Nurses' Informatics Competency Assessment of Health Information System Usage: A Cross-sectional Survey.

Nurses' informatics competencies are nurses' professional requirements to guarantee the quality of patient care and affect nurses' use of health information systems. The purpose of this survey was to describe nurses' perceptions of their informatics competencies regarding health information system usage. A previously tested web-based questionnaire with multiple-choice questions was sent to nurses whose e-mail address was available through three Finnish Nursing Associations (N = 58 276). A total of 3610 nurses working in Finland responded. Both descriptive and explanatory statistics were used to analyze the data. The three dependent variables "nursing documentation," "digital environment," and "ethics and data protection" were formulated from the data. Nurses' overall informatics competency was good. The "ethics and data protection" competency score was higher than that of "nursing documentation" or "digital environment." Recently graduated nurses and nurses working in outpatient care, virtual hospital, examination, or operation had highest "digital environment" competency score. Health information system experience was associated with "nursing documentation." Nurses are highly qualified health information systems users. However, the competency requirements generated by rapidly expanding digitalization have challenged nurses. It is important to increase educational programs for nurses of how to use digital devices, and how to support patients to use digital services.

Factors Related to Health Informatics Competencies for Nurses-Results of a National Electronic Health Record Survey.

In 2015, the Finnish Ministry of Social Affairs and Health published an eHealth and eSocial strategy with key objectives that by 2020 health information systems will be smart and providers will be able to maximize their use. Measures include improving system usability and decision support, involving professionals in system and service development, and increasing professionals' training in information management, electronic documentation, data protection, and data security. The aim of this study was to explore the level of nurses' informatics competencies and sufficiency of in-house training regarding technology-induced changes in work practices. An electronic questionnaire produced by the National Institute of Health and Welfare was sent in February to April 2017 to 29 283 Finnish working-age nurses, community nurses, and midwives; 3607 replies were received. Respondents rated their overall informatics competency relatively high, with the lowest competency scores on terminology-based documentation (Finnish Care Classification) and patient-related digital work. Education, electronic health record system used, experience using electronic health record systems, sufficiency of training, higher levels of technical functionality, ease of use, and usefulness were all associated with competency and remained significant after all adjustments. One-third of the respondents felt that they had not received sufficient training. Age and participation in system development were associated with experiences of sufficiency of training.

The Biomedical and Health Informatics Recommendation Domains in Relation to the Nurse Competence Scale Categories.

The purpose of this mapping review was to examine the Recommendations of the Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics (BMHI) in relation to the contents of the Nurses' Competency Scale (NCS). The BMHI domains were mapped to the NCS categories to find analogous competence areas. As a conclusion, a consensus is presented on what each of the BMHI domain could mean on a responding NCS category. The number of the relevant BMHI domains were two for the Helping role, the Teaching and coaching, the Diagnostics functions, the Therapeutic interventions, and the Ensuring quality domains. The number of the relevant BMHI domains was four for the Managing situations and the Work role domains, of the NCS. The essence of nursing care has not changed, however, current means and equipment in practice require updated knowledge and digital skills for nurses. Nurses have a special role in narrowing the view gap between the views related to clinical nursing and informatics practice. Documentation, data analyses, and knowledge management are essential parts in nurses' competence today.

Using standardized nursing data for knowledge generation - Ward level analysis of point of care nursing documentation.

BACKGROUND: Standardized nursing terminology is a prerequisite for describing nursing care processes and generating knowledge for decision-making and management. The structure of the Finnish Care Classification (FinCC) facilitates documentation of nationally agreed core nursing data: nursing diagnoses, interventions, and outcomes. PURPOSE: To analyze the use of FinCC to assess patient care needs (nursing diagnoses), care implementations (interventions) and evaluation of the outcomes of nursing care in electronic health records. METHODS AND MATERIALS: The descriptive study applied purposeful sampling of nursing data from nursing data repositories in three surgical wards in tertiary and secondary care hospitals. The aggregated, anonymous ward level data from a six-month period was analyzed to show distributions within frequencies and means of component, main and subcategory level use of FinCC in the three hospitals. RESULTS: Each of the three levels of the FinCC (component, main and subcategory) were used for recording nursing care. In all hospitals, the three most used diagnosis components covered about one third of the use of all the 17 components. The five most used intervention components cover about one third of the components. The most often used components for diagnoses and interventions were Coordination of care and follow-up care, Pain Management, Activities of daily living and independence and Medication. The prevalence of different components and the main and subcategory level usage for both diagnoses and interventions varied between the hospitals. CONCLUSION: Standardized point-of-care nursing data makes patients' daily nursing care transparent. Structured, standardized, and point-of-care nursing data can be utilized to generate new knowledge of nursing care processes and nursing care practice at ward level.

Nursing informatics competences of Finnish registered nurses after national educational initiatives: A cross-sectional study.

BACKGROUND: Nursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates. OBJECTIVES: To examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined. DESIGN: Cross-sectional study. SETTINGS: The study was carried out between October-December 2018 in Finland. PARTICIPANTS: Registered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives. METHODS: Nursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance. RESULTS: Nurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence. CONCLUSIONS: The national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs.

The Definition of Informatics Competencies in Finnish Healthcare and Social Welfare Education.

Finland is a world leader in the use of public electronic services. Continuous improvement to competencies is a prerequisite for the success of digitalisation in the service development sector. The increasing use of information technology in health and social care needs to be taken into account in the education of the health and social care sector work force. The mandate of the national SotePeda 24/7 project is to identify and define the informatics competencies required for multidisciplinary education of this sector in Finland. The project has adapted international recommendations for use in the national context. The national recommendation covers 12 areas of competency and related content. In addition to defining competencies, the project has produced a toolbox of materials for use by educators of these topics in universities that cover applied sciences and lifelong learning. The results of the project are expected to significantly improve the preparedness of graduating health and social care and related engineering and business sector students to make full use information technology, all of which benefits the national health and social welfare system.

Developing competences and use of the Finnish model of documentation of nursing care - R&D project eNNI.

Electronic documentation of nursing care is going to be realized in Finland with FINCC and using a coherent model. The research and development project for creation of competences needed in the country is financed by the Ministry of Education and the partners are 14 universities of applied sciences (UAS).

Nurse informaticians in Finland - who are they and what are they doing?

The role of a nurse informatician is not yet common in health care settings in Finland although electronic patient records have been in use since 1980's. A web-based survey instrument was compiled based on the surveys conducted by HIMSS in spring 2009. The aim was to find out what kind of positions nurses have in nursing informatics in the Finnish health care sector. Based on the results the role of nurse informaticians varied between hospitals and health centres based on organization size and affiliation weather on IT-department or clinical setting. In many organizations nurses are also working quite isolated due to scarce number of nurses in the field of informatics.

Identifying Biomedical and Health Informatics Competencies in Higher Education Curricula.

This study describes the knowledge, skills and competencies found in bachelor's degree curricula for health and social care, engineering and business. The International Medical Informatics Association (IMIA) biomedicine and health information (BMHI) management recommendations was used as a framework to analyse bachelor's degree curricula (n=14). The results showed that the curricula contained a variety of subjects related to competencies in the IMIA's BMHI. The information technology (IT) engineering curriculum included the highest number of competencies and the business curricula the fewest. The nursing curricula included more competencies than any other health care curricula. When educating students in various professions, their diverse backgrounds and expertise must be considered. As future eHealth developers, students will learn to work as multidisciplinary teams.

Developing Digital Health and Welfare Services in an International Multidisciplinary Student Team.

The rapid growth of digital health and welfare services demands new competences for health and social care, information technology, and business professionals. This study aims to describe the competences that students have before their studies and those they expect to gain from the study module "Developing Digital Health and Welfare Services" in multiprofessional groups during their bachelor studies. This study reports open-ended questions about students' knowledge concerning digital health prior to the study units. The results, analyzed by QSR NVivo 10 for Windows, show that students are keen to learn about developing digital health and welfare services, and they see that multiprofessional work requires a communicative environment and respect for every profession. Students also believe that they have competences to bring to the multiprofessional group. A successful multidisciplinary development of digital health and welfare services requires changes and cooperation in education between various professions.

The Development Process of eHealth Strategy for Nurses in Finland.

Growing use of information and communication technology (ICT) demands have caused a need for nursing to strengthen the knowledge, skills and competences related to ICT in health (eHealth) and define its versatile roles. The Finnish Nurses Association (FNA) named a group of eHealth experts from various professional fields that are closely connected to nursing e.g. nursing practice, higher education, nursing research and administration. The main purpose was to describe nurses' contribution to the national strategy concerning eHealth development and implementation in health and social care. The group searched for answers, discussed strategic issues, wrote drafts, and sent texts for open commentary circles. The chosen themes of the eHealth strategies deal with the role of the client, nursing practice, ethical aspects education and eHealth competences, nursing leadership, knowledge management and research and development. The article describes the strategic work and the structure of eHealth strategy of nurses in Finland.

Adolescents with cancer: experience of life and how it could be made easier.

This study is about what adolescents with cancer think about their life situation, the support they get, and the information they receive about their illness. The data for this qualitative and descriptive study were collected in 3 focus group interviews with 20 adolescents aged 13 to 18 years attending a cancer adjustment camp. Interpretation was based on the method of inductive content analysis. The adolescents' experiences of their current situation were analyzed into 5 categories: views on life here and now, negative experiences of self because of the illness, resources recognized in self, difficulties caused by the illness in relation to life around them, and resources identified in the world around. They made very little, if any, conscious effort to plan ahead for the future. The information received by the adolescents concerned their illness and its treatment here and now, various practical matters, as well as the future impacts of the illness and its treatments. Most of this information focused on the here and now, whereas the adolescents' information needs were mainly oriented to the future. As for the adolescents' chances to take part in making decisions about their care and life, the analysis yielded 6 categories: joint decision making, inadequate chances for decision making, independent decision making, illusion of decision making, reluctant to make decisions, and excluded from decision making. Finally, the adolescents' hopes for improvement were focused on staff activities, physical care facilities, chances to discuss and work through their experiences of the illness, and the support received from society.