Data governance and stewardship is the process of ensuring that there is the knowledgeable and accurate application of data that is derived from the individuals' personal health information (Rosenbaum, 2010). Ethical principles are applicable in the process of data collection, viewing, storage, exchange, aggregation, and analysis (Brous, Janssen, & Vilminko-Heikkinen, 2016). Additionally, the core principle ethical consideration in data governance and stewardship is accountability (Rocheleau, 2006). The health data stewardship support is a benefit to the society, and therefore ethical review is a significant concern. Concerning the data governance three aspects are used to define the integrity of personal data which include confidentiality, privacy, and security (Louwerse, 2011). In data confidentiality, the ethical considerations in the IRB process should ensure that no data being disclosed in a manner that will breach the patient confidentiality. Hospital-acquired pressure ulcers should be treated like any other health information where patient confidentiality, security, and privacy are ethical priorities (John, 2008). The IRB project will, therefore, use knowledgeable and accurate application of HAPU data from the personal health records database.
Regarding the data management plan in the IRB process on HAPU management, various steps will be applied to ensure the proper integrity of personal health data and thus a suitable data application process. The first step in the plan is individual rights whereby an individual has the right to know their health records (Snyder & Gauthier, 2008). It is the mandate of the skin care champion to ensure data accuracy which enhances the utility of the data. Regarding individual rights, transparency is another approach where individuals will be notified of the information to be shared and under what circumstance and also allowing individual participation to make decisions concerning the exchange. The second step in the plan will be ensuring responsibilities of the health data stewardship. In the above step, skin care champions will adhere to privacy and confidentiality principles, limiting the disclosure, data de-identification and ensuring data quality including accuracy, completeness, and integrity (Ball, Weaver, & Kiel, 2009). The third plan will focus on security and controls in the IRB process. For a reliable confidentiality, integrity, and accuracy of health data, data stewardship calls upon implementation of reliable administrative and technical safeguards to mitigate the inappropriate access and disclosure personal health data (McWay & McWay, 2010). The fourth approach concerning the data management plan is accountability and remedies in data management. Data stewardship requires the establishment of policies that defines proper use and data accountability (Mills, Romano, & Heller, 2009). The need of having remedies in data management is to provide the mechanism that will detect and correct any misappropriate use or application of HAPU data by the skin care champions.
Ethical principles for the protection of human subjects and confidential information in the completion of IRB application will be confidentiality, privacy, and security of individual data (Rutherford-Hemming, Vlasses, & Rogers, 2012). Data confidentiality involves safeguarding the information collected in the context of a patient-nurse relationship from disclosure to the third parties (Lowrance, 2012). Data security is the measure put in place to ensure there is a policy to control who has access to personal information and under what condition (Fierz, et al., 2014). Privacy, on the other hand, is the practice in the context of data confidentiality and data security relationship (Humber, & Almeder, 2011). The above ethical principles will be applied in the IRB process of HAPU management.
Project management strategies
Effective project management strategies in the IRB process concerning the management of HAPU cases by the skin care champions through the application of collected data will require all the participants to contribute through their distinct duties and each with their set of objectives and responsibilities (Harris, et al,. 2016). The set objectives and responsibilities will focus on ethical considerations applied in data governance and stewardship. The core responsibility is informed consent. Informed consent is the stepwise process of acquiring the go ahead before conducting any medical intervention to a patient or even anything associated with their medication like personal health records (Jenkins, 2009). Through an informed consent, the gathering of information from individuals with HAPU cases is a project strategy towards effective data governance and stewardship. Informed consent also involves the provision of appropriate information to patients for them to make a voluntary choice (Corrigan, 2009). In the IRB project, the bedside skin care champions are authorized to provide informed consent to clients with HAPU cases before gathering any form of information. Another authorization is the application of informed consent as an ethical concept in data governance.
Another strategy is de-identification of patient's data. De-identified data means that the personally identifiable information is obscured which reduces the risk of unintended disclosure (Gkoulalas-Divanis, & Loukides, 2015). The remaining information after de-identification should not provide the background of identifying an individual. De-identified data may also be released without the patient consent (Meystre, et al., 2010). For the purpose of the bedside care skin care champions, a code may be attached to the de-identified data for the purpose of identification and data review when linking to the original sources. Using an aggregated data is another data management strategy which provides a summary statistics rather than using the data warehouse. Regarding the plan to ensure confidentiality in data governance, de-identified data is more useful than aggregate data. In this project, therefore, using de-identified data will be more effective.
The institutional review board is required to strategize measures that will keep personal health information in a private custody. Another core requirement is using the available bedside skin care champions as the key initiators of the HAPU management project. The bedside skin care champions will also be required to practice the ethical principles as discussed in the above as well as using the clinical investigation to support the collected data (Fierz, et al., 2014). The last requirement of IRB is to adhere to the ethical considerations.
Management strategies for project implementation
Concerning DNP project implementation strategies, a six-step procedure will be used as the effective approach. The first step is the initiation phase where participants and other stakeholders will are informed on project feasibility, partners, results and the boundaries of the project. The second phase is definition phase all the requirements of the project will be identified. On the third phase of the DNP project (design phase) the appropriate design to produce the results will be determined. The next step is development stage that will be used to prepare the implementation phase where actual constructions are made. In implementation phase results are gathered and evaluated. The last phase of the DNP project is the follow-up phase which will bring the project to a successful completion (Kerzner, 2012). The milestones in the DNP project are having a practice change and using the available data to evaluate the HAPU management strategies. The components of implementation success in the DNP project include having an effective system of HAPU management and prevention, effective practice change in the bedside skin care champions and having a zero incidence of HAPU cases after project implementation (Moran, Burson, & Conrad, 2017).
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