How can we allow health care systems to dictate changes in practice that don't take into account unintended outcomes? Diana Mason's Editorial ("Unintended Consequences," April) clearly identifies the cause of the problem: data collection. As long as data are collected for the purpose of measuring health care improvements, it's likely that best practices will fall by the wayside. But health care systems are focused on certain outcomes and not on others. While they rejoice over the improvements, they overlook the unintended adverse consequences. So the answer is simple. Collect data only on what's important. Provide the resources and training to make this data collection possible. Reeducate nurses in the nursing process and in how to measure all outcomes.

Patients, families, and nurses have suffered too long with a splintered approach to patient care. We cannot permit outside forces to dictate "best practices" that don't meet basic standards.

Mary Meiser, MEd, BSN, RN, LNHA

Cincinnati, OH