Informatics competencies essential to decision making in nursing management

A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations

Introduction

One vital strategy for the success of healthcare organisations currently resides in the capacity of the nurse managers (NMs) to develop informatics competencies in management.

Aim

The aim of this review was to synthesise the evidence related to the informatics competencies of NMs in healthcare settings.

Methods

The databases of PubMed, Web of Science, Scopus and Education Resources Information Center were searched. All publications were accepted if they had been published in English and full texts were accessible. The study was carried out using a systematic literature search of work published between January 2000 and December 2021. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications was carried out independently by two reviewers using the Critical Appraisal Skills Programme guidance. A descriptive summary with data tables was produced to summarise the literature.

Results

After screening the search results, 12 studies published between the period 2001 and 2019 met the inclusion criteria. Analysis of the included studies led to the classification of informatics competencies in three main themes: skills related to work with computers (four sub-themes), informatics skills of NMs (three sub-themes) and knowledge of NMs about informatics (five sub-themes).

Conclusion

These systematic review results can lead to the identification of informatics competency gaps and recommend and provide solutions to address these gaps and increase competencies for nursing managers.

POTENCIALIDADES E DIFICULDADES DA MEDIAÇÃO TECNOLÓGICA NO TRABALHO DE ENFERMEIROS GESTORES EM HOSPITAIS

RESUMO Objetivo descrever potencialidades e dificuldades mencionadas por enfermeiros gestores no uso de tecnologias em hospitais. Método estudo qualitativo, descritivo-exploratório, realizado no período de um ano, 2019 a 2020, no Brasil e Portugal, em quatro hospitais. Os dados foram coletados através de entrevistas, seguindo roteiro semiestruturado, envolvendo 71 enfermeiros gestores. Para análise dos dados utilizou-se recursos do software ATLAS.ti, seguindo preceitos da análise de conteúdo temática e da teoria do processo de trabalho. Resultados enfermeiros gestores consideram que tecnologias contribuem para melhoria dos processos institucionais, registro de informações, gestão do tempo, armazenamento dos dados e segurança do paciente. Dentre as dificuldades destacaram problemas relacionados aos próprios instrumentos de trabalho, como: a falta de equipamentos/computadores, lentidão e falta de integração de sistemas; e relacionados à força de trabalho, como: gestão do tempo, adaptação cultural, falta de conhecimento e capacitação para utilizar a tecnologia. Conclusão tecnologias inovadoras contribuem para o trabalho de gestão, mas sua efetividade depende de capacitação, quantitativo adequado de profissionais, além de equipamentos e sistemas de informação eficientes e integrados.

POTENTIALITIES AND DIFFICULTIES OF TECHNOLOGICAL MEDIATION IN THE WORK OF NURSE MANAGERS IN HOSPITALS

ABSTRACT Objective to describe the potentialities and difficulties mentioned by nurse managers in the use of technologies in hospitals. Method qualitative, descriptive-exploratory study, conducted in the period of one year, 2019 to 2020, in Brazil and Portugal, in four hospitals. Data were collected through interviews, following a semi-structured script, involving 71 nurse managers. For data analysis, resources of the ATLAS.ti software were used, following the precepts of thematic content analysis and work process theory. Results nurse managers consider that technologies contribute to the improvement of institutional processes, information recording, time management, data storage and patient safety. Among the difficulties, problems related to the work instruments themselves are highlighted, such as lack of equipment/computers, slowness and lack of systems integration; and related to the workforce, such as time management, cultural adaptation, lack of knowledge and training to use technology. Conclusion innovative technologies contribute to management work, but their effectiveness depends on training, adequate number of professionals, in addition to efficient and integrated equipment and information systems.

Information and communication technologies: interfaces the nursing work process

OBJECTIVES

to unveil the meanings that nurses attribute Information and Communication Technologies for the nursing work process.

METHODS

qualitative research, theoretically and methodologically based on the Complexity Theory and on the Grounded Theory, respectively. Research with 19 participants, being 12 clinical nurses, and 7 resident nurses. Semi-structured interviews were used for data collection.

RESULTS

the results revealed the meanings that clinical nurses attribute to Information and Communication Technologies and, thus, the motivations and limitations for the use of these technologies, pointing out possibilities and strategies that impact the nursing work process, based on the interactions promoted by the official and non-official use of these resources.

FINAL CONSIDERATIONS

the meanings that nurses attribute to Information and Communication Technologies are dependent on their ability to successfully employ those technologies and their importance to the work process developed by the professionals.

Approaches for defining and assessing nursing informatics competencies: a scoping review

OBJECTIVE

The objective of this scoping review was to examine and map the literature on defining and assessing nursing informatics competencies for nurses and nursing students.

INTRODUCTION

Over the past three decades, nursing informatics competency research has evolved markedly within countries and nursing roles. It is important to examine the available literature on defining and assessing nursing informatics competencies to inform education, clinical practice, policy, and future research.

INCLUSION CRITERIA

We considered literature that defined or assessed the concept of nursing informatics competency as a combination of knowledge, skills, and attitudes. This included nursing informatics competencies of nurses and nursing students in a variety of health care or academic settings.

METHODS

An extensive search was conducted in Ovid MEDLINE, CINAHL Plus with Full Text via EBSCO, Ovid Embase, Ovid PsycINFO, ProQuest ERIC, Health and Psychosocial Instruments, ProQuest Australian Education Index, ProQuest Education Databases, ProQuest Dissertations and Theses Global, OCLC PapersFirst, Scopus, Web of Science Core Collection, Wiley Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and the JBI Database of Systematic Reviews and Implementation Reports. The initial search was conducted in May 2017 and updated several times. Nursing informatics websites were searched for gray literature, including unpublished research and organizational documents. Additional papers were identified based on a search of reference lists of all the included papers. Neither language nor date restrictions were applied. Two reviewers assessed each of the included papers independently. Data extraction was undertaken using an extraction tool developed specifically for the scoping review objectives.

RESULTS

Fifty-two papers were included. Thirty-four papers identified nursing informatics competencies, grouped into four categories: i) nursing informatics competencies for students, entry-level nurses, or generalist nurses; ii) nursing informatics competencies for a specific nursing role; iii) recommendations for consensus on defining core nursing informatics competencies at the international level; and iv) forecasting future nursing informatics competencies as per evolving nursing roles. Eighteen papers reported on nursing informatics competency assessment tools. Results were discussed in a narrative format supported by tables.

CONCLUSIONS

This review provided insights to the state of the science on defining and assessing nursing informatics competencies for nurses and nursing students. Several nursing informatics competency lists are available, and despite some variations in domains of nursing informatics competency and indicator statements, they mostly share common themes. This literature demonstrates a heightened awareness of the importance of nursing informatics competency; however, the availability of many lists may be challenging for frontline nursing staff, nursing educators, administrators, researchers, and students to assimilate. Further research is needed to reach a consensus on core domains of nursing informatics competency and associated indicators, preferably per nursing roles, with international involvement and consensus. Additionally, while many nursing informatics competency assessment tools exist, further research is needed to examine psychometric properties of some of these tools.

Designing a national model for assessment of nursing informatics competency

Background

Due to the need for informatics competencies in the field of nursing, the present study was conducted to design a psychometric instrument to determine the qualification of informatics competencies of employed nurses in educational care centers.

Methods

The questionnaire was made by reviewing existing scientific resources and assessment tools. Two hundred nurses were selected using simple random sampling. Structural equation modeling was used using the measurement model technique and the average variance was calculated. Linear structural relations (LISREL) software was used to test the assumptions and correlations of the model.

Results

Findings showed relatively good estimation in the fit of first-order measurement model. The informatics knowledge subscale with a determining rate of 0.90 had the greatest explanatory effect among the subscales and informatics skill with a determining rate of 0.67 and basic computer skill with a determining rate of 0.60 were observed. The second-order measurement model of fitness indicators showed that the three factors can well explain the multidimensional construct of informatics competency.

Conclusions

The designed tool can be used to develop educational strategies in relation to nursing students in the field of informatics and prepare them in the rich environment of information technology, which can be helpful in training nursing instructors.

Issues affecting nurses' capability to use digital technology at work: An integrative review

BACKGROUND

Digital capability, that is the ability to live, work, participate and thrive in a digital world, is imperative for nurses because increasingly nurses' work and patient outcomes are influenced by technology.

AIM

To evaluate and synthesise the evidence regarding the development of digital capability in nurses and the strategies that support effective integration of digital skills into the workplace.

DESIGN

Whittemore and Knafl's methodology, following the preferred reporting items for systematic reviews (PRISMA) guidelines.

DATA SOURCES

CINAHL, Embase, PsychINFO, Medline (Ovid) and PubMed databases were searched for articles published in English from 2008-2019. Search terms included; digital capabil*, digital literacy, informatics, nursing informatics, health informatics, nurs*, knowledge, knowledge integration, competency, continuing education, nursing skills, workplace and work environment.

REVIEW METHODS

A total of 35 studies were retrieved for quality assessment by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute (JBI-MAStARI and JBI-QARI). Minimum essential criteria and scores were agreed prior to appraisal.

RESULTS

The 17 studies included comprised quantitative (n = 7), qualitative (n = 8) and mixed methods (n = 2). Integration of digital capability in nurses' workplaces is dependent on user proficiency and competence (theme 1). Nurses use technology to access data at the point of care, specifically accessing evidence to guide care (theme 2a) as well as accessing the medical records (theme 2b). Nurses have several concerns related to the use of technology at point of care (theme 3), some of which can be resolved through investment for implementation (theme 4).

CONCLUSIONS

There are key attributes of digitally proficient nurses. Nurses with these attributes are more inclined to use digital technology in their work. Involvement of the nurses as end users in the development of digital systems to ensure they are fit for purpose, alongside investment in professional development opportunities for nurses to develop digital capability, should be prioritised.

Technologies used by nursing managers in Portuguese hospitals

ABSTRACT Objective: To analyze the association between the characteristics of nurse managers and the use of information technologies in Portuguese hospitals. Method: A cross-sectional quantitative study involving 138 nurse managers. The managers answered a questionnaire about the use of key information and communication technologies in management. The findings were submitted to descriptive and analytical statistical analysis. Results: Women predominated, with more than 25 years in the profession and more than ten in management. It showed that the managers identify the utility and easiness of a singular way for each technology, the use of which is influenced by the nurses' socio-occupational characteristics, their gender, specialization (having it or not), and the time of experience in services and management being significant. Conclusion: The study contributes to explain and predict the intention to use, as well as the mastery of technologies in hospital management, providing support of choice in the management of services and need for qualification for use.

Electronic and manual registration of Manchester System: reliability, accuracy, and time evaluation

OBJECTIVE

to evaluate the degree of reliability, accuracy and timing to perform the Manchester Triage System in electronic and manual records.

METHOD

exploratory-descriptive research. Case series corresponded to a total of 20 validated simulated clinical cases applied to a sample of 10 nurses. For data collection each participant received 4 clinical cases in 2 different phases of the study, using manual and electronic registration. The variables related to the triage were: incomplete data filling, discriminator, flowchart, priority level, vital signs and triage timing.

RESULTS

moderate reliability for choosing flowcharts and substantial reliability for determining discriminators in both records; substantial and moderate, for priority, respectively, in manual and electronic registration. For vital signs, it was weak in manual recording and substantial in electronic. Accuracy showed a statistically significant difference related to vital signs. The average timing on triage was shorter with the use of electronic registration.

CONCLUSION

the use of electronic registration has advantages regarding reliability, accuracy and timing to perform the triage, pointing to the importance of adopting technologies in the management and care work process in health services.

Informatics Competencies for Nurse Leaders: A Scoping Review

OBJECTIVE

To consolidate informatics competencies for nurse leaders.

BACKGROUND

Nurses in leadership positions with financial and human resource responsibilities have the capacity to shape how technologies are selected, implemented, and used. Many nurse leaders are not equipped with the essential informatics competencies to do so effectively. There have been efforts to identify a set of standard informatics competencies that should be core to every nurse leader's suite of capabilities; nonetheless, these efforts have yet to be disseminated widely.

METHODS

A scoping review was conducted by: 1) identifying the research questions; 2) identifying relevant studies; 3) selecting studies; 4) extracting collected data; and 5) reporting the results.

RESULTS

Fifteen articles were found, and 11 competency themes related to informatics knowledge, informatics skills, and others were identified.

CONCLUSION

Findings of this review can be used to support nursing leaders in their identification of gaps in their informatics knowledge and skill.

Avaliação da acurácia diagnóstica em enfermagem: papel versus sistema de apoio à decisão

Resumo Objetivo Comparar o grau de acurácia dos diagnósticos de enfermagem determinados, por graduandos de enfermagem, em sistema de apoio à decisão e manuscrito. Métodos Estudo descritivo-exploratório com amostra de 17 graduandos de enfermagem. Realizada coleta de dados por meio de formulários de caracterização dos graduandos e de um caso clínico, validado previamente, para a indicação dos diagnósticos no sistema e manuscrito. Avaliada a acurácia diagnóstica por meio da Escala de Acurácia de Diagnósticos de Enfermagem (EADE) e de testes não paramétricos. Resultados Houve significância estatística nos diagnósticos altamente acurados (p=0,013), quando os graduandos utilizam o sistema de apoio à decisão, demonstrando a determinação de diagnósticos mais acurados em estudos de caso clínicos. Conclusão A utilização de sistemas de apoio a decisão favorece a acurácia diagnóstica de enfermagem e infere-se que pode apoiar o raciocínio clínico de graduandos de enfermagem.