Page 141 - Encyclopedia of Nursing Research

108 n DATA STEWARDShiP

well as the increased awareness of potential defined as data that are structured and orga-
risks associated with incorrect or inappro- nized and that have meaning or interpreta-
D priate uses of health data. Data stewardship tion. information that has been synthesized
is the responsibility of everyone who uses so as to identify and formalize interrelation-
or interacts with health data, identified or ships is referred to as knowledge. When one
de-identified, for any purpose including, but term represents all three types of content, it
not limited to, health care, research, quality is usually information. nursing data issues
assessment, population monitoring, policy, revolve around several factors. The first
and payment. relates to identification of the universe of rel-
The national Committee on Vital and evant nursing data. Currently, there is no con-
health Statistics has worked with other sensus regarding what data elements make
organizations and agencies to develop key up a minimum nursing data set nor what
principles and practices of health data stew- data elements are required to capture nurs-
ardship to protect the rights and privacy ing diagnoses, interventions, and outcomes.
of persons whose data are involved and to Systems to label or name these elements are
assure the quality and integrity of data. These also inconsistently defined. next, the com-
practices and principles can be grouped into plex nature of nursing phenomena poses
four categories. Principles about individual measurement difficulties. Measurement is
rights address access to one’s health data the process of assigning numbers to objects
and the opportunity to make corrections, to represent the kind or amount of a character
transparency about use, and participation possessed by those objects. it includes quali-
and consent for use. Principles that address tative means (assigning objects to categories
responsibilities of the health data steward include that are mutually exclusive and exhaustive)
identification of the purpose for data use; and quantitative measures (assigning objects
de-identification (when relevant); data qual- to categories that represent the amount of a
ity, including integrity, accuracy, timeliness, characteristic possessed).
and completeness; limits on use, disclo- Unlike other biological sciences, few
sure, and retention; and oversight on uses. nursing phenomena can be measured by
Principles and practices for security safeguards using physical instruments with signal pro-
and controls require the implementation of cessing or monitoring. Measurement diffi-
administrative, technical, and physical safe- culties occur because nursing consists of a
guards to protect information and to mini- multiplicity of complex variables that occur
mize risks of unauthorized or inappropriate in diverse settings. if one is able to identify
access, use, or disclosure. And finally, princi- what significant variables should be mea-
ples of accountability, enforcement, and remedies sured, then one is challenged with the diffi-
address requirements for policies that spec- culty of isolating those variables to measure
ify appropriate use, implementation of mech- them. Ambiguities and abstract notions must
anisms to detect noncompliance and enforce be reduced to develop concrete behavioral
consequences, and remediation for individu- indicators if measurement is to be mean-
als whose data are involved. Although these ingful. Measuring nursing phenomena also
principles have been established, the work of requires the acknowledgment of the “fuzzy”
translating them into practice will continue and complex nature of nursing phenomena
to evolve as the urgency for data stewardship and the richness of the meaning contained in
grows even greater (Kanaan & Carr, 2009). the context of the data. Finally, the value and
Data and information are the symbolic use of data that are not coded or numeric,
representation of the phenomena with which such as whole text data, must be studied to
nursing is concerned. Data are defined as dis- understand their benefits and boundaries for
crete entities that are objective; information is representing nursing phenomena. Content