DOI Number: 10.5958/0974-9357.2019.00015.
Competency in Informatics for Nursing Professional in India:
Imbibing the Tech-culture among Nursing Professionals
Medha Piplani Verma1, Sandhya Gupta2
1
Senior Manager (Nursing Education), Bodhi Health Education Pvt. Ltd., Gurugram,
2
Faculty, Department of mental health nursing, AIIMS, New Delhi
ABSTRACT
Nameless nursing informaticians have been part of the tech-culture for more than two decades imbibing it
like a sponge and have muddled through the successful and not so successful initiatives in healthcare. With
the changing times and recognition of efforts that nurses continue to put in digital patient care, universally
nursing informatics has grown as a separate field. In India, Health Information Technology (HIT) has made
the nursing fraternity to adopt digital healthcare, however the extent of percolation remains questionable until
we measure it as objectively as possible. The only way to do so is educate and check the skill competencies
of nursing students and practicing nursing professional including researchers, educators, administrators and
clinical nurses. The article explores the nursing informatics curriculum taught to student nurses in India. The
basic and advance competencies in computer application, information literacy and management have been
proposed for nursing students and nursing professionals in Indian setting.
Keywords: Nursing Informatics, Informatics Competency, Digital Health, Nurse Informaticians, Informatics
curriculum
INTRODUCTION as ‘Health IT professionals’ and their role definition in
various settings5. Competency development still remains
Nursing informatics is the knowledge, behavior, and issue of concern to be explored by experts owing to large
skills required for nurses to collect, store, retrieve, and population and defining educational requirements for the
process information1. Nurses are learning on the job with task force6.
practice the various application of Health Information
Technology (HIT) in the clinical setting. Assessing and Blue print to Competency Development
enhancing knowledge of professionals would encourage
The steps to develop informatics competency
the adoption of informatics with open purview for
would require series of steps with the evolution of field
practice2. From simple mobile devices to e-ICU nursing
dramatically every passing moment.
informatics has influenced the practice undoubtedly3.
Informatics Working Group- Nurse leaders have
Studies have demonstrated that nurses have the
pivotal role in competency development process7.
right attitude to take informatics seriously4. Courses
Experts must work and update themselves by literature
exclusively teaching nursing informatics do not exist in
review, educational programs and interaction with
India but institutes offer real time and online courses with
professional organizations to refine the concept and
the dilemma whether such professionals are accepted
implement informatics in nursing practice8,9.
Corresponding Author: Assessment of knowledge and skills- Literature
Medha Piplani Verma suggests use of self-assessment scales for testing
Senior Manager (Nursing Education), Bodhi Health informatics knowledge and competency among students
Education Pvt. Ltd., Gurugram and practicing nurses10. In addition to the competency
Email- medha.aiims@gmail.com assessment, it is critical to study knowledge and attitude
68 International Journal of Nursing Education, January-March 2019, Vol.11, No. 1
of nurses towards informatics11. informatics competency for nurses. The proposed
categories included basic computer competencies,
Informatics Competency Development-Defining
information literacy and management.
the competency per the role of nurses need attention
as technology continues to percolate in all aspects of Indian nursing informatics curriculum comprises
patient care. Competency assessment must exist at all of basic computer concepts and introduction to hospital
levels to ensure in synch progress with HIT12. Students management systems lacking the competency assessment
and nurses must be prepared to enter clinical areas to process. Students are familiar with technology but they
facilitate practice with lesser glitches13. need opportunities to understand and acquire broader
applications of informatics such as clinical and public
Pilot Projects- The exchange of learning from
health informatics.
pilot projects would be utilized for adoption in larger
population to avoid bigger blunders, recognize lacunae Informatics Competency for Nurses in India
and to understand technology applications rather than
Health professionals are expected to be oriented
blind adoption14. The advent of technological advances
to computer skills, informatics skills/knowledge and
can ease the overall adoption or may create chaos15.
information management which essentially targets the
Annual Review- Amendments based on feedbacks efficient use of Electronic Health Records (EHRs) with
for reflection on the current practices and for the future an understanding about data capture as well as other
would be warranted. Extensive adoption has ensured concepts of digitalization. With vast digitalization the
organizations to emanate the progress and monitor the world is now shrinking with telemedicine, e-ICUs and
professional growth in the field16. e-learning to reach places for quality patient care. The
nursing informatics competencies in India must focus on
Competency Development and Adoption
the following domains21.
Studies indicate continued interest in competency
1. Basic Computer and Information technology
development process in different settings across
Skills
countries17. The literature supports imbibing informatics
in all aspects of nursing actively as it is influencing • Basic computer skills applied to patient care,
patient care with wide use of patient care information nursing education and research
systems and communication technology18. Desktop operating skills
File management
In India nursing education includes computer
education as part of undergraduate nursing program Software programs
which is positive and encouraging but pragmatic • Able to use software as applied to nursing
implication are still questionable19. The undergraduate practice
nursing courses in India includes exposure to informatics Presentations
education in B.Sc. nursing (45 hours) as well as General
Word processing
nursing and Midwifery (15 hours) courses. However
restricted access to practical resources to both students Spreadsheets
and teachers affect their confidence when exposed to Media player
digital practice. • Able to use hardware devices as applied to
The Technology Informatics Guiding Educational nursing informatics
Reform (TIGER) model was proposed to define the Printout
nursing informatics competencies for nursing students Scanner
and nurses expected to provide quality patient care in a
Microphone
digital environment after the felt need with introduction
of Electronic Health Records20. Digital camera
Pen drive
TIGER model was the first to define nursing
International Journal of Nursing Education, January-March 2019, Vol.11, No. 1 69
CD research, administration and practice
External ports • Utilize internet to collaborate with
• Use operating system professionals in nursing education, research and
practice
• Use application software
• Understands and participates in software
• Microsoft office/ Libre office
development process (EHR, patient care devices,
• Utilize multimedia elements including text, telenursing) and testing
image, audio, video and animation as applied to nursing
• Participates in software selection and use of
education, research, administration and practice
nursing standardized language such as NANDA
• Utilize internet for nursing education, research
• Trains professional to use informatics in
and practice
patient care and tracks the competency of others
Review educational material nursing professionals
Use blogs and social media to connect • Use statistical packages applied to nursing
professionally e.g. YouTube, Facebook research
Use professionals websites e.g. LinkedIn, • Understands and demonstrate use of
Twylah standardized clinical terminology including SNOMED
Use mobile applications for professional CT, ICD classification as applied to clinical practice
connections e.g. WhatsApp, Viber, Skype, Zoom • Utilize computer aided teaching techniques
• Use email for personal and professional Simulation
correspondence
Standardized patients
• Understands application of statistical packages
• Synchronous/asynchronous e-learning, ICT
applied to nursing research
in health
• Understand and use nursing database
3. Basic Information Literacy Skills
management system e.g. CINAHL, Ovid, PubMed
• Information identification applied to nursing
• Understands standards relevant to digital health
practice
as applied to nursing practice and patient care e.g.
North American Nursing Diagnosis Able to retrieve information from the system
Association (NANDA)
Able to locate and retrieve relevant
SNOMED CT information through system navigation
ICD
• Evaluate information and act per patient
2. Advance Computer and Informatics Skills requirement
• Utilizes advance computer and information
skills as defined by bloom’s taxonomy to the level of Understands the function of digital
‘analyzing’, ‘evaluating’ and ‘creating’ level. information stored in the system
• Able to use software as applied to nursing Utilizes the information available in nursing
practice practice and patient care
Advance Presentations Understands concept of data security and
Advance Word processing authentication at organizational level
Advance Spreadsheets
• Ethical and Legal Implications
Advance database
Aware of ethical and legal implications of
• Able to edit and use multimedia elements
sharing patient information via digital platforms e.g.
including text, image, audio, video, computer aided
EHR, email, mobile applications, social websites
design and animation as applied to nursing education,
70 International Journal of Nursing Education, January-March 2019, Vol.11, No. 1
• Understands self-limitation to access patient progress
information ii. Nursing care plan
4. Advance Information Literacy Skills iii. Vital signs and clinical parameters entry
• Information identification applied to nursing iv. Documentation as per Standard operating
practice procedures (SOP)/ Clinical decision support system
Defines the role of nursing professionals in (CSSD)
digital health at organizational level v. Consent and procedural information
Able to analyze and evaluate the information vi. Patient discharge, transfers and referral
from the system
vii. Medication administration, reaction, allergic
• Evaluate information and act per patient reaction
requirement
viii. Adverse event documentation
Utilizes digital information stored in the system
ix. Lab and diagnostic tests
available in nursing practice and patient care
b. Understands the relevance of interoperability of
Checks and updates data security and
system and its limitation.
authentication procedure as applied to nursing at
organizational level • Big Data Analytics
• Ethical and Legal Implications Understands the impact of data for efficient
nursing care
Educates others about ethical and legal
implications of sharing patient information via digital • Telehealth
platforms e.g. EHR, email, mobile applications, social Understands use of various telecommunication
websites technologies in patient care
• Participation in issues related to ethical and Able to explain the benefits and limitations of
legal problems related to digital care Telehealth
5. Basic Information Application Skills • Cloud Computing in Health
• Understands and demonstrates use of devices Understands the concepts of cloud computing
related to nursing care Able to demonstrate cloud computing
Cardiac monitor applications at organizational level
Glucometer • Understands and explains ethical and legal
Mechanical ventilator aspects of digital health
Mobile devices
Simulation devices 6. Advance Information Application Skills
Other devices as per setting e.g. dialysis • Educates professionals and updates self about
machines, RFID devices, Telehealth, e-ICU, public patient care devices
health informatics, Artificial intelligence and automation Cardiac monitor
technology Glucometer
• Use Electronic Health Record Mechanical ventilator
Understands role of nurse in software Mobile devices
development and contributes in digital health initiatives
Simulation devices
Understands and able to use EHR
Other devices as per setting e.g. dialysis
Able to manage EHR information machines, RFID devices, Telehealth, e-ICU, public
a. Nursing documentation- health informatics, Artificial intelligence and automation
i. Assess, inform and digitally document patient technology
International Journal of Nursing Education, January-March 2019, Vol.11, No. 1 71
• Use Electronic Health Record would be necessary for nursing professionals to deliver
Participates in software development and patient care effortlessly and also empower nursing
contributes in digital health initiatives students to enter in clinical environment glyph by glyph
without feeling flustered. Students and nurses are at
Updates and educates to new features of EHR
present practicing many of the skills set learnt on their
Able to manage EHR information
own or trained by professionals as and when need arises.
a. Nursing documentation- It is time that nurses stood up and worked towards
i. Analyze and utilizes digital patient progress adding standardized nursing language such as North
contributing to quality improvements American Nursing Diagnosis Association (NANDA)
ii. Evaluates and improves the documentation in EHR which had been proposed and continued to
process related to nursing care plan be emphasized in the revised EHR standards for India
which are acceptable but no further steps have been
iii. Utilizes patient information and clinical
taken to incorporate it in the system yet.22,23
parameters in improving nursing care
iv. Updates and pilots Standard operating CONCLUSION
procedures (SOP)/ Clinical decision support system
Radical changes in healthcare in India is driving
(CSSD)
health professionals towards prompt adoption of
v. Updates consent and procedural information on Information and Communication Technology (ICT) as it
digital platform is bound to enhance practice, reach to far-out places and
vi. Works in collaboration with quality team to ease the ways to provide healthcare to the second largest
focus on events documented digitally populated country of the world. Nurses can choose to
• Demonstrate use of standardized clinical swim with the tide or against it but the option to adopt
terminology including SNOMED CT, ICD classification ICT would be inevitable in future. Nurses would have to
as applied to clinical practice work with ICT applications unceasingly in any setting24.
The scope of informatics competency skills for nursing
• Collaborates at national level about
professionals needs to remain flexible as it will keep
interoperability of system
intensifying with information technology dynamically
• Big Data Analytics presenting the novel face of healthcare day by day5.
Interpret and utilize data for efficient nursing
Conflict of Interest Statement : The corresponding
care
author confirms on behalf of all authors that there have
Analyze and interpret data; collaborates with been no involvements that might raise the question
health professionals for enhancing quality patient care of bias in the work reported or in the conclusions,
• Telehealth implications, or opinions stated.
Updates, contribute and educates about the use Source of Funding- Not Applicable
of telecommunication technologies in patient care
Explores and participates in development of Ethical Clearance- Not Applicable
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