HISTORY OF THE UNIQUE NURSE IDENTIFIER
The Nursing Knowledge: Big Data Science Initiative embraces a vision of better health outcomes resulting from the standardization and integration of the information nurses gather in electronic health records (EHRs) and other information systems.1 To this end, the Big Data Initiative is executing a national action plan to make nursing data sharable, comparable, timely, and more relevant to improving health and health outcomes. Nursing documentation can be used to capture social determinants of health data, improvements in health outcomes, patient safety, operational efficiency, and clinical effectiveness. However, nursing's contribution to the health and care of individuals is often invisible, in part due to the absence of a unique nurse identifier. Without a mechanism to enable the selection of data describing nurses' roles as individuals, finding tangible evidence of describing the care nurses provide and demonstrating the impact of patient care on delivery of patient outcomes are challenging.
UNIQUE NURSE IDENTIFIER POLICY STATEMENT ENDORSEMENT
The Big Data Policy and Advocacy Workgroup has been working to address this gap by advocating for widespread use of the National Council of State Boards of Nursing (NCSBN) identifier. This unique nurse ID can be used to demonstrate the value and contributions of nursing care to improved patient outcomes. In spring of 2020, the workgroup approached the Alliance for Nursing Informatics (ANI) to seek their endorsement of the NCSBN ID. After a careful review process, the ANI Governing Directors approved the ANI Unique Nurse Identifier Policy Statement in November 2020, on behalf of its 28 organizational members.
The ANI Unique Nurse Identifier Policy Statement recommends that the NCSBN ID should be used by key stakeholders as a nurse identifier to demonstrate the value of nursing through research and enhance individual care and health outcomes via more comprehensive documentation in the EHR, enterprise resource planning (ERP) systems, and technologies.
Alliance for Nursing Informatics will disseminate the Policy Statement and related materials to educate its members via a Webinar, publishing informational resources on the ANI Web site, advocacy outreach, and via social media postings. The ANI Policy Statement will also inform future public policy comments submitted by the organization.
DEFINITION AND RECOMMENDATION OF A UNIQUE NURSE IDENTIFIER
In nursing, a unique nurse identifier is a code that represents the individual nurse, which classifies an entity in computer systems, including repositories, registries, databases, and knowledge bases. It enables identifiable and actionable events in disparate healthcare technology systems. Associating a unique ID with the nurse in multiple technology systems will allow for matching and capturing the nurse's activity in those systems.
The Nursing Knowledge: Big Data Science Policy and Advocacy Workgroup recommends using the NCSBN ID as a unique nurse identifier. The NCSBN ID is a publicly available identifier matched exclusively to a nurse and not a state or organization assigned to all nursing students upon registration for the NCLEX.2 Leveraging this unique identifier is easy and convenient for health systems to use to connect siloed systems, including the EHR, ERP, and other technologies and systems.
BENEFITS TO PATIENTS: DEMONSTRATING CONTRIBUTION TO OPTIMIZE OUTCOMES
Without a nurse identifier, coupled with patient data, health systems have little means of demonstrating nursing's benefits to patient care. Nursing documentation captures what happens during a patient-care team interaction, including social and behavioral information. Also, documentation can help measure improvements in individual and population health outcomes, patient safety, operational efficiency, and clinical effectiveness.3 This information collected by nurses enables accurate reflection of nursing activities and their invaluable contributions to improve community health, better public health management, and ultimately enhance the patient experience.
BENEFITS TO NURSES: MEASUREMENT AND RESEARCH
There are numerous benefits for nurses in using a nurse identifier, including tracking and trending outcomes to improve nursing practice. A unique nurse identifier supports nursing care measurement as it relates nursing's role in contributing to safe, effective healthcare practices and enhancing ERP. Operationalizing a unique nurse identifier enables examining the variability of direct nursing care time and costs, and the relationships between patient and nurse characteristics and costs, quantifying nursing's' worth in value-based care models.4 The identifier also facilitates and enriches the research that provides evidence for nurse-specific assessments, interventions, and outcomes data. Nursing documentation is a rich source of healthcare data derived from health IT systems and technologies. These data will advance scientific inquiry to quantify nursing care and its impact on health outcomes.
CURRENT PILOTS USING THE NCSBN ID
Piloting of the use of a unique nurse identifier, specifically the NCSBN ID, is underway. One of these projects involves one of the nation's largest health systems uploading the ID data, as nurse records, to their Electronic Data Warehouse for use in an ERP system, with the goal being to track patient outcomes, nurse outcomes, compliance, and education and training needs. Also, the Center for Medical Interoperability, a cooperative research and development laboratory, tested the NCSBN ID to demonstrate how the known caregiver, identified through the application of a nurse's credentials within a pediatric code response care team, can intelligently coordinate patient care. Finally, schools of nursing are leveraging the NCSBN ID to link nurses and their preceptors using their credentials to digitize this manual process to improve efficiency in the nurse-professor match and to advance educational experiences. Interest in using a unique identifier is also growing among EHR and ERP vendors.
A CALL TO ACTION FOR ADOPTION
Nurse leaders and healthcare industry stakeholders have identified the need for a unique nurse identifier, and using the ID is gaining interest from EHR and ERP vendors. A unified voice is vital for adopting a unique nurse identifier in health IT systems for documentation, education, research, and training purposes in the United States and globally. To quantify nursing value, nurses and nurse leaders should adopt the unique nurse identifier policy recommendation and advocate with your organization and its health IT systems vendors to adopt the NCSBN ID as a unique nurse identifier.
References