The role of nursing informatics on promoting quality of health care and the need for appropriate education

The barriers and challenges of using health information technology in medication administration process for pediatrics and neonates: A qualitative study

Background and Aims

Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision-making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country.

Methods

Semi-structured face-to-face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi's seven-step approach.

Results

The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: "inappropriate management approaches" with two sub-categories ("Managers' reluctance to adopt new technology", "lack of adequate budget for hardware resources"), and "resistance to change" with two sub-categories ("A desire to use conventional (traditional) approaches in care", "cultural issues and impracticality of providing some specialized technology services").

Conclusion

The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved "effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers" interest in using new technology. The present findings can guide the development of more effective and user-friendly HIT systems in pediatric and neonatal care settings.

Evaluation of the nursing informatics competency among nursing students: A systematic review

AIM

This study aims to evaluate the nursing students' informatics competency reported in the literature.

BACKGROUND

Nursing informatics competency holds immense significance in the modern healthcare landscape, making it a vital requirement for nursing students before they graduate and embark on their professional careers. Nurses should integrate evidence-based nursing informatics (NI) into routine procedures to manage acute and chronic illnesses due to the increased complexity of the nursing profession and the healthcare systems.

DESIGN

A systematic review.

METHODS

PubMed, Scopus, Web of Science, and EMBASE were searched till December 2023 for any relevant studies evaluating the nursing informatics competency among students.

RESULTS

In this systematic review of 13 articles, the nursing informatics seems to be familiar among nursing students. Most of the included participants were generally competent, with an average total nursing informatics competency score of 3.4. In addition, they reported good scores for the clinical informatics role (Mean = 2.63), attitude (M= 3.7), basic computer knowledge and skills (M= 3.9), applied computer skills (M= 2.5), and wireless device skills (M= 3.2). However, these results were limited due to the use of structurally different assessment tools and their different cutoff values.

CONCLUSION

Nursing informatics competency has a great impact on the quality of services provided by healthcare systems. It is affected by several factors, such as the student's previous computer experience and the curricular and extracurricular exposure to informatics knowledge and skills. The available literature lacks a precise judgment on the competency of nursing students. But it seems to vary from fair to good among them. So, it is recommended to include nursing informatics as an obligatory course rather than an elective in the nursing baccalaureate. This helps prepare future nurses with the required knowledge and skills for better clinical decision-making.

Refining core competencies of first-line nurse managers in the hospital context: A qualitative study

Objectives

As the world moves towards a new normal, challenges continue to emerge while simultaneously inspiring us with new solutions. Strengthening the skills of first-line nurse managers (FLNMs) to fulfill a wide range of complex roles and responsibilities effectively necessitates refining core competency guidelines or standards. This study aimed to explore the perceived core competencies of Indonesian FLNMs within the context of the post-pandemic era.

Methods

The study employed a qualitative descriptive design. Face-to-face interviews were conducted in a public hospital in Indonesia from January 2022 through August 2022. Seven head nurses with direct experience managing a unit during the COVID-19 pandemic were selected. The interviews were audio-recorded, transcribed verbatim, and validated by re-listening. Data were analyzed using thematic analysis.

Results

Four main themes of the core competencies developed, including 1) managerial core competencies, 2) clinical core competencies, 3) technological core competencies, and 4) socio-emotional skills/personal traits consisting of the following: be brave, fast, patient, optimistic, consistent, and responsible.

Conclusions

The findings demonstrate that the managerial and clinical core competencies of the FLNMs must be aligned, while technological core competencies are the mediating component of both. Personal traits are essential for FLNMs as they undergird the other three core competencies and the success of the FLNMs.

Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis

AIMS

To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS).

DESIGN

A cross-sectional study.

METHODS

A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness.

RESULTS

Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest.

CONCLUSION

Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care.

IMPACT

This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.

Nursing Informatics Competency and Self-Efficacy in Clinical Practice among Nurses in Palestinian Hospitals

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00-2.59), beginner/moderate (2.60-3.39), and competent/high (3.40-5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses' informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

Analysis of the information ability of nurses in county hospitals in northern Henan province: a survey

OBJECTIVE

To investigate the status quo of nursing information ability of nurses in county-level hospitals and analyze its influencing factors.

METHODS

In June 2022, a total of 303 on-the-job clinical nurses from 3 county-level hospitals in Hebi City, Henan Province were selected as subjects by convenience sampling method. General data questionnaire and self-rating nursing information ability scale were used to investigate them.

RESULTS

The total score of nursing information ability of 303 nurses in county hospitals of Hebi City, Henan Province was (77.72 ± 18.76). There were statistically significant differences in the scores of nursing information ability among different ages, working years, positions, education, marriage, monthly income, whether they had learned computer-related knowledge and skills, and whether they had participated in the learning or training of nursing information system (all p < 0.05).Multiple linear regression analysis showed that age, years, position, monthly income and whether they had learned computer-related knowledge and skills were the main influencing factors of nursing information ability of county-level nurses (all p < 0.05).

CONCLUSIONS

The nursing information ability of nurses in county-level hospitals in northern Henan is at a medium level. The government or society should provide training and guidance on nursing information ability, so as to provide more opportunities for nurses in county-level hospitals to participate in and learn nursing information technology to improve their ability.

Improvements in the infrastructure for nursing research in universities in Kazakhstan

AIM

This study aimed to describe the status and analyze the improvements made by universities in Kazakhstan to nursing research infrastructure in the following services: library, internationalization, finance, information and communication technology (ICT), and research, development, and innovation (RDI).

BACKGROUND

In higher education institutions (HEIs), a strong research infrastructure is a necessity for academic education and research. In Central Asian countries, nursing is regarded as an assistive field to medicine, affecting nursing research infrastructures.

METHODS

In this descriptive study, following benchmarking and a recommendations report, an interview of nursing faculty members was used to obtain data regarding nursing research infrastructure in ten universities in Kazakhstan. The SQUIRE-EDU was used to ensure the quality of reporting.

RESULTS

The Kazakhstani universities providing nursing education are still in the process of developing their nursing research infrastructure. They have not acquired access to nursing databases, and only one textbook concerning nursing research can be found from their libraries. None of the universities have joined international nursing networks. The participation of the university staff and students in conferences with nursing themes has increased. The universities are investing in staff capacity building, but not yet in nursing research projects.

DISCUSSION AND CONCLUSION

Kazakhstani universities have the autonomy to develop nursing research and its infrastructure. Active measures by the university management, such as financing access to nursing databases, international cooperation, and international projects, are necessary.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Research infrastructures' quality strongly impacts the development of nursing science and practice in any country. It is crucial to increase the volume of research that demonstrates the effectiveness of clinical nursing and its contribution to health outcomes. To enable the faster development of nursing science in Central Asian countries, this development should be supported through international collaboration.

Global utilization of online information for substance use disorder: An infodemiological study of Google and Wikipedia from 2004 to 2022

INTRODUCTION

The increasing number of people who use drugs (PWUDs) can be attributed to the rising online sales of drugs and other related substances. Information on drugs and drug markets has also become easily accessible in web-search engines and social media. Aside from providing direct care, nurses have essential roles in preventing substance use disorder. These roles include health education, liaison, and researcher. Thus, nurses must examine and utilize the Internet, where information and transactions related to these substances are increasing.

DESIGN/METHODS

This study utilized an infodemiological design in exploring the worldwide information utilization for substance use disorder. Data were gathered from Google Trends and Wikimedia Pageview. The data included relative search volumes (RSV), top and rising related queries and topics, and Wikipedia page views between 2004 and 2022. After describing the data, autoregressive integrated mean averaging (ARIMA) models were used to predict future utilization of online information from Google and Wikipedia.

RESULTS

Google trends ranked 37 countries based on the search volumes for substance use disorder. Ethiopia, Finland, the United States, Kenya, and Canada have the highest RSVs, while the lowest-ranked country is Turkey, followed by Mexico, Spain, Japan, and Indonesia. Google searches for substance use disorder-related information increased by more than 900% between 2004 and 2022. In addition, Wikipedia page views for substance use disorder-related information increased by almost 200% between 2015 and 2022. Based on the ARIMA models, RSVs and page views are predicted to increase by about 150% and 120% by December 2025. Top and rising search-related topics and queries revealed that the public increasingly utilized online information to understand specific substances and the possible mental health comorbidities related to substance use disorders. Their recent concerns revolved around diagnostics, specific substances, and specific disorders.

CONCLUSION

The Internet can be of paradoxical use in substance use disorder. It has been previously reported to be increasingly used in drug trades, contributing to the increasing prevalence of substance use disorder. Likewise, the present study's findings revealed that it is increasingly utilized for substance use disorder-related information. Thus, nurses and other healthcare professionals should ensure that online information regarding substance use disorders is accurate and up-to-date.

CLINICAL RELEVANCE

Nurse informaticists can form and lead Internet- and social-media-based health teams that perform national infodemiological investigations to assess online information. In doing so, they can inform, expand, and contextualize ehealth substance use education and strengthen the accessibility and delivery of substance use healthcare. In addition, public health nurses can collaborate to engage patients and communities in identifying harmful substance use disorder information online and creating culturally-appropriate messages that will correct misinformation and improve ehealth literacy, specifically in substance use disorder.

Effects of HIS-based intervention on patient education process and patient satisfaction with nurses' education

OBJECTIVE

This quasi-experimental study (before and after intervention) was designed to determine the impact of hospital information system-based intervention on the patient education process and patient satisfaction in cardiac and cardiac intensive care units.

RESULTS

Each nurse was observed at the time of patient education on average on eight shifts (total of 256 shifts), and at last 1350 computerized reports before and after the intervention were analyzed and 150 patient satisfaction with nurses' education questionnaires were completed before and after the intervention. After the intervention, the patient education scores were significantly improved (p < 0.001). In addition, the results of a survey of patients about the level of satisfaction with the quality of patient education showed a significant increase compared to before the intervention (p < 0.001). The ability to easily, completely, and quickly edit and record the provided education, eased the process of patient education and documentation.

Exploring nurses' experiences of social media and in-person educational interventions for professional development: a qualitative study

BACKGROUND

Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses' experiences of receiving social media and in-person education to integrate the findings into practice.

METHODS

This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews.

RESULTS

In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics.

CONCLUSION

Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.

Nursing engagement in research priorities focused on health systems and services in Latin America countries

BACKGROUND

A strong nursing research agenda in Latin America is fundamental to universal health coverage. Nursing science can make important contributions to the health of Latin American people through knowledge generation that directly informs nursing practice, professional education, and health policy.

METHODS

We used a cross-sectional survey design to assess nursing involvement in health systems and services research in Latin America in five priority areas: Policies and education related to nursing human resources; Structure, organization and dynamics of health systems and services; Science, technology, innovation, and information systems in public health; Health policies, governance, and social control; and Social studies in the health field.

RESULTS

Nursing and midwifery participants (N = 856) from Latin American countries completed the survey. Respondents who reported conducting research focused primarily on Policies and Education related to Nursing Human Resources and Structure, Organization, and Dynamics of Health Systems and Services. Across the five priority areas, more nurses reported using research findings and/or being aware of research than conducting research.

CONCLUSIONS

Survey results indicate that nursing research in Latin America is currently disproportionately focused on nursing education and practice. More research focused on information technology, nurse's impact on public health, and the threats posed by nurse migration is needed to better address health needs of Latin American populations.

VNursLab 3D Simulator: A Web-Based Nursing Skills Simulation of Knowledge of Nursing Skill, Satisfaction, and Self-Confidence among Nursing Students

The use of technology-based learning methods in nursing education is necessary in the era of digitalization, but these methods are limited, especially in developing countries, including Indonesia. We aimed to evaluate the effectiveness of the Virtual Nursing Skills Simulation Lab (VNursLab), a web-based nursing skills simulation using 3D technology, to improve the knowledge of nursing skills for intravenous catheterization, satisfaction, and self-confidence of nursing students in Indonesia. A quasi-experimental design was used. A total of 139 nursing students participated and were divided into intervention and control groups (69 and 70 participants, respectively). The intervention group had access to the VNursLab 3D simulator for three weeks and had three meetings. The control group had traditional learning (lecture and three meetings). The data were analyzed using the paired t-test, Wilcoxon test, and Mann–Whitney U test. The means and standard deviations of the post-test values in the two groups for the three parameters were 12.26 + 4.11 vs. 9.67 + 3.13 for nursing skill knowledge, 23.00 + 2.32 vs. 21.70 + 2.68 for satisfaction, and 36.25 + 3.48 vs. 34.96 + 3.39 for self-confidence. We found significant differences between the intervention and control groups regarding knowledge of nursing skills (p < 0.001), satisfaction (p < 0.001), and self-confidence (p = 0.014). The VNursLab 3D simulator could be an alternative learning medium to improve nursing students’ understanding of nursing skills, satisfaction, and self-confidence. However, this medium cannot replace direct practical experience. A combination of the two learning methods, virtual-based learning and hands-on practical learning, is beneficial in helping nursing students achieve nursing competencies.

Characterization of doctor of pharmacy/health informatics dual degrees in the United States

INTRODUCTION

Health care is trending towards an increasing reliance on data management, technology, analytics, and automation which is also reflected in pharmacy education. This study aimed to identify and characterize doctor of pharmacy (PharmD)/master of science in health informatics (MSHI) dual-degree offerings at pharmacy institutions within the United States (US).

METHODS

A list of PharmD/MSHI programs was obtained from the American Association of Colleges of Pharmacy and the Pharmacy College Application Service. Furthermore, websites of the 143 accredited schools and colleges of pharmacy in the US were inspected to identify additional PharmD/MSHI dual degrees not identified with the previous sources and to verify that the dual degree was being actively offered at each institution. A 26-item questionnaire focusing on program structure, admissions, and output was developed and administered to program representatives via phone interview. Descriptive statistics were calculated.

RESULTS

Thirteen schools offering a PharmD/MSHI dual degree were identified, of which 10 participated (response rate = 77%). All programs were created within the last 10 years. Programs were similar in terms of admission requirements such as grade point average thresholds and standardized testing. Variances existed in program structure and output, such as accreditation status and number of enrollees/graduates.

CONCLUSIONS

Although health informatics has become more prominent in health care, health informatics education is not yet as pervasive in the pharmacy field. The information collected may be useful for schools considering implementing or modifying their own dual degree program or for students who are interested in health informatics-specialized educational opportunities.

Utilization of information and communication technology (ICT) among undergraduate health science students: a cross-sectional study

BACKGROUND

We already know that incorporating information and Communication technology (ICT) into every aspect of human activity result in significant change and makes tasks easier to complete. It can help in areas of healthcare systems and medical education. Therefore, this study aimed to assess utilization ICT and its associated factors among Arba Minch University College Medicine and Health Science students.

METHODS

A cross sectional study design was conducted in June through August 2021 among under graduate students in college of medicine and health science at Arba Minch University, Ethiopia. A self-administered questionnaire was used to collect information on the students' socio-demographic factors as well as the utilization ICT. The data entry form was prepared with Epi-data 3.1 versions software and STATA version 14 software was used to analyze the data.

RESULTS

A total of 355 participants enrolled in the study, with a response rate of 98.34%. The percentage of students who used ICT was 55.77% [95% CI, 0.50, 0.60]. Regarding of field of study, health informatics students (84%) used the most ICT, while midwifery students (52%) used the least. Urban resident [AOR = 1.85, 95% CI = 1.08, 3.16], ICT knowledge [AOR = 3.8, 95% CI = 2.25, 6.40], having formal training of ICT [AOR = 1.9, 95% CI = 1.06,3.48], having IT in current course study [AOR = 2.2, 95% CI = 1.23, 3.84], and had good IT skill [AOR = 2.4, 95% CI = 1.34, 4.23] revealed a significant and positive correlation with the use of ICT.

CONCLUSION

In the current study previous residence, ICT knowledge, having formal training, having IT in current courses, and IT skill were significantly associated with student ICT utilization. Therefore, the university should continue to invest in professional development in order to improve teaching and student performance, as well as provide the college with student-centered ICT computer labs to encourage students to use technology.

Nursing informatics competencies in critical care unit

Nurses need professional competencies for safe and effective care. In this regard, nursing informatics competence is a significant need for intensive care unit nurses. In this study, the Delphi method was used during four rounds. The participants included 30 panelists selected by purposive sampling method. The data were analyzed using qualitative content analysis and descriptive statistics. During the rounds, the items were evaluated for importance, necessity, relevancy, and percentage of agreement. The findings of nursing informatics competencies in the intensive care units (ICU) were classified in three categories including basic computer skills (7 subcategories and 20 items), skills to use information management software (2 subcategories and 9 items), and specific nursing informatics skills (2 subcategories and 22 items). In order for nurses to perform successfully in ICU, they must meet some abilities such as computer skills, available software management, nursing information systems familiarity, nursing databases, web search methods, and English proficiency.

Jordanian nurses' attitudes toward using electronic health records during COVID-19 pandemic

Electronic health records (EHRs) have proven their effectiveness during the coronavirus disease (COVID-19) pandemic. However, successful implementation of EHRs requires assessing nurses' attitudes as they are considered the first line in providing direct care for patients. This study assessed Jordanian nurses' attitudes and examined factors that affect nurses' attitudes toward using EHRs. A cross-sectional, correlational design was used. A convenient sample of 130 nurses was recruited from three major public hospitals in Jordan. All Participants completed the Nurses' attitudes Towards Computerization (NATC) Questionnaire. The overall nurses' attitude was positive; the mean was 61.85 (SD = 10.97). Findings revealed no significant relationship between nurses' attitudes toward using EHRs and nurses’ age, gender, education level, previous computer skills experience, years of work experience, and years of dealing with EHRs. However, the work unit was found to have a significant correlation with nurses' attitudes toward using EHRs. Therefore, nurse administrators should arrange for the conduct of educational workshops and continuous training programs considering the needs of the nurses.

Nursing informatics competences of Finnish registered nurses after national educational initiatives: A cross-sectional study

BACKGROUND

Nursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates.

OBJECTIVES

To examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined.

DESIGN

Cross-sectional study.

SETTINGS

The study was carried out between October-December 2018 in Finland.

PARTICIPANTS

Registered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives.

METHODS

Nursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance.

RESULTS

Nurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence.

CONCLUSIONS

The national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs.

The information system stress, informatics competence and well-being of newly graduated and experienced nurses: a cross-sectional study

BACKGROUND

The use of information systems takes up a significant amount of nurses' daily working time. Increased use of the systems requires nurses to have adequate competence in nursing informatics and is known to be a potential source of stress. However, little is known about the role of nursing informatics competence and stress related to information systems (SRIS) in the well-being of nurses. Moreover, the potential impact of nurses' career stage on this matter is unknown. This study examined whether SRIS and nursing informatics competence are associated with stress and psychological distress in newly graduated nurses (NGNs) and experienced nurses.

METHODS

A cross-sectional study was conducted in Finland between October and December 2018. The participants were NGNs (n = 712) with less than two years of work experience and experienced nurses (n = 1226) with more than two years of work experience. The associations of nursing informatics and SRIS with nurses' stress and psychological distress were analyzed with linear regression analysis. Analyses were conducted separately for NGNs and experienced nurses. Models were adjusted for age, gender, and work environment.

RESULTS

SRIS was associated with stress / psychological distress for both NGNs (β = 0.26 p < 0.001 / β = 0.22 p < 0.001) and experienced nurses (β = 0.21 p < 0.001/ β = 0.12 p < 0.001). Higher nursing informatics competence was associated with lower stress (β = 0.20 p < 0.001) and psychological distress (β = 0.16 p < 0.001) in NGNs, but not among experienced nurses.

CONCLUSIONS

SRIS appears to be an equal source of stress and distress for nurses who are starting their careers and for more experienced nurses, who are also likely to be more experienced users of information systems. However, informatics competence played a more important role among NGNs and a lack of adequate competence seems to add to the strain that is already known to be high in the early stages of a career. It would be important for educational institutions to invest in nursing informatics so that new nurses entering the workforce have sufficient skills to work in increasingly digital health care.

Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study

BACKGROUND

Teaching students about electronic health records presents challenges for most nursing programs, primarily because of the limited training opportunities within clinical practice settings. A simulated electronic health record is an experiential, learner-centered strategy that enables students to acquire and apply the informatics knowledge needed for working with electronic records in a safe learning environment before the students have encounters with real patients.

OBJECTIVE

The aim of this study is to provide a preliminary evaluation of the Lippincott DocuCare simulated electronic health record and determine the feasibility issues associated with its implementation.

METHODS

We used one-group pretest-posttest, surveys, and focus group interviews with students and instructors to pilot the DocuCare simulated electronic health record within an undergraduate nursing program in Western Canada. Volunteering students worked through 4 case scenarios during a 1-month pilot. Self-reported informatics knowledge and attitudes toward the electronic health record, accuracy of computerized documentation, satisfaction, and students' and educators' experiences were examined. Demographic and general information regarding informatics learning was also collected.

RESULTS

Although 23 students participated in this study, only 13 completed surveys were included in the analysis. Almost two-thirds of the students indicated their overall understanding of nursing informatics as being fair or inadequate. The two-tailed paired samples t test used to evaluate the impact of DocuCare on students' self-reported informatics knowledge and attitudes toward the electronic health record revealed a statistically significant difference in the mean score of knowledge before and after using DocuCare (before: mean 2.95, SD 0.58; after: mean 3.83, SD 0.39; t 12=5.80, two-tailed; P<.001). There was no statistically significant difference in the mean scores of attitudes toward the electronic health record before and after using DocuCare (before: mean 3.75, SD 0.40; after: mean 3.70, SD 0.34; t 12=0.39, two-tailed; P=.70). Students' documentation scores varied from somewhat accurate to completely accurate; however, performance improved for the majority of students as they progressed from case scenarios 1 to 4. Both the faculty and students were highly satisfied with DocuCare and highly recommended its integration. Focus groups with 7 students and 3 educators revealed multiple themes. The participants shared suggestions regarding the DocuCare product customization and strategies for potential integration in undergraduate nursing programs.

CONCLUSIONS

This study demonstrated the feasibility and suitability of the DocuCare program as a tool to enhance students' learning about informatics and computerized documentation in electronic health records. Recommendations will be made to academic leadership in undergraduate programs on the basis of this study. Furthermore, a controlled evaluation study will be conducted in the future.

Training needs assessment of intensive care nurses in Zabol University of Medical Sciences' Hospitals

BACKGROUND

The improvement of the knowledge, skill, and attitude of nurses working at the intensive care unit (ICU) through implementing training need assessment and holding continuous in-service training courses are of main requisites for providing better health services to the community. Based on this, in the present work, we are looking for the identification and prioritization of the training need of intensive care nurses in the Zabol University of Medical Sciences' hospitals.

MATERIALS AND METHODS

As a cross-sectional, descriptive study, including two phases of identification and prioritization of training needs of ICU nurses, it was conducted by a close-ended researcher-made questionnaire for collecting the data on training needs from the viewpoint nursing officials, supervisors, and head nurses of the ICU wards in the first phase and a multiple-choice scientific test plus a checklist for measuring the knowledge and skill of the nurses in the ICU in the second phase. In both phases, census method was used for collecting the data. The validity and reliability of data-gathering tools, mentioned above, were tested and verified before gathering data. Data were analyzed with the descriptive statistics.

RESULTS

The results indicated that ventilator setting according to arterial blood gas sampling and interpretation (77.81), cardiac monitoring, detecting dysrhythmia and taking immediate intervention (73.04), ventilator setting according to patient's respiratory status (68.61), airway management, oxygenation and intubation (64.39), and adults cardiopulmonary resuscitation (61.77) were the high-priority training needs of the nurses successively.

CONCLUSION

To improve the quality of training programs and upgrading the knowledge, skill, and attitude of nurses working at ICU, the significance and the weight of each training titles should be determined according to the standards and the continuous in-service training plan along with nurses' training needs and duties.

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.

Nurses' experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran

Background

Information technology (IT) plays an important role in nursing practice. Hence, nurses’ experiences and viewpoints about IT integration into healthcare help improve nurses’ adoption of IT. This study aimed to explore the nurses’ experiences and viewpoints about the benefits of IT integration and adoption in healthcare.

Methods

This study was conducted with a qualitative research approach. Participants included 14 nurses from four hospitals affiliated to a large medical university in Iran, who were selected using a purposive sampling method. Data were collected through semi-structured interviews and analyzed using the conventional content analysis of Lundman and Graneheim.

Results

Six categories in the study reflected the nurses’ experiences and viewpoints about the benefits of integrating IT into health care. These categories included improving the quality and efficiency of medical services and care, facilitating the communication management in the technological environment, improving information documentation, management, and monitoring, improving resource management, improving management performance and policymaking, and facilitating pathways of organizational and professional growth.

Conclusions

Lessons learned in this study can help overcoming the barriers of IT adoption, and developing appropriate strategies to familiarize nurses with the benefits of IT in healthcare settings. Healthcare managers are recommended to investigate the experiences of nurses with IT in their hospitals and organize courses to orient hesitant nurses toward adopting IT.

Integrating nursing informatics into undergraduate nursing education in Africa: A scoping review

Background

Information and communication technologies have become omnipresent in healthcare systems globally, and since nurses comprise the majority of the health sector workforce, they are expected to be adequately skilled to work in a technology‐mediated environment. Integrating nursing informatics into undergraduate nursing education is a cornerstone to nursing education and practice in Africa.

Aim

This scoping review aimed to evidence the integration of nursing informatics into undergraduate nursing education in Africa.

Methods

A scoping review of the literature used electronic databases including CINAHL Plus databases; EmCare; MEDLINE Ovid; Scopus; ERIC ProQuest; Web of Science; Google; and Google Scholar to locate papers specific to the African context. From a total of 8723 articles, 19 were selected for critique and synthesis.

Results

Selected studies indicated that nursing students used several information and communication technologies tools primarily for academic purposes, and rarely for clinical practice. In Africa, the challenges for teaching informatics in nursing education included: limited information and communication technologies skills among faculty and students; poor teaching strategies; and a lack of standardization of nursing informatics competencies. Successful integration of nursing informatics into undergraduate nursing education in African countries depends on restructuring nursing informatics content and teaching strategies, capacity building of the faculty and students in information and communication technologies, political commitment, and collaborative partnership.

Conclusion

Nursing informatics is scarce in undergraduate nursing education in Africa due to the implementation and adoption challenges. Responding to these challenges requires a multi‐sectoral approach in the revision of undergraduate nursing curricula.

Implication for nursing education, practice, policy and research

This study highlights the importance of nursing informatics in undergraduate nursing education, with its challenges and success. Nursing education policies should support the development of well‐standardized nursing informatics content and appropriate teaching strategies to deliver it. Further research is needed to establish which aspects of nursing informatics are integrated into undergraduate nursing education and nursing practice, implementation process, challenges and possible solutions. Collaborative partnerships are vital to developing nursing informatics policies to better prepare graduate nurses for the African healthcare workforce in the digital era.

Evaluating the effectiveness and feasibility of nurse-led distant and face-to-face interviews programs for promoting behavioral change and disease management in patients with diabetic nephropathy: a triangulation approach

BACKGROUND

We examined whether telecommunication-device-based distance interviews are inferior to face-to-face interviews in terms of facilitating behavioral changes and disease management in patients with diabetic nephropathy. We also examined the feasibility of a newly designed six-month telenursing program.

METHODS

This study represents a post-hoc analysis of data from a randomized controlled trial, in which we compared the efficacy of remote self-management education with that of direct education for patients with diabetic nephropathy. The participants were 40 company employees, who were randomly divided into two groups. Over 6 months, the intervention group (n = 21) received three distance interviews using a tablet computer. Meanwhile, the control group (n = 19) received three face-to-face interviews. In addition, both groups received biweekly nine telephone calls. A triangulation approach was used. We first compared the two groups in inferiority tests. Then, we analyzed data from semi-structured interviews with all participants and nurses, examining whether trusting relationships and motivation were developed, and the accuracy of the information exchanges. Further, for the intervention group, we also enquired about the overall operability of the telenursing device.

RESULTS

The completion rates for the program were 81.0 and 78.9% for the participants in the intervention and control groups, respectively. Both groups showed similar behavioral changes, and the participants verified the feasibility of the distance interviews. The participants in the intervention group felt that they understood the severity of their diseases and the necessity of self-management, and felt confidence in the nurses. On the other hand, their degree of behavioral change regarding self-monitoring was lower than that shown by the control group.

CONCLUSION

Our findings show that both interview methods are effective for encouraging the adoption of self-management; further, in terms of taking medication and improving the main clinical indicators, we found that the distance method is not inferior to the direct face-to-face method. However, when considering long-term effects, based on the respective degrees of improvement in behavioral change, the direct method seems to be more effective.

TRIAL REGISTRATION

The trial was registered with the University Hospital Medical Information Network clinical trial registry (No. UMIN000026568) on March 15, 2017, retrospectively.

Assessing nurses' informatics competency and identifying its related factors

Background

Due to the increasing use of informatics as an infrastructure in developing the quality of care and patient safety, informatics competency has become a crucial requirement for nurses.

Aim

This study was conducted to assess nursing informatics competency, and identify related factors in registered nurses.

Method

This research is an analytical descriptive study in which the research community included 205 nurses working at Tabriz University of Medical Sciences' hospitals. The researcher-made questionnaire was developed as a data collection tool (α = 98%). The data was entered into SPSS₁₆ software and correlation analysis and regression were carried out.

Results

The mean score percentage of total nursing informatics competency was 59.92%. The highest mean score was related to informatics skills (62.98), followed by the informatics knowledge subscale (59%). In addition, informatics competency was positively correlated with self-efficacy (r = 0.27, p = 0.001), evidence-based practice (r = 0.55, p = 0.001) and time spent on hospital information systems (r = 0.16, p = 0.01).

Conclusion

Computer skills, self-efficacy, evidence-based practice and time spent on hospital information systems are determinant factors of nurses' informatics competency. Developing nurses' basic computer skills and incorporating informatics education programmes into the curriculum can enhance nurses' informatics competency.

Bits, Bytes, Nibbles, and Clusters-An Interprofessional Practicum Experience: An Innovative Application of a Doctor of Nursing Practice Essential IV

BACKGROUND

The Doctor of Nursing Practice (DNP) practicum should reflect the application of the American Association of Colleges of Nursing's Eight Essentials. This student's personal practicum experience combined her interest in interprofessional collaboration and the relationships with the Sexual Assault Response Team.

OBJECTIVE

An innovative practicum was developed to assist in fulfilling the Fourth Essential: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care, as it pertained to the student's scholarly project.

METHODS

Clinical Practicum.

RESULTS

A criminal investigator, specializing in digital forensics, offered his expertise toward this educational opportunity as related to the student's scholarly project.

CONCLUSIONS

This experience provided a practicum that was considered "outside the box" for this Fourth Essential.

IMPLICATION FOR NURSING

It may be necessary for the Doctor of Nursing Practice student to consider a variety of opportunities to meet the Fourth Essential competency.

Development and Psychometric Properties of Managerial Competence Scale for First-Line Nurse Managers in Indonesia

This study aimed to develop and psychometrically test the managerial competence scale for first-line nurse managers (FLNMs) in Indonesia. The scale was based on items derived from an integrative review and interviews with experts. A total of 300 FLNMs from 16 public hospitals were randomly selected for this test of psychometric properties. A principal component analysis generated seven dimensions with 43 items as a final scale, with overall Cronbach's α of .95 while the dimensions' Cronbach's α ranged from .71 to .90. The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of managerial competence of FLNMs.

The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education

BACKGROUND

Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education.

PURPOSE

To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice METHOD: A quantitative descriptive method was used to analyze assessment tools from 23 universities.

RESULTS AND CONCLUSION

Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies.

Evaluation of Nursing Documentation Completion of Stroke Patients in the Emergency Department: A Pre-Post Analysis Using Flowsheet Templates and Clinical Decision Support

The primary aim of this performance improvement project was to determine whether the electronic health record implementation of stroke-specific nursing documentation flowsheet templates and clinical decision support alerts improved the nursing documentation of eligible stroke patients in seven stroke-certified emergency departments. Two system enhancements were introduced into the electronic record in an effort to improve nursing documentation: disease-specific documentation flowsheets and clinical decision support alerts. Using a pre-post design, project measures included six stroke management goals as defined by the National Institute of Neurological Disorders and Stroke and three clinical decision support measures based on entry of orders used to trigger documentation reminders for nursing: (1) the National Institutes of Health's Stroke Scale, (2) neurological checks, and (3) dysphagia screening. Data were reviewed 6 months prior (n = 2293) and 6 months following the intervention (n = 2588). Fisher exact test was used for statistical analysis. Statistical significance was found for documentation of five of the six stroke management goals, although effect sizes were small. Customizing flowsheets to meet the needs of nursing workflow showed improvement in the completion of documentation. The effects of the decision support alerts on the completeness of nursing documentation were not statistically significant (likely due to lack of order entry). For example, an order for the National Institutes of Health Stroke Scale was entered only 10.7% of the time, which meant no alert would fire for nursing in the postintervention group. Future work should focus on decision support alerts that trigger reminders for clinicians to place relevant orders for this population.

The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management

Background:

The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM).

Methods:

A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers’ ratings collected from January 9, 2014 to February 17, 2014 were included in the study.

Results:

Overall, the consumers’ ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications.

Conclusions:

Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients.