Nursing Informatics: Competency Challenges for Nursing Faculty.

Nursing is the largest workforce in health care with nurses increasingly required to work with digital health technologies. However, despite the adoption of nursing informatics in Australia in the mid-1980s, nursing graduates are not being adequately equipped to use these technologies in a way that benefits the profession and improves patient care. Using a scoping review approach, this paper presents an analysis of contemporary published literature and describes the barriers to faculty engagement with digital health technologies in undergraduate nursing education. Thirty five articles were included and identified faculty lack of understanding of nursing informatics and resistance to technologies, limited infrastructure and expenditure, and limited educational resources and best practice recommendations as significant barriers to the integration of nursing informatics into undergraduate nursing curricula. Recommendations for faculty development will be explored.

Challenging the Myth of the Digital Native: A Narrative Review.

BACKGROUND AND AIMS: Nurses are increasingly engaging with digital technologies to enhance safe, evidence-based patient care. Digital literacy is now considered a foundational skill and an integral requirement for lifelong learning, and includes the ability to search efficiently, critique information and recognise the inherent risk of bias in information sources. However, at many universities, digital literacy is assumed. In part, this can be linked to the concept of the Digital Native, a term first coined in 2001 by the US author Marc Prensky to describe young people born after 1980 who have been surrounded by mobile phones, computers, and other digital devices their entire lives. The objective of this paper is to explore the concept of the Digital Native and how it influences undergraduate nursing education. MATERIALS AND METHODS: A pragmatic approach was used for this narrative review, working forward from Prensky's definition of the Digital Native and backward from contemporary sources of information extracted from published health, education and nursing literature. RESULTS: The findings from this narrative review will inform further understanding of digital literacy beliefs and how these beliefs influence undergraduate nursing education. Recommendations for enhancing the digital literacy of undergraduate nursing students are also discussed. CONCLUSIONS: Digital literacy is an essential requirement for undergraduate nursing students and nurses and is linked with safe, evidence-based patient care. The myth of the Digital Native negates the reality that exposure to digital technologies does not equate digital literacy and has resulted in deficits in nursing education programs. Digital literacy skills should be a part of undergraduate nursing curricula, and National Nursing Digital Literacy competencies for entry into practice as a Registered Nurse should be developed and contextualised to individual jurisdictions.

Evaluating fundamental care knowledge to inform educational leadership.

AIM: To explore undergraduate nursing students' understanding of fundamental care and identify educational leadership opportunities to deepen students' understanding of fundamental care concepts. DESIGN: Sequential-explanatory mixed methods study. METHODS: We conducted a cross sectional survey (n = 202) and focus groups (n = 24) to explore undergraduate nursing students' ability to identify fundamental care needs. All data were collected between November 2020 and April 2021. Survey data were analysed using descriptive and inferential statistics and focus group data were thematically analysed. RESULTS: Year One students scored significantly lower in their ability to identify fundamental care needs compared with students in other years, even after controlling for route, gender and age. Post-degree students scored significantly higher than direct entry or transfer students. Students ≤19 years of age had significantly lower scores compared with students ≥25 years of age. Our focus group findings highlighted that students were often unable to define fundamental care, but they identified learning about various components of fundamental care in a variety of ways. While students understood that fundamental care was required in all settings, they were challenged in providing this care in acute and virtual settings. Students shared several suggestions to support fundamental care skills development across the curriculum. CONCLUSIONS: There is a need for a clear definition and description of the fundamentals of care that is used consistently by faculty, students and curriculum documents. It is important to encourage and support educators to share real-world nursing stories, offer students time to share their personal experiences, develop creative learning opportunities and foster student reflection to deepen students' understanding of the fundamentals of care. IMPACT: Educators need support to meaningfully incorporate fundamentals of care learning opportunities across multiple care settings. Educational leaders can use these findings to develop or adapt their curricula to support fundamental care skill development.

Nursing informatics and undergraduate nursing curricula: A scoping review protocol.

AIM: This scoping review aims to review contemporary published literature on Nursing Informatics education in undergraduate nursing education. INTRODUCTION: Nursing is the largest workforce in health care and nurses are increasingly required to work with digital information systems. The need for nurses to understand and embrace information technology is closely linked with the ability to function in the contemporary healthcare workplace. However, despite the early adoption of Nursing Informatics in Australia in the 1980 s, there remain barriers to Nursing Informatics engagement and proficiency, including poor computer literacy, limited professional development and a lack of undergraduate informatics education. DESIGN: This scoping review will be developed in adherence with the JBI Manual for Evidence Synthesis: Scoping Reviews and the PRISMA-ScR Checklist. METHODS: To be included in this scoping review, papers need to include Nursing Informatics education for undergraduate nursing students in a Bachelor of Nursing program. Undergraduate nursing students are defined as individuals enrolled in a recognised nursing program leading to registration as a Nurse. To meet the requirements for registration as a Registered Nurse, in Australia, individuals are required to complete a Bachelor of Nursing program at a university (Australian Qualifications Framework Level 7) For the purpose of this scoping review, undergraduate nursing students are defined as those individuals undertaking a three year Bachelor of Nursing program at a university. Equivalent international definitions will be also used in the scoping review procedure. Sources of information will be included if they were published between 2015 and 2022 and describe curriculum recommendations (including barriers to implementing Nursing Informatics education). The purpose of the identified timespan is to reflect the rapidly evolving nature of health informatics and digital technologies. The requirement for curriculum recommendations is to reflect the purpose of the scoping review as the basis for a Delphi study, where Nursing Informatics and its integration into Bachelor of Nursing curricula will be explored and described in collaboration with domain experts. ETHICS AND DISSEMINATION: Ethics approval has been obtained for this scoping review (Project ID: 2156) from the Flinders University's Human Research Ethics Committee and has been determined to be low risk.

The impact of virtual simulation on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students.

A major patient safety challenge is recognition and response to deteriorating patients since early warning signs are often not detected in a timely manner. Nursing students typically learn the skills for early identification through clinical placement, but clinical placements are not guaranteed to provide exposure to deteriorating patients. Nursing students require practice with emergency scenarios to develop their competency and confidence to act in this area. This study aimed to explore the impact of a virtual simulation intervention on the recognition and response to the rapidly deteriorating patient among undergraduate nursing students. A mixed methods study involving a quasi-experimental pre/post design and focus groups. The participants were third or final year undergraduate nursing students from five university sites across four countries (Canada, England, Scotland and Australia, n = 88). Students were randomly assigned to a treatment or control group. The treatment group received a virtual simulation intervention and participated in a focus group. The virtual simulation intervention had a significant effect on improving nursing student knowledge and clinical self-efficacy in the recognition and response to the rapidly deteriorating patient. Students reported that the virtual simulations decreased anxiety, helped them prioritize, filled gaps in their learning, and encouraged autonomous learning within a safe 'low risk' environment. Virtual simulation is an effective strategy for improving knowledge and confidence in recognizing and responding to the rapidly deteriorating patient among undergraduate nursing students.

Defining Nursing Informatics: A Narrative Review.

Healthcare has experienced rapid transformation with the development of digital technologies which aim to make healthcare safer and more efficient. In response, health informatics has evolved, including nursing informatics, which integrates nursing, information and communication technologies (ICT) and professional knowledge to improve patient outcomes. New language has developed to describe informatics and its processes; however, this has generally been poorly understood. This paper will describe current definitions of nursing informatics from three different healthcare contexts: Australia, the United States of America and Canada, to identify the similarities and differences between these definitions and to summarise the distinct bodies of knowledge described by each country. These countries have amongst the oldest definition attempts in the literature. A pragmatic approach was taken in this narrative review, working forward from historic references and backwards from recent references extracted from published health and nursing informatics literature.

The Care Informatics and Technologies Project - Enhancing Capability, Motivation and Opportunities in Digital Health Among Health Professionals and Students.

A change in the behaviour of the current and future workforce in regards to how they approach the needs and challenges in the healthcare sector is necessary to transit from the current curative paradigm in health to a new one focused on prevention and rational use of resources. Digital health is instrumental in the adoption of this new paradigm as most e-health applications focus on a preventive and personalized approach, on lifestyle changes (e.g. fitness and nutrition), health literacy and self-tracking allowing consumers to manage their own heath. The Capability-Opportunity-Motivation Behaviour (COM-B) model and the Behaviour Change Wheel framework (BCW) have been applied to characterise interventions for behaviour change in health professionals. They provide a systematic way of characterising interventions and enable their outcomes to be linked to mechanisms of action. Acknowledging the potential of informatics and technologies in current and emerging health issues and the importance of focusing on care needs rather than on the development of technologies per se to achieve meaningful clinical outcomes, the College of Nursing and Health Sciences (CNHS) in Flinders University is undertaking the Care Informatics and Technologies project. This priority project aims to build capacity in digital health within the College's students and staff, so that informatics, digitisation and technologies become part of clinical learning, research and ongoing clinical practice. We aim to report the protocol of this project and discuss it in the context of the expected change in behaviour of health professionals that is deemed necessary to address the Australian digital health agenda.

The use of digital badges by undergraduate nursing students: A three-year study.

During a three-year study, 32% (n = 67) in 2015, 16% (n = 44) in 2016 and 55% (n = 161) of students in 2017 expressed an interest in using digital badges to enhance their learning. But who are these students? This paper explores the features of students who are interested in using digital badges as a motivational reward to prepare for weekly face-to-face classes through engaging with online activities and resources. This paper uses a first-year undergraduate Bachelor of Nursing bioscience topic at an Australian university to report nursing students' interests around playing games, their digital badge history during the topic, and their self-reported attitudinal interest in using digital badges to enhance and personalise their learning. Overall, the results indicate that some students chose to enhance their learning potential in class by earning digital badges prior to class. The results of this paper are relevant for nursing educators and educational designers seeking to integrate digital badges into motivational teaching practices, by evaluating the role digital badges play as a motivational game-based learning design element.

E-learning & information communication technology (ICT) in nursing education: A review of the literature.

OBJECTIVES: To examine primary research articles published between January 2001 and December 2012 that focused on the issues for students and educators involved with E-learning in preregistration nursing programs. The literature was systematically reviewed, critically appraised and thematically analyzed. BACKGROUND: E-learning is arguably the most significant change to occur in nursing education since the move from hospital training to the tertiary sector. Differences in computer and information literacy for both students and educators influence the success of implementation of E-learning into current curricula. DATA SOURCES: Online databases including CINAHL, MEDLINE, OVID, the ProQuest Central, PubMed, ERIC and Science Direct were used. METHODS: The criteria used for selecting studies reviewed were: primary focus on electronic learning and issues faced by nursing students and/or nurse educators from undergraduate preregistration nursing programs; all articles had to be primary research studies, published in English in peer reviewed journals between January 2001 and December 2012. RESULTS: Analysis of the 28 reviewed studies revealed the following three themes: issues relating to E-learning for students; use of information technologies; educator (faculty) issues involving pedagogy, workload and staff development in E-learning and associated technology. CONCLUSION: The review highlighted that commencing preregistration nursing students required ongoing education and support surrounding nursing informatics. This support would enable students to progress and be equipped with the life-long learning skills required to provide safe evidence based care. The review also identified the increased time and skill demands placed on nurse educators to adapt their current education methodologies and teaching strategies to incorporate E-learning.

Flight nurses in Australia: maintaining their midwifery competence - a case study.

Flight nurses (FNs) in Australia care for a wide diversity of patients as sole practitioners. No studies could be located regarding how FNs maintain their midwifery competence. The purpose of this study was to investigate how levels of competence in midwifery practice are determined amongst Australian FNs and explore if continuing professional development (CPD) contributes to the maintenance of FN's midwifery clinical skills and knowledge. Data was collected using computer mediated communication and content analysed using a thematic framework. The results of this study showed that the maintenance of current midwifery practice was complex due to the low numbers of midwifery patients cared for by FNs. CPD was identified as essential however this research demonstrated a lack of motivation by this small group of FNs to attend CPD, mainly due to the absence of a programme that recognises the different context and scope of their practice.

Third-year undergraduate nursing students' perceptions of high-fidelity simulation.

High-fidelity simulation, with the potential to enhance cognitive, associative, and autonomous skills, can help students develop clinical reasoning. This study examined third-year students' (N = 300) perceptions about the implementation of high-fidelity simulation into an existing clinical course. Data were collected using an evaluation form completed by students after the simulation. Students perceived high-fidelity simulation as enjoyable, with an appropriate degree of challenge yet possessing congruency with concepts studied in the course. Students' transient feelings of confusion were interpreted as a natural component of the problem solving process as they analyzed, clustered, and interpreted cues to respond to rapid changes in the simulated patient's clinical condition. Debriefing was viewed as an important component and assisted in clarifying students' knowledge and rationale for practice. Further research is required on the relationship between the degree of confusion and its impact on learning and whether high-fidelity simulation increases the ability to reason in the clinical setting.

Suprapubic catheters--a shared understanding, from the other side looking in.

OBJECTIVE: The objective of this study was to explore the experiences of people living with a suprapubic catheter. METHOD: This descriptive study was guided by the philosophy of Gadamerian hermeneutics. Data were gathered via indepth interviews with 6 adults living in the community who had a suprapubic catheter for long-term urinary bladder drainage. Interpretation of the data occurred via thematic analysis of the participants' stories. RESULTS: Two distinct but interrelated themes emerged. Participants shifted, over time, from negative to positive experiences (psychologically, physically, and practically) to adjustment to life with a catheter. Participants also related that health professionals had not adequately prepared or supported them as they learned to live with a suprapubic catheter. Many of the participants' initial negative experiences were augmented by this deficiency. Issues revolved around perceptions of being psychologically unprepared, the changed body image, altered sexuality, and support needs. CONCLUSION: The findings of this study revealed that the insertion of a suprapubic catheter brought about significant life changes for the participants. The data highlighted disparities between the needs of people who have a supra-pubic catheter and health professionals' perceptions of their needs.