As healthcare transitions to a value-based reimbursement model, focusing on the quality of care rather than the quantity, nursing documentation becomes increasingly important.
A primary role of nursing practice is to advocate for the care of individuals, families, communities and populations, and as such, nurses are positioned to holistically address the social determinants of health. The social determinants of health are the environmental and social conditions that have a significant impact on an individual’s health status. The health of populations can also be influenced by changes in policy, infrastructure and the use of IT.
Nursing documentation captures not only what happened during a patient-provider interaction, but also information related to the social determinants of health and can help measure improvements in individual and population health outcomes, patient safety, operational efficiency and clinical effectiveness.
And while nurses are making a difference in patients’ health outcomes, without a nurse identifier, which is a unique numeric identifier automatically generated for each RN at the time of their state board exam, health systems have no way of demonstrating the full value of nursing.
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Benefits of a Unique Nurse Identifier
Nursing’s contribution to the health and care of individuals and communities is difficult to measure and often invisible. This lack of visibility is due, in part, to the absence of a unique identifier for nurses. Hospitals and health systems need the ability to uniquely identify nurses in the EHR and other health IT systems for documentation, education, research and training purposes.
The widespread use of a unique nurse identifier would enable measurement of the impact of nursing practice including nurses’ role in contributing to safe and effective health and care practices, variations in direct nursing care time, assessing the cost per patient and enhancing enterprise resource planning. Leveraging a unique nurse identifier will enable scientific inquiry whereby researchers can measure and quantify nursing care and its impact on health outcomes. Mining nurse-specific assessment, intervention and outcomes data with the help of the unique identifier can serve as a source and means to successfully research nursing documentation data points from EHRs and from other health IT systems.
These data points can then inform researchers, academics and quality experts in measuring and quantifying the characteristics of nursing populations, nursing care and, ultimately, the impact on health outcomes.
For nurses, a unique identifier also allows each nurse to keep track of their education, and licensing information and status.
Canadian nurses recommend the use of a unique nurse identifier as a key data element for health information interoperability. In Switzerland, researchers have used a unique nurse identifier to calculate a detailed skill mix including nurse education and role to identify an association between inadequate staffing and increased adverse events.
Advocates, including HIMSS and other stakeholders, are working toward shifting policies in the U.S. to utilize the National Council of State Boards of Nursing’s (NCSBN) unique nurse identifier for sharing and comparing timely and more relevant nursing data to improve patient health.
Vendor and provider organizations can use available application programming interfaces to enable access to the unique identifier within health IT systems. Leveraging this technology will simplify the implementation process and ease adoption.
A unified voice is essential for advancing advocacy efforts to ensure adoption of a unique nurse identifier. By equipping nurses and other key stakeholders with education, tools and resources, they can become knowledgeable advocates for health IT policy efforts.