Nursing Informatics Competencies: Are We There Yet?
In 2004, President Bush mandated that all Americans will be using electronic health records (EHR) by 2014. Shortly after taking office in 2009, President Obama continued this vision by signing the American Recovery and Reinvestment Act (ARRA), which earmarked $19 billion to develop an electronic health information technology infrastructure that will improve the efficiency and access of healthcare to all Americans. These executive directives clarified the need for healthcare providers, and nurses in particular to be able to function in an age of automated healthcare tools.
As more facilities become automated, the ability to find paper policies, clinical resources and patient information is becoming more and more limited. Combined with the number of patients and families with computers in their homes, we are beyond the need for basic computer skills and to the point of requiring Computer Literacy and Information Literacy to function.
Basic computer skills include the ability to open files, send and retrieve emails, and to enter and retrieve information from the electronic record. Information Literacy, according to the Association of Colleges and Research Libraries is "a set of abilities allowing individuals to recognize when information is needed and to locate, evaluate and use that information appropriately." Information literacy builds on computer literacy and includes the ability to identify information needed, to locate, evaluate, and apply the information correctly.
Nurses need to function at the level of Information Literacy in order educate patients and families on the EHR to incorporate evidence based practice, to evaluate the relevancy of information retrieved from the Internet and to incorporate evidence-based practice into their practice. The TIGER initiative, a grass roots organization was organized with the vision of incorporating informatics into nursing practice. The TIGER Executive Report and TIGER Competency Collaborative Report are excellent resources on this subject.
The Journey Has Begun
We have not yet achieved informatics competency across the board, but we have started the journey. According to a Healthcare Information and Management Systems Society (HIMSS) in 2009, 67% of hospitals have installed some parts of the electronic record, requiring only one or two applications to meet the basic ARRA EHR criteria. This means a large number of nurses have been exposed to using technology to enter and/or retrieve patient information, it does not mean they are truly information literate. To reach this stage, nursing leaders, peers and informatics nurses need to be able to understand and communicate the relationship between the HER and clinical practice and to mentor critical thinking skills as it relates to technology.
Nursing education is also making strides in the right direction. While there are still nursing programs that have not incorporated Informatics into their curriculum, that number is decreasing. In 2008, the National League for Nursing issued a statement calling for Faculty Development and Curricular Initiatives in Informatics. Technology is also recognized as "critical for the delivery of patient care" by the American Association of Colleges of Nursing in their Toolkit for Essentials of Bachelorette Education.
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