Nursing Informatics Competencies Research Articles

Innovation behavior levels and its relation with TIGER-based nursing informatics competencies among critical care nurses

Background Currently, worldwide nursing experts have been inspiring nurses to pursue innovation in nursing in order to improve nursing outcomes. As a consequence, practicing nurses ought to have the capability to be receptive to the innovation in their practice environment; therefore, a new specialty called ‘nursing informatics’ (NI) has emerged to keep pace with these emerging innovations. Aim The aim of this study was to measure the relationship between innovation behavior levels and TIGER-based NI competencies among critical care nurses. Participants and methods A descriptive correlational design was used in carrying out this study. This study was conducted in a Critical Care Unit at an International Private Hospital in Egypt. The convenience sampling method was used to select 30 participants who met the inclusion criteria to join the study. Data were collected using a three-section questionnaire as follows: (i) demographic data sheet; (ii) Innovation Behavior Questionnaire; and (iii) Nursing Informatics Competency Assessment Tool. Results More than half of the participants had a moderate level of innovation behavior. Moreover, more than one-third of the studied sample rated themselves as competent in NI. In addition, a significant positive relationship was found between innovation behavior and overall NI competency levels as perceived by the participants. Conclusion This study contributes to the identification of informatics competency levels that are pertinent to the role of critical care nurses. Moreover, this study signifies that the innovative behavior of critical care nurses would help in generating proactive approach concerning developing a NI competency level in the future. Recommendation Future studies should relate the demonstrated and perceived NI competency levels in critical care units and other work settings. Moreover, integration of the NI and nursing innovation courses as one of the core courses, and not as an elective, in the nursing curriculum is recommended.

Nursing Informatics Competencies for Emerging Professionals: International Leaders Panel.

To achieve a cursory review of the competencies necessary for acquire a successful career in a competitive job market, the panel will bring together leaders from renowned academic, successful health corporations, and international leaders in nursing informatics to the table for discussion, dialogue, and make recommendations. Panelists will reflect on their experiences within the different types of informatics organizations and present some of the current challenges when educating skillful professionals. The panel will provide personal experiences, thoughts, and advice on the competencies development in nursing informatics from their lens.

Assessment of the Need to Integrate Academic Electronic Medical Records Into the Undergraduate Clinical Practicum: A Focus Group Interview.

As healthcare systems demand that nurses be competent in using electronic medical records for patient care, the integration of electronic medical records into nursing curricula has become necessary. The purpose of this study was to explore how students, new nurses, clinical instructors, and faculty perceive the integration of academic electronic medical records into the undergraduate clinical practicum. From January to February 2014, four focus group interviews with 18 participants were conducted based on purposive sampling. Content analysis was used on the unabridged transcripts to extract themes and develop meaningful categories. Three major themes and eight subthemes were revealed from the focus group interviews. The major themes were "electronic medical record as a learning tool for clinical practicum," "essential functions of academic electronic medical records," and "expected outcomes of academic electronic medical record." Participants expected academic electronic medical records to enhance students' nursing informatics competencies. The findings of this study can inform the process of developing academic electronic medical records for clinical practicum, which will then augment students' informatics competencies.

Factors Influencing Intention to Use Smart-based Continuing Nurse Education*

Purpose: There is increasing attention to smart-learning as a new education paradigm. The purpose of this study was to identify the level of intention to use smart-based Continuing Nurse Education (CNE) and factors influencing intention to use smart-based CNE. Methods: Participants were 486 nurses from 14 organizations, including 12 hospitals, a nurses association, and an office of education. Data were collected from November 5 to 18, 2014 using self-report questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. Results: The mean score for intention to use smart-based CNE was 6.34 out of 10. The factors influencing intention to use smart-based CNE were nursing informatics competency, current unit career, and smartphone addiction. These variables explained 10% of variance in intention to use smart-based CNE. Conclusion: The findings of this study suggest that efforts to enhance the nursing informatics competency of nurses could increase usage rate of smart-based CNE. The CNE policy makers will find this study very useful and the findings of this study will help to provide insight into the best way to develop smart-based CNE.

Current Status of Nursing Informatics Education in Korea.

ObjectivesThis study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea.MethodsA set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics.ResultsA total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support.ConclusionsNursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses.

Refining a self-assessment of informatics competency scale using Mokken scaling analysis

Healthcare environments are increasingly implementing health information technology (HIT) and those from various professions must be competent to use HIT in meaningful ways. In addition, HIT has been shown to enable interprofessional approaches to health care. The purpose of this article is to describe the refinement of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) using analytic techniques based upon item response theory (IRT) and discuss its relevance to interprofessional education and practice. In a sample of 604 nursing students, the 93-item version of SANICS was examined using non-parametric IRT. The iterative modeling procedure included 31 steps comprising: (1) assessing scalability, (2) assessing monotonicity, (3) assessing invariant item ordering, and (4) expert input. SANICS was reduced to an 18-item hierarchical scale with excellent reliability. Fundamental skills for team functioning and shared decision making among team members (e.g. “using monitoring systems appropriately,” “describing general systems to support clinical care”) had the highest level of difficulty, and “demonstrating basic technology skills” had the lowest difficulty level. Most items reflect informatics competencies relevant to all health professionals. Further, the approaches can be applied to construct a new hierarchical scale or refine an existing scale related to informatics attitudes or competencies for various health professions.

Nursing Informatics Competencies Among Nursing Students and Their Relationship to Patient Safety Competencies: Knowledge, Attitude, and Skills.

With implementation of information technology in healthcare settings to promote safety and evidence-based nursing care, a growing emphasis on the importance of nursing informatics competencies has emerged. This study assessed the relationship between nursing informatics and patient safety competencies among nursing students and nursing interns. A descriptive, cross-sectional correlational design with a convenience sample of 154 participants (99 nursing students and 55 interns) completed the Self-assessment of Nursing Informatics Competencies and Patient Safety Competencies. The nursing students and interns were similar in age and years of computer experience, and more than half of the participants in both groups had taken a nursing informatics course. There were no significant differences between competencies in nursing informatics and patient safety except for clinical informatics role and applied computer skills in the two groups of participants. Nursing informatics competencies and patient safety competencies were significantly correlated except for clinical informatics role both with patient safety knowledge and attitude. These results provided feedback to adjust and incorporate informatics competencies in the baccalaureate program and to recommend embracing the nursing informatics course as one of the core courses, not as an elective course, in the curriculum.

Bibliometric Patterns of Research Literature Production on Nursing Informatics Competence

Nursing informatics competence is a prerequisite for successful information management, evidence-based practices optimizing patient care health promotion, and communication with information communication technology-literate patients. The aim of this study was to assess the trends in the production of nursing informatics competence research literature and to identify the most productive bibliometric entities. In addition to the correspondence analysis, bibliometric analysis and mapping were used to achieve the aim. A total of 366 information sources were extracted, 14.5% of which were sponsored studies. The production of research literature on nursing informatics competence is growing, but this research is only occasionally published in the most recognized nursing journals. Identifying where the intensive research on nursing informatics competence is beneficial to care for the patient of the future and building user-friendly online lifelong learning platforms, where a required level of nursing informatics competence could be acquired, are two gaps in the current research that should be covered in future.

간호정보역량이 간호사의 직무만족 및 간호업무성과에 미치는 영향

This study carries out a declarative survey research designed to ascertain nursing informatics competency, job satisfaction and nursing performance of nurses and investigates the influence of nursing informatics competency on job satisfaction and nursing performance. The research was performed with 274 nurses who have been working for at least 6 month in P national university hospital in Y city, during the 30-day period of 15th October 2014 to 15th November 2014, using a questionnaire composed of questions on nursing informatics competency(30 items), job satisfaction(20 items), and nursing performance(23 items). The collected data underwent descriptive statics, t-test, ANOVA and Scheffe`test. Pearson correlation coefficients were also obtained and a stepwise multiple regression was performed by the SPSS WIN 19.0 program. The regression coefficient is positive between nursing informatics competency and conducting an information search(${\beta}

Competencies and Barriers to the Use of Nursing Informatics among Nurses in Primary, Secondary and Tertiary Healthcare Facilities in Nigeria

Background and Purpose: Nurses have always been at the forefront of patient’s care and are expected to provide safe and quality care that is moderated by technology to consumers of health care. To meet these expectations, nursing informatics competencies are critical and essential for nursing practice. This study explored nurses’ knowledge, perception of their competencies and the barriers to the use of nursing informatics at the three levels of care in a State in Nigeria. This was done with the purpose of collecting baseline data to inform intervention for knowledge update and enhanced use of nursing informatics in practice. Methods : Adopting a cross sectional survey design, data was collected from 350 nurses from 1 tertiary, 6 secondary and 30 primary health care facilities using multistage sampling technique from 6 towns that have at least two out of the three categories of health care facilities in the State,. Proportionate samples were drawn based on the population of nurses in the 3 categories of health facilities with 175 from tertiary, 115 from secondary, and 60 from primary health care facilities. Results : The result showed a fair knowledge of nursing informatics by 55.4% of the respondents. In each of the three levels of competency, respondents perceived themselves as ‘competent’ and ‘not competent’ based on their self assessment. ‘Limited access to computer’ was the most perceived barrier by 55% of respondents to the utilization of nursing informatics. Conclusions : The study concluded that the competency of nurses in nursing informatics is poor due to various perceived barriers. Keywords: Competencies Informatics Barriers Nurses Nigeria

Measuring nursing informatics competencies of practicing nurses in Korea: Nursing Informatics Competencies Questionnaire.

Informatics competencies are a necessity for contemporary nurses. However, few researchers have investigated informatics competencies for practicing nurses. A full set of Informatics competencies, an instrument to measure these competencies, and potential influencing factors have yet to be identified for practicing nurses. The Nursing Informatics Competencies Questionnaire was designed, tested for psychometrics, and used to measure beginning and experienced levels of practice. A pilot study using 54 nurses ensured item comprehension and clarity. Internal consistency and face and content validity were established. A cross-sectional survey was then conducted on 230 nurses in Seoul, Korea, to determine construct validity, describe a complete set of informatics competencies, and explore possible influencing factors on existing informatics competencies. Principal components analysis, descriptive statistics, and multiple regression were used for data analysis. Principal components analysis gives support for the Nursing Informatics Competencies Questionnaire construct validity. Survey results indicate that involvement in a managerial position and self-directed informatics-related education may be more influential for improving informatics competencies, whereas general clinical experience and workplace settings are not. This study provides a foundation for understanding how informatics competencies might be integrated throughout nurses' work lives and how to develop appropriate strategies to support nurses in their informatics practice in clinical settings.

Why Nurses Need to Understand Nursing Informatics

N ursing informatics is an exciting nursing specialtydit affects learning environments, meaningful use, interprofessional collaboration, patient care settings, strategic planning, patient satisfaction, and, ultimately, patient outcomes. Simply put, nursing informatics is the practice of using nursing science and technology to enhance the pathway that data take to become knowledge to improve patient care. Furthermore, nursing informatics “is the synthesis of nursing science, information science, computer science, and cognitive science for the purpose of managing and enhancing health care data, information, knowledge, and wisdom to improve patient care and the nursing profession.” According to Hebda and Czar, it is “broadly defined as the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research. The definition of nursing informatics is evolving as advances occur in nursing practice and technology.” Nursing informatics is important to all nursing specialty areas. It is important for nurses to understand the relevance of nursing informatics to their practice. In clinical practice, for example, nursing informatics can be used to track patient outcomes, find data trends, and assess workload and interventions. It also can help develop technologies, such as apps, to help health care workers virtually monitor and stay in touch with patients, improve workflows, and help patients deal with their diseases. The use of nursing informatics in nursing education supports virtual teaching and learning, assessment, analytics associated with educational outcomes, and the paradigm shift of bringing the library to the student virtually. Nurse executives use nursing informatics to help them with cost containment, improved workflows, decision support, budgeting tools, and trending costs and savings. Nursing informatics also can facilitate and support nursing research by evaluating patient outcomes, evidence-based practice, standardized terminologies, and virtual knowledge bases. As nurses learn nursing informatics, they must learn to use all information technologies effectively, recognize the benefits and limitations of this technology, and integrate them into how they implement these technologies. In this era of large amounts of data, nursing informatics competencies are key to safe, efficient, and quality practice, and good use of nursing informatics can result in enhanced patient care outcomes.

An instrument for assessing advanced nursing informatics competencies

Background/Objective: Researchers set out to develop reliable, valid instruments for nurses to self-assess nursing informatics (NI) competencies at the basic and advanced levels. The focus of the research presented in this article is measurement of competencies at the advanced level, which includes Level 3, the informatics specialist and Level 4, the informatics innovator. Informatics competencies are critical in the technology-rich healthcare delivery system. Nurse leaders experienced in informatics need to be prepared to consistently mentor nurses to use health information technology (HIT) in ways that foster continual growth in nursing informatics competencies. This article addresses the research problem, the concept of competency, previous work on NI assessment, instrument development, and pilot results. Methods: Resulting items from round one and two were reworded to reflect measurable behaviors then subjected to a third round of reviews to establish content validity, using the content validity index (CVI). The Nursing Informatics Competency Assessment L3/L4 (NICA - L3/L4) © instrument development began with a synthesis of seminal and current literature. Participants were asked to rate themselves in one of the categories for each item: beginner or N/A, comfortable, proficient or expert. The NICA-L3/L4© instrument was piloted following Institutional Review Board (IRB) approval using a purposeful, convenience sample from the NI community. Results: For NICA-L3/L4©, the CVIs demonstrated strong content validity and the Chronbach’s alpha showed high internal consistency. The initial data from both the Delphi and pilot studies indicated the need for self-assessment of NI competencies. Conclusion: Results of this study indicate that continued education in NI is necessary to reach the level of nurse innovator, a Level 4 competency. As the healthcare system continues to rely on electronic means of gathering, storing, and retrieving data, self-assessment of informatics competencies is key to providing a benchmark for the identification of skills that require further development.

Perspectives from nurse managers on informatics competencies.

Background and Purpose. Nurse managers are in an excellent position for providing leadership and support within the institutions they serve and are often responsible for accessing information that is vital to the improvement of health facility processes and patients' outcomes. Therefore, competency in informatics is essential. The purposes of this study are to examine current informatics competency levels of nurse managers and to identify the variables that influence these competencies. Methods. A questionnaire designed to assess demographic information and nursing informatics competency was completed by 68 nurse managers. Multiple linear regression analysis was conducted to analyze the factors influencing informatics competency. Results. Descriptive analysis of the data revealed that informatics competency of these nurse managers was in the moderate range (77.65 ± 8.14). Multiple linear regression analysis indicated that level of education, nursing administration experience, and informatics education/training were significant factors affecting competency levels. Conclusion. The factors identified in this study can serve as a reference for nurse managers who were wishing to improve their informatics competency, hospital administrators seeking to provide appropriate training, and nursing educators who were making decisions about nursing informatics curricula. These findings suggest that efforts to enhance the informatics competency of nurse managers have marked potential benefits.

Developing nurse educators’ computer skills towards proficiency in nursing informatics

The purpose of this paper is to assess nurse educators’ competence development in nursing informatics (NI) and to compare their competence to the NI competence of other healthcare professionals. Electronic health records (EHR) have been in use for many years. However, the adoption of the nursing care plan finally made it possible for nurses in Finland to develop a model for structured documentation with nursing terminology. A total of n = 124 (n = 85 pre-test and n = 39 post-test) participants from Universities of Applied Sciences (UAS), hospitals, hospitals’ information management and health centres were surveyed with a e-questionnaire designed to assess the development of their NI competences during the nursing documentation development project. The questionnaire included 145 structured questions and 6 open questions. Data analysis focused on classification and comparison of NI competences through data description and statistical parameters using figures and tables. The basic NI competences of the nurse educators were good at the end of project and the nurse educators had better information literacy and information management competences than other participants. The information retrieval skills varied greatly, but they improved evenly towards the end. The nurse educators mastered better evidence-based nursing and use of nursing process models in their work.

Self-Assessment of Nursing Informatics Competencies for Doctor of Nursing Practice Students

This study examined the informatics competencies of doctor of nursing practice (DNP) students and whether these competencies differed between DNP students in the post-baccalaureate (BS) and post-master's (MS) tracks. Self-reported informatics competencies were collected from 132 DNP students (68 post-BS and 64 post-MS students) in their first year in the program (2007 to 2010). Students were assessed in 18 areas of 3 competency categories: computer skills, informatics knowledge, and informatics skills. Post-BS students were competent in 4 areas (computer skills in communication, systems, documentation, and informatics knowledge about impact of information management), whereas post-MS students were competent in only 1 area (computer skills in communication). Students in both tracks reported computer skills in decision support as their least competent area. Overall, post-BS students reported slightly higher than or similar competency scores as post-MS students, but scores were statistically significant in only 3 of 18 areas. The assessment indicated that knowledge and skills on informatics competencies need to be improved, especially in computer skills for data access and use of decision support systems. Strategies are suggested to integrate competencies into existing informatics course and DNP curricula. Further studies are recommended using an objective measure of informatics competencies.

Nursing informatics competencies: assessment of undergraduate and graduate nursing students

To report the informatics competencies of students in selected undergraduate and graduate nursing programmes, to examine whether informatics competencies differed between the different programmes and to suggest competency-based applications that will strengthen informatics courses and informatics-related content throughout the curricula. Nursing students in undergraduate and graduate nursing programmes have different educational backgrounds and different practice experience. Thus, their informatics preparation is apt to be varied, and nursing curricula must reflect this variation while advancing students towards informatics proficiency. However, studies on informatics competency assessment in these nursing students are scarce. A descriptive survey design. Data were collected from 289 nursing students using a 30-item Self-Assessment of Nursing Informatics Competencies Scale via an email sent to students using a LISTSERV mailing list. The email embedded link to the Internet survey package, SurveyMonkey, which included the Self-Assessment of Nursing Informatics Competencies Scale and demographic questions along with an online consent form. Students in both programmes were competent in three subscale areas: basic computer knowledge and skills, clinical informatics attitude, and wireless device skills. Graduate students reported slightly higher mean competency scores than did undergraduate students in three subscales: clinical informatics role, clinical informatics attitude and wireless device skills. Findings indicate specific topics for nurse educators to consider when designing informatics curricula. The comparison of undergraduate and graduate students indicates similarities in informatics competencies in terms of areas where students were competent and small mean score differences. Further studies are suggested to examine whether there are differences in informatics competencies between undergraduate and graduate students. These results assist nurse educators in determining specific areas of informatics content that need greater focus and inclusion in the design of better nursing educational programmes. Examples of integrating competencies into existing curriculum or informatics courses are suggested.

TIGER-based measurement of nursing informatics competencies: The development and implementation of an online tool for self-assessment

Background/Objective: The aim of this research was to develop a reliable, valid instrument for self-assessment of perceived nursing informatics (NI) competencies. This article describes the development and validity assessment of the instrument. Informatics competencies are deemed a necessity in today’s technologically-rich healthcare delivery system. Work to identify essential informatics skills commenced shortly after the introduction of information technology into healthcare. In subsequent years, professional organizations and individual experts have established NI competencies needed at various levels of nursing practice, from entry level through advanced practice. The Technology Informatics Guiding Educational Reform (TIGER) Initiative represents one such effort. The TIGER Initiative emerged in 2006 as a grassroots effort dedicated to the preparation of a clinical workforce capable of using information technology and informatics to improve the delivery of healthcare. TIGER quickly organized into several different collaborative groups, including one that identified a set of recommended informatics competencies for nurses in 2009. The TIGER effort listed NI competencies in three areas: basic computer skills, information literacy, and clinical information management but did not operationalize these competencies into an instrument that could be used for assessment purposes. Methods: Three rounds of reviews were conducted. In the first review, the researchers examined TIGER competencies, removing duplicative terms and combining items with similar content. The second and third rounds of reviews were each done by two separate sets of three experts in nursing informatics. During the second round, the list from round one was examined for items to retain or add. Resulting items were reworded to reflect measurable behaviors and then subjected to a third round of reviews to establish content validity, using the content validity index (CVI) methodology. Results: CVIs demonstrated moderate validity for the instrument, and items not deemed relevant to the objective of the instrument were deleted, reducing the number of the items on the instrument. The instrument was piloted by posting the invitation on the online discussion forum of a nursing informatics organization. An additional invitation was extended to a group completing a weekend-long NI course. There were 184 respondents. Most respondents ranked themselves as expert on the majority of items, although a lesser degree of confidence was seen with items related to information literacy Conclusions: TIGER competencies provided a useful foundation for the creation of a feasible online instrument for self-assessment of levels of competency. Fewer respondents identified themselves as expert in information literacy competencies. The instrument developed for this research project could be useful in planning educational opportunities in NI.

Information literacy during entry to practice: Information-seeking behaviors in student nurses and recent nurse graduates

The ability to locate information pertinent to guide clinical practice is important for quality nursing care and patient safety. To date, little is known about the transfer of information literacy skills as student nurses transition to clinical practice as new graduates. This study begins to address this gap from the perspective of student nurses, recent nurse graduates (RNs), nurse leaders and library staff. To describe the information-seeking behaviors of student nurses and RNs within their clinical settings. This is a descriptive study that included both cross-sectional surveys and key informant interviews. Participants were senior-level undergraduate students and recently graduated RNs (graduated since 2008), and nurse leaders and library staff employed in one of the clinical sites accepting undergraduate students from the McMaster Mohawk and Conestoga BScN program. The study was completed in two large hospital corporations in Hamilton, Ontario, Canada. Student nurses and RNs were invited to complete online surveys to assess their access to and use of information sources and resources within clinical practice. Students completed a survey comprised of five open-ended questions, while RNs completed a survey comprised of 13 fixed choice and open-ended questions. Nurse leaders and library staff participated in qualitative interviews to verify the extent and availability of information resources. Eighteen RNs and 62 students completed their respective surveys. Three categories of information sources and resources were identified: electronic, print and interpersonal. Electronic sources of information were the most used resource by both students and RNs. More RNs reported using interpersonal sources, while students reported using more print sources of information. Recent RN graduates meet the Canadian Association of Schools of Nursing performance indicators related to information access for the entry to practice Nursing Informatics competencies.

Validation of the Self-Assessment of Nursing Informatics Competencies Scale Among Undergraduate and Graduate Nursing Students

This study investigated the psychometrics of the Self-Assessment of Nursing Informatics Competencies Scale for nursing students in undergraduate (n = 131) and graduate (n = 171) programs. The scale had a valid five-factor structure, accounting for 69.38% of the variance, high internal consistency reliabilities (0.96 for the total scale and 0.84 to 0.94 for subscales), and good responsiveness (standardized response mean = 0.99), as well as significantly improved scores in nursing students with diverse demographic and educational backgrounds after taking an informatics course. Our factor structure was similar to the original scale, differing slightly in four items' loadings. This difference may reflect current informatics practice or the greater diversity of our sample. Further research is needed on the factor, data/information management skills, and related item loadings. This scale could be used to assess informatics competencies and develop educational strategies that prepare nursing students as informatics-competent graduates in information technology-rich environments.