Nursing informatics knowledge and competencies: A national survey of nursing education programs in the United States

Summary

An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as “novice” and “advanced beginners” in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice.

Introduction

The uses of new and emerging technologies are being considered key to decreasing medical errors and easing the burden of paperwork for the nurse. As healthcare increasingly focuses on timely information to drive decision-making and to support the electronic health record, the use of informatics to support practice must be integrated into nursing education program curricula to prepare graduates for the workforce of which informatics is increasingly an integral part.

The importance of including informatics knowledge and skills within nursing curricula is well supported in nursing literature and by major professional organizations [1], [2], [3], [4]. In 1997, the Division of Nursing of the Health Resources and Services Administration (HRSA) convened the National Nursing Informatics Work Group (NNIWG) comprised of 19 experts in the country to advise the National Advisory Council on Nurse Education and Practice (NACNEP) about priorities for nursing informatics education and practice in the U.S. From these recommendations, the National Informatics Agenda for Nursing Education and Practice was generated as well as recommendations for including core computing and nursing informatics (NI) concepts in nursing curricula [5].

The American Nurses Association recently revised the Scope and Standards for Nursing Informatics Practice [6]. Within these standards, computer literacy skills, information literacy skills and overall informatics competencies are delineated for the beginning nurse, experienced nurse and the Informatics Nurse Specialist. Computer literacy skills include use of word processor, database, and spreadsheet software, and using email and other informatics applications to document care. Information literacy is a skill set that enables the nurse to locate, access and evaluate information. Access includes the ability to conduct bibliographic retrievals and to locate, retrieve, and evaluate information from the Internet. Overall informatics competencies are those that relate to the care of patients such as interpreting patient and nurse information, using informatics applications for nursing and addressing privacy, confidentiality and security of information in nursing practice.

A complete review of the last 15 years of empirical studies addressing the integration of information technology competencies and the progression of information technology in nursing education can be found in the article by Staggers, Gassert and Curran [7]. They concluded that the integration of information technology knowledge and skills into nursing education curricula has been a slow process and that no consistent curricula for nursing information technology exist in nursing education programs. The work of Staggers, Gassert, and Curran has been the most recent work in promoting information technology in nursing education. Using a review of the literature from 1986 to 1998, and input from a panel of NI experts, these authors have developed 304 nursing informatics competencies for four levels of practicing nurses: beginning nurse, experienced nurse, informatics nurse specialist and informatics innovator. The broad categories of competencies and accompanying specific competencies should guide nurse educators in designing curricula to prepare nurses for all levels of professional practice.