A Canadian Perspective on Nursing Informatics

by Dr Lynn Nagle, Senior Editor

Citation

Nagle, L. (2013). Making Informatics Competency Development Explicit.  Online Journal of Nursing Informatics (OJNI), 17 (1), Available at  http://ojni.org/issues/?p=2382

COLUMN

“Whether recognized or not, in today’s world, informatics is simply a part of every faculty member’s tool kit. Therefore, it should not be offered or developed as a separate course. Rather it should be integrated with approaches to the theoretical and practical teachings in every course” (Nagle, 2007, p. 24).

Nurses are being increasingly supported but also challenged by the integration of information and communication technology (ICT) in clinical settings across the globe.  To this end, it behooves the profession to prepare nurses to effectively and appropriately use these tools, to recognize the potential benefits and risks, but also appreciate the opportunities for the profession into the future. Notwithstanding employers’ efforts to train nurses and other health professionals in the use of electronic record applications and associated tools, demonstrating an understanding of functionality and or mastery of technical operations does not alone constitute acceptable competence. Indeed nursing graduates require a breadth and depth of ICT competency that in this author’s opinion will not and should not be primarily provided by employers. Rather these competencies need to be integrated with the learning of other essential nursing knowledge, concepts and skills in basic nursing education.

Over the last 3 decades, nurse educators and authors have focused efforts on the identification of core informatics competencies for all nurses (Bond & Proctor, 2009; Grobe, 1989; Gassert, 2008; Hebert, 2000; Ornes & Gassert, 2007; TIGER, 1997) as well as advanced competencies for nursing informatics practitioners (American Nurses Association, 2008; Hebert, 2000). Additionally, several studies have identified the need for the inclusion of informatics competencies in entry level nursing programs (Fetter, 2009; McNeil et al 2005; Nagle & Clarke, 2004). Today the incidence of explicit informatics competency development remains a rarity in entry level undergraduate nursing programs in Canada – and dare I say, this situation is likely not that different within schools of nursing elsewhere.  Those actively engaged in this work will readily appreciate the fact that while many informatics concepts and competencies are already embedded in nursing curricula, a majority of faculty would likely not describe them as such. While the attribution of specific knowledge and skills to “informatics” may not be happening and frankly is not at issue here, more importantly there are essential informatics competencies receiving little or no attention in undergraduate programs.

Over the past 18 months with the leadership of the Canadian Association of Schools of Nursing (CASN) and support of funding from Canada Health Infoway, a transformation to this landscape is unfolding. To date, a nationally constituted task force and working groups have focused on: a) delineating informatics core competencies for entry-to-practice, b) identifying informatics resources for nurse educators, and c) developing demonstration models of informatics curricular integration.

This author has been primarily engaged in the competency development work which included an extensive literature review, and the development of competency statements and measureable indicators of each.  The competency development work engaged  informatics experts, nurse educators and other stakeholders who iteratively vetted a number of drafts concluding with the publication of a nationally endorsed set of nursing informatics entry-to-practice competencies in the spring of 2012 (CASN, 2012). The document indicates the need to expect a core set of foundational skills and knowledge for all incoming nursing students while  schools of nursing focus on the provision of learnings that lead to the achievement of an overarching competency:

Uses information and communication technologies to support

information synthesis in accordance with professional and

regulatory standards in the delivery of patient/client care.

The following competencies constitute this statement and each is supported by a number of indicator statements that can be used to evaluate attainment of each (examples of indicators are provided).

Uses relevant information and knowledge to support the delivery of evidence informed patient care (e.g., Articulates the importance of standardized nursing data to reflect nursing practice, to advance nursing knowledge, and to contribute to the value and understanding of nursing).

Uses ICTs in accordance with professional and regulatory standards and workplace policies (e.g., Demonstrates that professional judgement must prevail in the presence of technologies designed to support clinical assessments, interventions, and evaluation).

Uses information and communication technologies in the delivery of patient/client care (e.g., Uses ICTs in a manner that supports (does not interfere with) the nurse-patient relationship).

The complete statement of competencies and indicators is available from the CASN website for download (CASN, 2012).

Although CASN and members of the Task Force will continue to advance this agenda with the delivery of other products of use to nurse educators, there is much opportunity for all of us to continue to be explicit about the importance of this work in adequately preparing nurses now and into the future.

References

American Nurses Association. (2008). Nursing informatics practice scope and standards of practice. Retrieved from http://www.nursingworld.org/HomepageCategory/NursingInsider/Archive_1/2008NI/Jan08NI/RevisedNursingInformaticsPracticeScopeandStandardsofPractice.html

Bond, C. S. & Procter, P. (2009). Prescription of nursing informatics in pre-registration nurse education. Health Informatics Journal, 15(1), 55-64.

Canadian Association of Schools of Nursing (CASN). (2012). Nursing informatics: Entry-to-practice competencies for registered nurses. Retrieved from http://www.casn.ca/vm/newvisual/attachments/856/Media/NursingInformaticsEntryToPracticeCompetenciesFINALENG.pdf

Fetter, M. S. (2009). Curriculum strategies to improve baccalaureate nursing information technology outcomes. The Journal of Nursing Education, 48(2), 78-85.

Gassert, C. A. (2008). Technology and informatics competencies. Nursing Clinics of North America, 43(4), 507-521.

Grobe, S. J. (1989). Nursing informatics competencies. Methods of Information in Medicine, 28(4), 267-269.

Hebert, M. (2000). A national education strategy to develop nursing informatics competencies. Canadian Journal of Nursing Leadership 13(2),11-14.

McNeil, B. J., Elfrink, V. L., Pierce, S. T., Beyea, S. C., Bickford, C. J., & Averill, C. (2005). Nursing informatics knowledge and competencies: A national survey of nursing education programs in the United States. International Journal of Medical Informatics, 74(11-12), 1021-1030.

Nagle, L. M. (2007). Everything I know about informatics I didn’t learn in nursing school. Canadian Journal of Nursing Leadership, 20(3), 22-25.

Nagle, L. M. & Clarke, H. (2004).  Assessing informatics in Canadian schools of nursing. Proceedings 11^th World Congress on Medical Informatics. San Francisco, CA.

Ornes, L. L. & Gassert, C. A. (2007). Computer competencies in a BSN program.  Journal of Nursing Education 46(2), 75-78.

Technology Informatics Guiding Education Reform (TIGER). (2007).  Evidence and informatics transforming nursing: 3-year action steps toward a 10-year vision. Retrieved from http://www.thetigerinitiative.org

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