the author has implemented several safety measures for patients, such as properly caring for IV ports to reduce infection risks. In the ICU specifically, patients have more limitations that require extra safety precautions. For one immobile and sedated patient, the author took responsibility for his safety by providing regular oral care, repositioning, and cleaning his central line ports. These safety interventions can help improve patient outcomes in the ICU. The author is committed to providing the highest quality of care that aligns with her Christian faith and upholds patient safety.

1. CAPSTONE PROJECT/ PROFESSIONAL PORTFOLIO
Title: Safety and Quality Outcomes
Exemplar:
Safety is a conscious effort to minimize the risk of harm through the use of systems and personal
actions. Quality improvement is the data collected to measure the outcomes of safety practices. As a
nursing student in the clinical setting, I have had countless opportunities to implement safety as I care for
patients. In nursing, our main focus is maintaining our patient’s safety and also implementing new ways to
improve and provide a safe environment. Almost every patient in the hospital setting has an intravenous
catheter (IV) or central line to receive fluids and medications. IVs serve as a port of entry for pathogens to
enter the body. We have implemented measures to decrease the risk of infection in line ports such as using
gloves, scrubbing the port with alcohol pads before administration, and using chlorohexidine caps when the
ports are not in use. I am currently in the ICU in my senior preceptorship. Although my time in this unit
has not been extensive, I have already recognized the importance of maintaining a port and decreasing the
risk of infection for these patients.
One specific difference between a medical surgical floor and ICU is the state of the patients. For
example, on a medical surgical floor a patient is most likely alert and oriented, breathing on their own, able
to speak and verbalize needs, and possibly ambulate. With these characteristics, these patients can also
implement some safety measures on their own. While in the ICU a patient may be slightly sedated, on a
mechanical ventilator and nonverbal, and unable to ambulate. This difference serves as a barrier for the
patient to provide themselves with safety in minor ways that we overlook daily. Recently, a patient
assigned to me was at risk for harm. This patient was under slight sedation because he extubated his
endotracheal tube that was protecting his airway. This tube was put into place to help him maintain his
breathing while other health issues were being treated. From the trauma of forced extubation, this patient
put himself in harm of not being able to breathe. Now, with an endotracheal tube attached to a ventilator
and a central line administering light sedation to decrease his work of breathing and agitation by the tube,

2. this patient is immobile and it was my responsibility to help keep him safe. By doing proper oral care every
two hours, turning and repositioning every shift, cleaning his central line ports with alcohol, saline flushes,
and chlorhexidine caps, we can maintain and even improve his safety as he heals. These measures can
improve the patient’s safety and improve the quality of care given in the unit.
Reflection:
Safety and quality improvement are very much dependent on the actions of the nurse. The safety is
implemented through the nurses and the data from safety interventions will tell how effective we are at
maintaining patient safety through measures such as root cause analysis, fall risk assessments, and sepsis
rates. I am convicted on a personal level to do my best when I know it’s my responsibility to provide
appropriate care to patients because of my relationship with Christ. I have laid down my wants and needs
to take on what God desires of me and to be his hands and feet. To be an accurate representation of Christ,
his Word in accordance with facility policy, national patient safety goals, and QSEN competencies
encourage me to provide optimal care to my patients. In nursing, we advocate for patients that do not have
a voice and to operate within their best interest with the goal of healing and quality care. The safety
measures we implement or choose to work around are detrimental to our patient’s well-being.