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Nursing's Problematic Informatics

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When many nurses reflect on ethical dilemmas, the topics of dying patients or the equitable distribution of medical services immediately come to mind, but there are many other issues nurses face that are just as important and complex.

One such problem is the lack of nursing informatics skills and technology competencies.

Despite using technology daily, many nurses do not have the skills needed to practice effectively, safely and competently within the nursing profession in the 21st century.

Informatics Competency

In addition to possessing good clinical skills, competent nurses must have excellent technology skills, or at the bare minimum should possess basic computer skills, which will allow the nurse to work efficiently and safely within nursing.

Examples of these basic technology skills are:  

  • the ability to protect patient privacy within a paperless environment;
  • the capability to document properly within an electronic health record (EHR);
  • the aptitude to use software applications, and
  • the ability to use bar code technology to administer medications.1

Establishing nursing informatics competency standards is necessary so that nursing administrators and educators understand and recognize what skills are needed for different nursing positions.

Currently, little research is available regarding what basic computer science and informatics technology competencies are needed within nursing.

While dated, Staggers, Gassert, and Curran (2001) determined informatics competencies for nurses functioning at four different levels of practice. Their study found entry-level nurses must have informatics skills in areas that include e-mail, telecommunications, the Internet, basic keyboarding, word processing and documentation within an EHR.

As nurses progress throughout their careers, informatics competencies should increase and include the ability to use and manage databases for administrative, education and research purposes. Nurses able to manage projects with software applications, develop and modify spreadsheets, teach others to use computers, and discover innovative uses for computer applications as it relates to nursing, may be considered an informatics specialist.2

Hospital and nursing administrators need to understand what levels of informatics competencies are needed within the different roles in nursing, as this can help facilitate the recruiting and promotion of nursing professionals. Informatics competency standards can help ensure the right person is selected for a position and improve patient safety and nursing job satisfaction and retention.

Integration into Education

One way to increase nursing informatics competency within the nursing profession could begin by employing such courses within nursing school curricula.

Ornes and Gassert (2007) noted that entry-level nurses who are competent with technology while in a nursing program are likely better prepared to function as a novice nurse upon graduation.

Nursing schools must evaluate the curricula and begin the integrating nursing informatics education. In addition, nursing schools should evaluate the informatics competency of nursing instructors to ensure they understand the technology and can teach the subject effectively.1

Axley (2008) furthered this idea, stating educators who did not grow up with technology often face the same challenges as students. Teaching and understanding nursing informatics and technology can be difficult to achieve if the person providing the education lacks the needed skills as well.

Additionally, Axley noted that the digital age is growing rapidly and that it is critical for faculty to understand informatics technology competency is critical. Nursing informatics competency also must be a focus for education administrators as increasing the technological competency of the nurse educator can increase faculty retention and enhance student learning.4

Lindemann (as cited in Glasgow & Cornelius 2005) stated that nursing faculty must be efficient and competent with technology so the nursing student is prepared to function in a technology driven healthcare environment upon graduation.


Nursing's Problematic Informatics

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Thank you for supporting my ideas outlined in this article.

Understanding how nursing informatics influences the nursing profession can help improve patient outcomes and nursing job satisfaction. As the electronic health record and other software applications become integrated into health care, nursing must understand and develop informatic competencies/standards that will ensure nurses are working safely and competently. According to the American Nurses Association (2008) set minimum informatic competencies are needed for all practice levels of nursing and the introduction of nursing informatics should begin within nursing education programs.

Thanks,
Sue Hamilton Hill

Reference

American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.



Susan Hamilton Hill,  Informatics NurseJuly 16, 2009
Dayton, OH



Excellent article on nurses need for better technology skills in healthcare. As we progress further with telehealth and telecommunication technologies in the healthcare environment increased knowledge and technology skill sets will be needed.

Diane Castelli, RN, MS,MSN,  Director of Clinical Training,  AMD Global Telemedicine, Inc.July 15, 2009
North Chelmsford, MA



The NLN could not agree more with Ms. Hamilton-Hill’s proposal that nursing schools need to begin integrating nursing informatics into the curriculum. In 2006, an NLN task group developed a survey to determine the extent to which informatics was included in the curriculums of all types of nursing education programs. Results clearly demonstrated that “while most schools of nursing focused on computer and information literacy, there was considerable confusion as to what nursing informatics entails and what constitutes the necessary knowledge to practice in an informatics-rich environment.” (quote from our Pos. Statement). In response, the NLN developed a position statement, "Preparing the Next Generation of Nurses to Practice in a Technology-Rich Environment: An Informatics Agenda," with recommendations for administrators, faculty, and the NLN to work toward preparing the next generation of nurses with the necessary informatics competencies to provide safe and quality care.

The NLN also established a task group to formulate a comprehensive plan for faculty development related to the integration of informatics into the nursing curriculum. Furthermore an NLN staff member has been involved in the Technology Informatics Guiding Education Reform (TIGER) initiative, formed in 2004 to “bring together nursing stakeholders to develop a shared vision, strategies, and specific actions for improving nursing practice, education, and the deliver of patient care through the use of health information technology (TIGER 2007).” The TIGER Education and Faculty Development Collaborative emerged from recommendations at the TIGER Summit to focus on faculty development and pre-licensure education of nurses. This group recently completed one phase of its work and a summary is included in the executive summary of TIGER’s work (2009).

Mary Anne Rizzolo, EdD, RN, FAAN
Senior Director, Professional Development
National League for Nursing

References:

National League for Nursing (2008), Preparing the Next Generation of Nurses to Practice in a Technology-Rich Environment: An Informatics Agenda, [Online]. Available www.nln.org/aboutnln/PositionStatements/informatics_052808.pdf

Thompson B, Skiba D (2008). Informatics in the nursing curriculum: A national survey. Nursing Education Perspectives, 29 (5), 312-316.

Technology Informatics Guiding Education Reform. (2007). The TIGER Initiative: Evidence and informatics transforming nursing: 3-year action steps toward a 10-year vision. [Online]. Available: www.tigersummit.com/.

TIGER (2009): The TIGER initiative: Collaborating to integrate evidence and informatics into nursing practice and education: An executive summary. [Online]. Available http://www.tigersummit.com/



Mary Anne Rizzolo,  Senior Director, Professional ,  National League for NursingJuly 14, 2009
New York, NY




     

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