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Tuijin Jishu/Journal of Propulsion Technology
ISSN: 1001-4055
Vol. 45 No. 1 (2024)
__________________________________________________________________________________
4341
Assessing the Nursing Informatics
Competency among Registered Nurses of
Selected Hospitals in India
Ms. Vimala Varatharajan1, Dr. Tulsi Shringi2
1Research Scholar & Lecturer, Department of Nursing, SJJT University, Jaipur,
Rajasthan, India& Gulf Medical University, Ajman1
2Guide, Department of Nursing, SJJT University
Jaipur, Rajasthan, India2
Abstract - Informatics competency has become an essential requirement for nurses to fulfill their professional
roles. This pilot study examined the factors affecting informatics competency to help develop strategies to
improve nurses' informatics practice. The study was conducted in India to assess the factors affecting nursing
informatics competencies among registered nurses. A cross-sectional survey was conducted among 35 samples.
A questionnaire was designed to collect data on nurses' informatics competency, basic computer skills, attitudes
toward computerization, and general characteristics. The data was entered into SPSS16 software and correlation
analysis, and regression were carried out.The mean score percentage of total nursing informatics competency
was 94.30%. The highest mean score was related to informatics skills (40.30%), followed by computer literacy
skills (32.80 %). In addition, informatics competency is mainly affected by education, age, position of job, and
frequency of using devices. Nurses had favorable attitudes toward computerization. Significant factors
associated with informatics competency were basic computer skills and formal informatics education. The study
findings suggest that the enhancement of basic computer skills and incorporation of informatics into formal
nursing curricula are needed to improve the nurses' competency in managing and using healthcare information.
Keywords: Nursing informatics, Computer literacy, Hospital Management System, Electronic Health records.
I INTRODUCTION
In today's rapidly evolving healthcare landscape, the integration of technology and information systems has
become paramount for delivering efficient and effective patient care. Nurses, as frontline healthcare providers,
play a pivotal role in this digital transformation1. Their ability to harness the power of health informatics and
seamlessly navigate through a plethora of electronic health records (EHRs), data-driven tools, and evidence-
based resources is essential for optimizing patient outcomes and healthcare delivery. This phenomenon, known
as nurse informatics competency, represents a critical juncture where nursing practice intersects with
technological advancement2.
The realm of healthcare informatics encompasses a wide array of skills and knowledge, ranging from
understanding complex health information systems to utilizing digital platforms for communication and
decision-making3. As healthcare organizations continue to adopt and implement sophisticated technologies, it
becomes increasingly pertinent to investigate the factors that contribute to and influence nurse informatics
competency. By delving into these factors, healthcare institutions can gain insights into the mechanisms that
drive successful technology integration within nursing practice, ultimately leading to improved patient care,
streamlined workflows, and enhanced professional development for nurses4,5.
This research endeavours to explore the multifaceted landscape of factors associated with nurse informatics
competency. By unravelling the interplay between education, experience, support systems, technological
infrastructure, and individual attributes, this study seeks to shed light on the intricate web of influences that
shape a nurse's proficiency in health informatics6. In doing so, it aims to provide healthcare leaders, educators,
and policymakers with valuable insights that can guide the design of comprehensive training programs,
supportive environments, and strategic initiatives to foster nurse informatics competency7,8.
Tuijin Jishu/Journal of Propulsion Technology
ISSN: 1001-4055
Vol. 45 No. 1 (2024)
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4342
As the healthcare industry embraces the digital era, understanding the underpinnings of nurse informatics
competency emerges as a critical endeavour. By examining the factors that contribute to this competency,
stakeholders can better equip nurses with the skills and knowledge needed to thrive in an increasingly
technology-driven healthcare environment9,10. Through empirical analysis and comprehensive exploration, this
research aims to contribute to the ongoing dialogue surrounding nurse informatics competency and its role in
shaping the future of nursing practice.
II Objectives
To assess the nursing informatics competency among registered nurses.
III Material & Methods
Study Design & Participants
This research is an analytical descriptive study. The research community included 35 registered nurses working
in a hospital.
Samples
The research population included nurses working in the hospitals, 35 of whom were selected as the sample
based on Cochran’s equation 10% of the main study. The non-probabilistic sampling technique with a
combination of convenient sampling methods was applied to obtain responses from the study population. The
inclusion criteria were being a registered nurse working in the hospitals, and an inclination to cooperate in the
study, and familiarity with nursing informatics based on the nurse’s self-declaration.
Instrument
The study instruments were Section A – Demographic data. It includes (age, gender, level of education in
nursing, years of experience as a nurse, area of assignment, and if attended any nursing informatics training
courses before). Section B - Nursing Informatics Competency Assessment Tool (NICAT). Nursing Informatics
Competencies Questions. It included 30 Items. It consists of three dimensions (computer literacies, informatics
literacies, and information management literacies.
IV Analysis & Results
Statistical analysis was done using the SPSS 16 statistical software package. Cleaning of data was carried out to
be sure that there were no missing or abnormal data by running frequencies and descriptive statistics. Data were
presented using descriptive statistics.
As shown in Table 1 42.9% of nurses belong to the age group of between 20 to 30 years. Regarding level of
education, most of the participants had bachelor’s degrees (68.6%). Also, most participants were documenting
both electronically and manually (54.3%). 77.1% of the nurses had exposure to the hospital information system
through the staff development Program. Most of the nurses were using the digital devices regularly (71.4%)
Table 1 - Frequency & Percentage Distribution Of Demographic Variables
Demographic Variables
Frequency
Percentage Distribution
Age
20 – 30
15
42.9%
31 - 40
12
34.3%
41 – 50
05
14.3%
< 51
0 3
8.6%
Gender
Male
07
20.0%
Female
28
80.0%
Tuijin Jishu/Journal of Propulsion Technology
ISSN: 1001-4055
Vol. 45 No. 1 (2024)
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4343
Job position
Staff Nurse
24
68.6%
Head nurse
02
05.7%
Supervisor
04
11.4%
Nurse educator
05
14.3%
Education level
Bachelors
24
68.6%
Master
10
28.6%
Ph.d
01
02.9%
Mode of documentation
Electronic
05
14.3%
Manual
11
31.4%
Electronic & manually
19
54.3%
Clinical experience
> 1 year
02
5.7%
1 - 3 years
07
20.0%
4 - 6 years
12
34.3%
7- 10 years
05
14.3%
11 – 20 years
07
20.0%
> 20 years
02
5.7%
Time spent on hospital information system per day.
> 1 hour.
11
31.4%
1 - 2 hours
12
34.3%
2 - 4 hours
07
20.0%
< 4 hours
03
8.6%
Never
02
5.7%
Experience in using electronic health records
Highly experienced
03
8.6%
Experienced
24
68.6%
No experience
02
5.7%
Beginner
06
17.1%
Mode of exposure to hospital information system
Staff development program
27
77.1%
Workshop
03
08.5%
Nursing curriculum
00
00.0%
No previous exposure
05
14.2%
Frequency of using digital devices – computer/laptop/tab
Used regularly
25
71.4%
Used Rarely
10
28.6%
Availability of digital devices in clinical settings
Individual devices
10
28.6%
Common devices
24
68.6%
No devices
01
02.9%
As shown in Table 1 42.9% of nurses belong to the age group of between 20 to 30 years. Regarding level of
education, most of the participants had bachelor’s degrees (68.6%). Also, most participants were documenting
both electronically and manually (54.3%). 77.1% of the nurses had exposure to the hospital information system
through the staff development Program. Most of the nurses were using the digital devices regularly (71.4%).
Tuijin Jishu/Journal of Propulsion Technology
ISSN: 1001-4055
Vol. 45 No. 1 (2024)
__________________________________________________________________________________
4344
Table 2 – Level Of Competency Regarding Nursing Informatics Among Registered Nurses
N=35
Q.No
Self-Competency Assessment
Not
Competent
Somewhat
Competent
Competent
Very
Competent
Expert
I. Computer Literacy Assessment
1
Recognize the basic components of the
computer system such as mouse, screen,
and workstation.
0
(0.0%)
5
(14.3%)
15
(42.9%)
7
(20.0%)
8
(22.9%)
2
Use of telecommunication tools such as
email & fax
0
(0.0%)
8
(22.9%)
10
(28.6%)
12
(34.3%)
5
(14.3%)
3
Use of remote communication tools such
as Google Meet, Skype, and Zoom
4
(11.4%
)
9
(25.7%)
11
(31.4%)
6
(17.1%)
5
(14.3%)
4
Create, rename, move, and delete files
using computer operating systems such as
Microsoft Windows.
1
(2.9%)
9
(25.7%)
8
(22.9%)
11
(31.4%)
6
(17.1%)
5
Use word processing functions such as
save, categorize, copy, paste, and delete
documents.
1
(2.9%)
6
(17.1%)
11
(31.4%)
8
(22.9%)
9
(25.7%)
6
Navigate computer operating systems to
access the installed application and choose
active printer.
0
(0.0%)
10
(28.6%)
12
(34.3%)
7
(20.0%)
6
(17.1%)
7
Use software to create presentations such
as Microsoft PowerPoint.
3
(8.6%)
5
(14.3%)
12
(34.3%)
6
(17.1%)
9
(25.7%)
8
Use external devices such as USB flash
drive, digital camera, CDROM
2
(5.7%)
11
(31.4%)
9
(25.7%)
7
(20.0%)
6
(17.1%)
9
Perform basic computer systems
troubleshooting such as checking the
power source, rebooting the computer, and
printing.
1
(2.9%)
9
(25.7%)
14
(40.0%)
6
(17.1%)
5
(14.3%)
10
Manage computer systems security to
protect data, devices, and passwords.
0
(0.0%)
11
(31.4%)
12
(34.3%)
8
(22.9%)
4
(11.4%)
II. Informatics Literacy Assessment
11
Use the Internet to locate and download
items of interest.
0
(0.0%)
7
(20.0%)
11
(31.4%)
10
(28.6%)
7
(20.0%)
12
Navigate the electronic health record.
1
(2.9%)
12
(34.3%)
10
(28.6%)
8
(22.9%)
4
(11.4%)
13
Review and acknowledge patient orders in
the electronic health record.
1
(2.9%)
12
(34.3%)
8
(22.9%)
9
(25.7%)
5
(14.3%)
14
Develop and document care plans in
electronic health records.
3
(8.6%)
8
(22.9%)
17
(48.6%)
3 (8.6%)
4
(11.4%)
15
Review point-of-care data such as urine
dipstick, glucose check, and hemoglobin
meter to make timely decisions.
0
(0.0%)
9
(25.7%)
15
(42.9%)
9
(25.7%)
2 (5.7%)
16
Respond appropriately to alerts from
clinical decision-making tools such as
algorithms, and best practice alerts.
1
(2.9%)
12
(34.3%)
16
(45.7%)
4
(11.4%)
2 (5.7%)
Tuijin Jishu/Journal of Propulsion Technology
ISSN: 1001-4055
Vol. 45 No. 1 (2024)
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4345
17
Conduct literature searches on inaccessible
proprietary database systems such as
CINAHL, EBSCO, etc.
6
(17.1%
)
11
(31.4%)
11
(31.4%)
5
(14.3%)
2 (5.7%)
18
Use medication administration tools such
as barcode medication verification and
scanning.
6
(17.1%
)
6
(17.1%)
11
(31.4%)
10
(28.6%)
2 (5.7%)
19
Use of medication dispensing system.
3
(8.6%)
9
(25.7%)
12
(34.3%)
8
(22.9%)
3 (8.6%)
20
Collect and document patient data relevant
to care such as vital signs, height, and
weight.
0
(0.0%)
6
(17.1%)
11
(31.4%)
9
(25.7%)
9
(25.7%)
21
View trended electronic documentation to
understand the effectiveness of nursing
interventions.
2
(5.7%)
8
(22.9%)
13
(37.1%)
8
(22.9%)
4
(11.4%)
22
Use systems to assist with the admission
and discharge process.
2
(5.7%)
6
(17.1%)
11
(31.4%)
11
(31.4%)
5
(14.3%)
23
Continue patient care documentation and
patient identification when the computer
system is down.
0
(0.0%)
6
(17.1%)
18
(51.4%)
5
(14.3%)
6
(17.1%)
III. Informatics Management Skills Assessment
24
Protect confidential patient data by logging
out, suspending sessions, and password
protection
0
(0.0%)
8
(22.9%)
16
(45.7%)
7
(20.0%)
4
(11.4%)
25
Use information technology as a primary
means of patient safety such as bedside
laboratory verification, barcode scanning,
etc.
2
(5.7%)
10
(28.6%)
9
(25.7%)
11
(31.4%)
3 (8.6%)
26
Use electronic health records and another
clinical information system as per
organizational policy for documentation.
3
(8.6%)
8
(22.9%)
14
(40.0%)
7
(20.0%)
3
(8.6%)
27
Use electronic communication with
colleagues, patients, or other departments.
1
(2.9%)
12
(34.3%)
13
(37.1%)
7
(20.0%)
2 (5.7%)
28
Find information stored in the clinical
information system to guide patient care
such as standardized care plans and
guidelines.
1
(2.9%)
12
(34.3%)
11
(31.4%)
8
(22.9%)
3 (8.6%)
29
Use nursing data for improving practice
and for clinical decision-making.
0
(0.0%)
10
(28.6%)
13
(37.1%)
10
(28.6%)
2 (5.7%)
30
Use data and statistical reports for unit-
based quality improvement initiatives and
practice evaluation.
1
(2.9%)
13
(37.1%)
11
(31.4%)
8
(22.9%)
2 (5.7%)
Above mentioned tables represent the self-competency of nursing informatics competency level among
registered nurses. Has 30 items each item representing the subcomponents.
Table 3 - Sub-Components Of Nursing Informatics Competency Among Registered Nurses
S. No
Computer
Literacy
Novice
(1- 10)
Advanced
Beginner
(11 – 20)
Competent
(21 – 30)
Proficient
(31 – 40)
Expert
(41 – 50)
f
%
f
%
f
%
f
%
f
%
Tuijin Jishu/Journal of Propulsion Technology
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1
1
2.8%
7
20%
12
34.28%
7
20%
8
22.85%
2
Informatics
Literacy
Novice
(1- 13)
Advanced
Beginner
(14 – 26)
Competent
(27 – 39)
Proficient
(40 – 52)
Expert
(53 – 65)
f
%
f
%
f
%
f
%
f
%
2
5.7%
9
25.71%
13
37.14%
8
22.85%
3
8.57%
3
Informatics
Managemen
t Skills
Novice
(1- 7)
Advanced
Beginner
(8- 14)
Competent
(15 – 21)
Proficient
(22 – 28)
Expert
(29 – 35)
f
%
f
%
f
%
f
%
f
%
1
2.8%
10
28.57%
13
37.14%
8
22.8%
3
8.5%
The table shows that the majority of registered nurses 12(34.28 %) were competent in computer literacy, 7
(20%) were proficient 7 (20%) were at the level of advanced beginner in computer literacy, and the least 1
(2.8%) were novice in computer literacy. Regarding informatics literacy 13 (37.14%) were competent then
8(22.85%) belonged to proficient in handling informatics literacy, 9(25.71%) were advanced beginners,
3(8.57%) were experts and least 2 (5.7%) were novices. Then moving on to Informatics management skills
majority 13 (37.14%) were competent, 10(28.57%) were advanced beginners, 8 (22.8%) were proficient in
handling informatics management skills and 3(8.5%) were experts and the least 1(2.8%) was a novice in
handling informatics management skills.
Table 4 – Mean Score Of Nursing Informatics Competencies
FACTORS
MEAN
STANDARD DEVIATION
Computer Literacy
32.8
09.4
Informatics Literacy
40.3
10.0
Informatics Management Skills
21.2
05.5
Nursing Informatics Competency Score
94.3
23.1
Table 5– Overall Competency Of Nursing Informatics
Nursing Informatics Competency
Competent
14 (40%)
Proficient
18 (51%)
Expert
03 (9%)
Data from Table 5 indicate that most of the participants were proficient in nursing informatics competency 18
(51%). 14(40%) of the participants were competent in using nursing informatics competencies and 3(9%)
participants were experts in handling the competencies.
Tuijin Jishu/Journal of Propulsion Technology
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Vol. 45 No. 1 (2024)
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Figure 1 - Competency of Nursing Informatics among nurses
Discussion
Nursing informatics competency is considered a main factor that affects the quality of services in healthcare. As
a vital component of the clinical staff, nurses have a great role in clinical practice, and the success and failure of
medical interventions are significantly dependent on their abilities and competencies. The results of this study
acknowledge that self-efficacy, job satisfaction, time spent on HIS, and clinical experience have a direct and
significant effect on nurses’ informatics competency. Also, we found that age has an indirect and significant
effect on nurses’ informatics competency. The findings of the present study showed that informatics
management skills have the lowest mean score compared with computer and informatics skills subscales. This
result agreed well with that of Ademuyiwa et al. (2020), who investigated nurses’ attitudes concerning evidence-
based practice12. The findings of the latter study reported that the highest mean score percentage was related to
the informatics literacy subscale, while the lowest mean score was related to computer literacy. These findings
disagreed with Farzandipour (2021), who found that the mean score of informatics management skills was low
5.
However, this result disagreed with Yang et al. (2017), who studied the manager nurses’ perspectives on
informatics competencies and reported that education level had a significant impact on informatics
competencies13. The results are also contrary to those of Farzandipour (2014), who found a statistically
significant difference in NI competency between the diploma nurses and MSN nurses, and those of Kleib and
Nagle13 (2018), who found significant differences in total mean scores of competencies in relation to education
level, suggesting that competency scores were more likely to increase with higher education14,15.
Conclusion
Based on the literature and the results of this study, nurses’ informatics competencies have a more critical
impact on patient outcomes and organizational success than the information systems themselves. It is therefore
vital to support informatics as a core competency of professional practice among current and future nurses16,17.
This study clearly identified NI competency-related factors and also shed light on the necessity for informatics
competency in practice, and opportunities that should be grasped by managers and educators to enrich the
informatics competency of nurses. In order to achieve this aim, nurse’s basic computer skills should be
improved, while incorporating informatics education programs into the curriculum18. The results indicate that
0
2
4
6
8
10
12
14
16
18
Novice Advanced
beginner
Competent Proficient Expert
0
0
14
18
3
Competency of Nursing Informatics N=35
Tuijin Jishu/Journal of Propulsion Technology
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Vol. 45 No. 1 (2024)
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informatics knowledge, computer skills, and self-efficacy require considerable attention in planning for high-
quality educational programs. Moreover, to train nurses for informatics practice, the components related to
informatics competency such as self-efficacy and time spent on HIS. will be the first step in initiating suitable
strategies to achieve this goal.
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