Creating Research-Based Informatics Competencies for Nurses
Learner Objectives: 1) Describe research-based informatics competencies for nurses at four levels of practice. 2) Compare and contrast results of this study with past work in the area including the general guidelines for informatics skills advocated by the International Medical Informatics Association.
Objective: A current, research-based list of informatics competencies is needed to guide nursing curricula development and nursing practice in the workplace. The objective of this research was to create a master list of informatics competencies for nurses at four levels of practice, from a beginning nurse to an informatics innovator.
Design: Descriptive
Methods: After a comprehensive literature review and item consolidation using a database, an expert panel defined initial informatics competencies. Subsequently, a three-round Delphi study was conducted to validate the items using a paper and web-based instrument.
Sample and Setting: 79 United States experts in nursing informatics were selected for participation in the study using a purposive sampling technique. Sixty-five participants (83%) completed Round 3 of the study.
Concept, Variable Studied: Consensus about informatics competencies for nurses.
Findings: Of the initial 305 competencies proposed, 281 competencies achieved an 80% or greater agreement for both importance as a competency and appropriateness for the correct practice level. Five competencies were rejected. Six competencies were considered valid competencies but the appropriate level of practice could not be agreed upon. Thirteen competencies did not reach any consensus after the three Delphi rounds.
Implications: The results of this research provide a valid, current, research-based list of informatics competencies for nurses at four levels of practice. This comprehensive list of knowledge and skills for informatics can be used to guide nursing curricula development as well as develop nurses’ job descriptions and expectations in the workplace. This is the first time competencies have been developed for multiple levels of nurses from beginning and experienced nurses to informatics nurse specialists and informatics innovators. A completely new set of skills and knowledge was defined for the advanced level of informatics nurse specialist (informatics innovator). The high rate of participation in this study reflects the interest in this topic and the perceived need for this work. A high rate of item acceptance was also evident. Out of the initial 305 competencies, only 24 items were not validated for both level of practice as well as importance, a 92% rate of acceptance. Determining the importance of an item was less difficult for the sample than consensus about the appropriate level of practice for a particular item. Of the five rejected items, one concerned experienced nurses being required to use applications for diagnostic coding; another item dealt with informatics nurse specialists being required to have skills in computer programming. The results of this study, a master list of informatics competencies, should be useful to faculty, employers and nurses themselves.
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