Data Sharing: HOW to Tell Your Story

Abstract

This is the second in a series of articles looking at school health data collection from identification of data points to utilizing data to share your story and submit your data to contribute to the National School Health Data Set: Every Student Counts! This article focuses on using data to share your story. Data storytelling versus data visualization will be discussed as well as HOW schools nurses can utilize easy access programs to support this process. Building on the first article in the series, the school nurse will not only identify the WHY and WHAT related to data collection but also HOW to link school health data to educational data to increase the audience of the story and follow data sharing regulations.

What Is Data Storytelling?

In a recent study, 87% of participants “. . . indicated their organizations would be more efficient if their front-line workers were more empowered by data” (Harvard Business Review, 2020; Mattison, 2023, para 1). These front-line workers include school nurses. Collecting and sharing your data is essential in using it to tell a story. Incorporating data into your story provides supporting evidence to engage the intended audiences. Bergren and Maughan (2020) discussed this need for school nurses to increase data literacy and “apply data and evidence to inform practice” (p. 140). Sharing data is a fundamental skill in advocating for the role and value of the school nurse in the 21st century (National Association of School Nurses [NASN], 2020). The benefits of utilizing data storytelling include

• increasing comprehension of complex data,

• making data more meaningful and memorable,

• simplifying the communication of the data to a wider range of stakeholders, and

• providing a more compelling story that increases the persuasiveness and impact of the data (Sigma, 2023).

Data visualization is the graphic representation of data and enables the viewers to identify trends and patterns from the data visually. Data storytelling incorporates the visual representation of the data with the narrative and context to make the data more relatable with a goal of influencing decision-making (Calzon, 2022; Sigma, 2023). Data storytelling requires three components: the narrative, the data, and the visual representations (Calzon, 2022). It is not enough to be at the table for discussions; utilizing data provides school nurses with a voice at the table.

WHAT Story Do You Want to Tell With the Data?

Children with medical conditions can experience barriers to learning and barriers to being present in the classroom because of issues related to their health, including side effects from medication, absences due to doctor visits, stress, pain, as well as ineffective coping skills . . . School-based care coordination is the most effective strategy for keeping children with chronic conditions healthy and ready to learn. (Missouri Kids Count, 2016, para. 9)

School nurses are experts in school-based care coordination and advocating for safe, supportive, and equitable learning environments for all students (NASN, 2023). School nurses collect data related to student needs, barriers, successes, and school nurse interventions every day. The next step in the process is utilizing the data to share your story. Refer to Box 1 for techniques and best practices in storytelling.

Box 1.

Seven Techniques and Best Practices for Data Storytelling

1. Turn metrics into actionable concepts—identifying the “ask”. 2. Build a narrative—WHAT do you want to tell and WHY. 3. Define your data sources—prioritize your data to best support the narrative. 4. Choose the right visualizations—easy to read visual representation and color palette. 5. Eliminate clutter—concentrate on only the data needed to support the narrative. 6. Simplify and make connections—connect the dots in a strategic manner through the narrative. 7. Rely on the right data tools—find the tools that work best for your skills.

Source. Calzon (2022).

The story you tell, HOW you share it, and WHO you share it with are dependent on WHAT data you are sharing and the WHY behind sharing it. School health data points are very versatile and can be utilized to tell many stories. As discussed in the first article in this series, the WHY and WHAT are essential in framing your story (Stanislo, 2023). Common stories utilizing school health data are framed around providing general awareness of the school nurse’s role and scope of practice, linking the presence of a school nurse to student outcomes, acuity level of student population, and staffing needs and models of care. The stakeholders for these stories may be parents, school staff, school administrators, legislators, or community partners. Remember the key to data storytelling is to match these data points to the priorities of stakeholders. You may utilize the same data to tell the same story, but from more than one perspective.

Table 1 provides a sampling of school health data points, how they link to student outcomes, and the academic indicators they can connect with in your storytelling. As a reminder from the first article, “academic achievement is measured through academic indicators. Academic indicators include academic performance (grades, graduation rates, test scores), educational behavior (attendance, dropout rate, behavior referrals), and school attributes (student engagement, school climate, parent/family engagement)” (Stanislo, 2023, p. 312). Identifying the academic indicators is essential in identifying the WHY for the story you will share and identifying your ask, as outlined by Calzon (2022).

Table 1.

Linking School Health Data to Educational Data

Data sets	Data points	Link to student outcomes	Academic indicators
Health office visits	• Provider • Total # • Disposition • Visit type • Chronic condition care • Acute care • Mental health • Health counseling • Visit volume (time of day) • Trends/patterns • Sent from lunch, physical education, playground injuries, etc.	• Time out of class • Attendance • SN value/efficiency to student outcomes • Funding • School staff workload • Staff engagement • Access to healthcare • Child Find	• Grades • Test scores • Graduation rates • State report card • Attendance • Dropout rates • Behavior referrals • Student engagement • Parent/family engagement • School climate
Screenings	• Type • Total # • Rescreens • Referrals • Follow-up	• Access to healthcare • Access to learning/accommodations • Outcomes of referrals • # Glasses • Hearing aids • SN value/efficiency to student outcomes • Funding • School staff workload • Staff engagement • Child Find	• Grades • Test scores • Graduation rates • State report card • Behavior referrals • Student engagement • Parent/family engagement
Care coordination	• EAP • IHP • 504 • IEP • Evaluations • Meetings • Communications • Medications • Treatments • Staff training • Delegation • Supervision	• Acuity level • Staffing model • SN role/Scope • Access to healthcare • Access to learning/accommodations • SN value/efficiency to student outcomes • Funding • School staff workload • Staff engagement • Child Find	• Grades • Test scores • Graduation rates • State report card • Attendance • Dropout rates • Behavior referrals • Student engagement • Parent/family engagement • School climate
Student health conditions	• Type • Total # • Medications • Route • Timing (daily/PRN) • Chronic absenteeism • Staff training • Staff responsibilities/expectations • Episodes of emergency care	• Acuity level • Staffing model • Access to learning/accommodations • Access to healthcare • SN value/efficiency to student outcomes • Funding • School staff workload • Staff engagement • Child Find	• Grades • Test scores • Graduation rates • State report card • Attendance • Dropout rates • Behavior referrals • Student engagement • Parent/family engagement • School climate
Evaluations	• ETR (504/IEP) • Child abuse • Home visits • SDOH • Substance abuse • Self-injury	• SN role/Scope • MTSS integration • Safety planning/response • SN value/efficiency to student outcomes • Access to learning/accommodations • Child Find • Access to healthcare • Access to community resources	• Grades • Test scores • Graduation rates • State report card • Attendance • Dropout rates • Behavior referrals • Student engagement • Parent/family engagement • School climate
Surveillance	• Immunizations • Time out of school for exclusion • Disease/symptom tracking • Time out of school for isolation/outbreak • Chronic absenteeism • Surveillance by health condition and symptoms (dx and non-dx)	• Access to healthcare • Access to learning • Safety planning/response • MTSS • Funding • School staff workload • Staff engagement • Child Find	• Grades • Test scores • Graduation rates • State report card • Attendance • Dropout rates • Behavior referrals • Student engagement • Parent/family engagement • School climate

Note. SN = school nurse; EAP = emergency action plan; IHP = individualized healthcare plan; IEP = individualized education plan; ETR = evaluation team report; SDOH = social determinants of health; MTSS = multi-tiered systems of support; dx = diagnosis.

Although submitting data for school, district, state, and or national utilization, such as the National School Health Data Set: Every Student Counts! (ESC!), is important, the most important part of the data collection process is the utilization of data by the school nurse at the local level (Bergren & Maughan, 2020). Identifying WHAT data are collected and how it relates to the stories that need to be shared at the building and district level provides the school nurse with opportunities to put the data into action (Johnson, 2019). The school and/or district nurses can utilize data storytelling to share how data provides opportunities to change and guide practice on a daily basis. This may include modifying a health procedure for better efficiency, identifying an increase in student needs addressed through additional staffing, or providing evidence to initiate a school policy review. The state and national data are important to address system-level changes, but if the local school nurses are not engaged with the value of their own data and practice, the participation rates and completeness of the state and national data suffer. As a result, the state or national data are not generalizable; making it difficult to utilize the data in guiding system-level practice and policy changes. It is also essential for increasing confidence in the decisions made utilizing that data and maintaining a high-quality data set (Bergren et al., 2017).

Data in school nursing practice represent the paver stones along the path. The most important step on this path is the first one; engaging with your data by starting where you are. See Box 2. The data helps frame the story you will share and the next steps on the path.

Box 2.

Questions to Consider When Reviewing School Health Data

• What are the data telling you? • Are the data telling you what you expected or identifying a gap or trend that you were not expecting? • What is the best way to share the data to tell your story? • Who needs to hear this story?

Data Sharing Standards

Data sharing, like any information sharing, presents privacy issues. This can seem complicated in schools. HOW you share school health data is protected by the Family Educational Rights and Privacy Act (FERPA, 1974) or on occasional, the Health Insurance Portability and Protection Act (HIPAA). For the most part, data privacy in schools is subject to FERPA. Sharing student data from educational records, including student health records, can be very beneficial in improving student outcomes. In general, FERPA prohibits the sharing of personally identifiable student data without written consent (U.S. Department of Education, 2021). There are exceptions, including sharing student data in aggregate or another format that is not personally identifiable. It is essential to ensure all personally identifiable information is removed. In some cases, reporting a small number even in an aggregate format may make a student’s identity easily traceable. In this case, the sharing of the data may not be advisable, or the format may need to be modified to a percentage rather than raw number. In addition to FERPA, you may need to check your district and state regulations related to data sharing outside of your school/district (Network for Public Health Law, 2020). Instances where HIPAA may protect the student health data are minimal, but include situations where data are utilized for billing services, such as Medicaid (U.S. Department of Health and Human Services, 2008).

Data Sharing Examples and Resources—HOW to Tell Your Story

Once the data points and stakeholders are identified, identifying the HOW to tell the story is next. Is the story told best through graphics, in writing, verbally, or a combination of each? Examples of methods to share your story include:

• Monthly report

• Newsletter

• Infographic

• In-services (beginning/end of year)

• Legislative testimony

• Data spotlight stories

• School/clinic bulletin board

• Scheduled meetings with school/district administrators

• Board meetings

The stories can focus on an explanation, identification, or comparison. Do the data tell a story of changes over a school year, differences between schools, identifying trends or gaps, or highlighting student outcomes or school nursing practice? Is the story about improvements or changes related to a new policy or practice or identifying trends by month over a year or year to year? WHAT successes can be shared? HOW can the data best be shared to express your ask or the anticipated action or decision by the stakeholders? Is the ask a change in practice or policy or additional resources, such as staffing?

The format for sharing data through storytelling is dependent on the WHY behind the story and WHO the story is intended to be shared. In cases where a comparison or trend identification tells the story, a graphic visual is helpful. Graphics provide a visual representation of the data and help guide the story without too much additional explanation. General information can be shared effectively in a newsletter or legislative testimony through writing; however, school bulletin boards and infographics are effective ways to share graphic and written stories. It can be helpful to visit the website of your state school nurse organization, department of health, and department of education to see samples of how data are being shared in your state. When data storytelling, the ability to reference or compare your data to state-level data can be helpful in telling your story. Table 2 illustrates samples of state-level infographics from Florida and Oregon.

Table 2.

Examples of State School Health Infographics

State	Infographic
Florida  https://www.floridahealth.gov/programs-and-services/childrens-health/school-health/school_nurse_infographic.pdf
Oregon  https://www.oregon.gov/oha/PH/HEALTHYPEOPLEFAMILIES/YOUTH/HEALTHSCHOOL/Documents/2020%20School%20Nurse%20Infographic.pdf

Creating graphics to share data can be intimidating. Table 3 provides examples of resources to create your own graphics or utilize premade templates, like the fillable infographic located on NASN’s ESC! website, that are easy to access and do not require expensive programs or apps. Microsoft and Google applications like Word, Excel, and PowerPoint also provide graphic features that are readily available.

• The Health Visit Disposition, Student Visits, and Life-Threatening Allergy examples were created with PowerPoint by adding a chart but could also be a Word document. Once selecting the insert option from top menu, a wide range of chart formats are available for choosing. Once a chart is selected, right clicking on the chart will open the edit data option where you can personalize the chart with your data and custom color palette.

• The Student Visits graphic was created with the same method but a different chart option. Once the data are inputted, you can change the chart option and view it in several formats before choosing the one that best fits your story. The add shape option was utilized to create the arrow and insert a text for a short-written description.

• The Life-Threatening Allergy graphic utilized multiple charts and shapes within a single slide or page to offer comparisons and visualization of more granular data.

• The Facts & Stats/SN Outcomes utilized shapes and icons to create a graphic that included text within each shape for comparison.

• The Facts & Statistics graphic utilized icons to represent data with smaller text explanations included. Graphic programs, such as Slidesgo, Canva, SmartDraw, Visme, and Adobe Express are all available with some free components.

Table 3

Data Storytelling Resources

Resource	Example
NASN ESC! fillable infographichttps://www.nasn.org/research/everystudentcounts/results-infographics
Sample Graphics from Microsoft and Google Applications (Word and Power Point) • Excel—charts and diagrams option • Icon option • Shape option • Text box option
Slidesgo www.slidesgo.com
Canva https://www.canva.com/ • Free accounts for educators• Free within Teams communication platform	Credit: C. Rogen (Ohio)
SmartDraw https://www.smartdraw.com/ • Free trial, can create work without an account, but can’t save it• Free within Teams communication platform
Visme https://www.visme.co/  Free trial
Adobe express https://www.adobe.com/express/  Signup for free educator account

Note. NASN = National Association of School Nurses; ESC! = Every Student Counts!

School districts may also have accounts that the school nurse can utilize for more advanced features. School nurses utilizing the Teams communication platform can now access Canva and SmartDraw free through the Teams platform under the applications option.

Call to Action

In this article series, we have now covered WHAT, WHY, HOW, and WHO of data collection and data sharing. It only takes one data point to get started. WHAT data do you have access to? WHAT do you want to do with the data? WHAT story needs to be told? WHO needs to hear the story? HOW can you utilize data storytelling and the resources provided to tell just one story this school year? Each of our journeys starts somewhere and always with the first step, no matter the size. NASN invites you to take one step forward toward collecting and sharing data hits school year (See Box 3). Use your data to tell your story and the story of your students.

Box 3.

NASN Resources

Resources to build your data capacity can be located on the NASN website https://www.nasn.org/research/everystudentcounts and through your SDC.A current listing of SDC can also be found on NASN’s website at https://schoolnursenet.nasn.org/viewdocument/state-data-coordinators.Contact [e-mail] for questions or more information.

Note. NASN = National Association of School Nurses; SDC = state data coordinators.

Once you tell your story, we invite you to help tell the collective story of school nursing through the National School Health Data Set: Every Student Counts! Our story is not complete without the story of each and every school nurse. NASN is also promoting a new initiative called Data Spotlight Stories (Figure 1). We want to hear from YOU! Every story, no matter how small, is an experience and example of school nurses utilizing data to drive evidence-based decision-making and promote evidence-based practice. Do you have a story you want to share? Do you want to highlight a school nursing peer in a story? We are looking for stories of local school nurses, district, state affiliates, state data coordinators (SDCs) to spotlight. Feel free to share a written story and/or graphic representation of the data. Email your story to [e-mail].

Figure 1.

Data Spotlight Initiative