Digital health competencies for primary healthcare professionals: A scoping review

BACKGROUND

Despite digital health providing opportunities to enhance the quality, efficiency and safety of primary healthcare, the adoption of digital tools and technologies has been slow, partly because of poor digital health literacy. For primary healthcare systems to take full advantage of these technologies, a capable, digitally literate workforce is necessary. Still, the essential digital health competencies (DHCs) for primary healthcare have not been explored. This review aims to examine the broad literature on DHCs as it applies to Primary Care (PC) settings.

METHODS

We performed a scoping review on all types of research linking DHCs to PC. We searched all major databases including Medline, Embase, CINAHL, and Cochrane Library in November 2019. Concurrently, a thorough grey literature search was performed through OpenGrey, ResearchGate, Google Scholar, and key government and relevant professional associations' websites. Screening and selection of studies was performed in pairs, and data was analysed and presented using a narrative, descriptive approach. Thematic analysis was performed to identify key DHC domains.

RESULTS

A total of 28 articles were included, most of them (54 %) published before 2005. These articles were primarily aimed at PC physicians or general practitioners, and focused on improving knowledge about information technologies and medical informatics, basic computer and information literacy, and optimal use of electronic medical records. We identified 17 DHC domains, and important knowledge gaps related to digital health education and curriculum integration, the need for evidence of the impact of services, and the importance of wider support for digital health.

CONCLUSIONS

Literature explicitly linking DHCs to PC was mostly published over a decade ago. There is a need for an updated and current set of DHCs for PC professionals to more consistently reap the benefits of digital technologies. This review identified key DHC domains and statements that may be used to guide on the development of a set of DHC for PC, and critical knowledge gaps and needs to be considered. Such a DHC set may be used for curricula development and for ensuring that the essential DHC for PC are met at a clinical or organizational level, and eventually improve health outcomes.

The moderating effects of demographic and individual characteristics on nurses' acceptance of information systems: A canadian study

OBJECTIVES

The purpose of this study was to educate on the moderating effects of demographic (i.e., educational level and age) and individual characteristics (i.e., years of nursing experience and computer knowledge) on nurses' acceptance of information systems (IS). The technology acceptance model (TAM) with its constituent variables such as perceived usefulness (PUSS) and perceived ease of use (PEOU) was the theoretical framework used for this study.

METHODS

A cross-sectional study was conducted in Nova Scotia, Canada. Usable data was collected from 197 registered nurses (RNs). Relevant hypotheses were formulated and the partial least squares (PLS) technique was used for data analysis.

RESULTS

The results of the hypothesized relationships showed that education and computer knowledge have positive moderating effects on the influences of PEOU and PUSS on nurses' attitudes toward IS (ATTI). The factors of nurses' years of nursing experience and age did not yield meaningful results. ATTI impacted behavioral intentions to use IS, which positively impacted nurses' use of IS. The nurses sampled in the study have positive IS use behaviors.

CONCLUSIONS

This study demonstrates that relevant demographic factors and individual characteristics, if incorporated into frameworks used for investigating nurses' acceptance of IS, could permit the emergence of useful insights for practitioners and researchers. Specifically, this study showed that nurses with higher educational attainments and more basic computer knowledge readily accept implemented IS at work. Hospital administrators benefit from insights such as the one presented in this study.

Development of a blended model of teaching and learning for nursing students on rostered placement to ensure competence in information and communication technology for professional practice in Ireland

Experiences gained from delivering a Health Informatics for Nurses course in a school of nursing and midwifery in a university teaching hospital in Ireland suggest that Web-based courses may facilitate an enhanced understanding of course content. Nursing education must recognize the importance of information and communication technology in nursing to prepare the nursing and midwifery profession to embrace current advances in information and communication technology in healthcare in Ireland, and ultimately to benefit patient care.

Nurses, computers and pre-registration education

Nursing informatics, the use of information and technology, to support the work of the nurse, is an essential part of the modern nurses' job. In the UK this is supported by a range of National Health Service policy documents over the past decade, starting with Information for Health in 1998. Research carried out over this period has however found that nurses lack the necessary skills and knowledge to use computers effectively, and that pre-registration education does not fully prepare student nurses for this aspect of the role of the nurse. This paper presents the results of a longitudinal study carried out with a cohort of nursing students, which found that although the students lacked computer skills and knowledge at the start of their programme they were willing to engage with this agenda. Two factors were found to be necessary for students to use the available IT on placement. One was a belief that they had the skills to use the computers; the other was a supportive environment that encouraged their use. Unfortunately only a minority of students reported that they had experienced a supportive environment.

Computer literacy study: report of qualitative findings

Computer literacy and information literacy are critical to the future of nursing. The very nature of health care is being transformed in response to environmental drivers such as the demands for cost-effective delivery of high quality services and enhanced patient safety. Facilitating the quality transformation depends on strategic changes such as implementing evidence-based practice (), promoting outcome research (), initiating interdisciplinary care coordination [Zwarenstein, M., Bryant, W. (2004). Interventions to promote collaboration between nurses and doctors. The Cochrane Library(I)], and implementing electronic health records (). Information management serves as a central premise of each of these strategies and is an essential tool to facilitate change. This report of the analysis of qualitative data from a national online survey of baccalaureate nursing education programs describes the current level of integration of the computer literacy and information literacy skills and competencies of nursing faculty, clinicians, and students in the United States. The outcomes of the study are important to guide curriculum development in meeting the changing health care environmental demands for quality, cost-effectiveness, and safety.

Readiness of U.S. Nurses for Evidence-Based Practice

Evidence-based practice is a systematic approach to problem solving for health care providers, including RNs, characterized by the use of the best evidence currently available for clinical decision making, in order to provide the most consistent and best possible care to patients. Are RNs in the United States prepared to engage in this process? This study examines nurses' perceptions of their access to tools with which to obtain evidence and whether they have the skills to do so. Using a stratified random sample of 3,000 RNs across the United States, 1,097 nurses (37%) responded to the 93-item questionnaire. Seven hundred sixty respondents (77% of those who were employed at the time of the survey) worked in clinical settings and are the focus of this article. Although these nurses acknowledge that they frequently need information for practice, they feel much more confident asking colleagues or peers and searching the Internet and World Wide Web than they do using bibliographic databases such as PubMed or CINAHL to find specific information. They don't understand or value research and have received little or no training in the use of tools that would help them find evidence on which to base their practice. Implications for nursing and nursing education are discussed.

Use of libraries and electronic information resources by primary care staff: outcomes from a survey

OBJECTIVES

To assess the use of existing libraries; usage of the Internet and biomedical databases; and need for training on use of the Internet and biomedical databases for primary care staff.

METHODS

A postal survey of general practitioners (GPs), practice nurses (PNs) and practice managers (PMs) in Nottingham and Rotherham, UK.

RESULTS

Overall, 243 questionnaires were used. The response rate in Nottingham was 24%, in Rotherham it was 34%. Reported use of libraries was low (30%), with PNs reporting significantly higher usage (65%) than others (P < 0.01). Most respondents reported using the Internet (81%), but fewer (44%) reported using databases. GPs and PNs were significantly more likely to report using databases than PMs (P < 0.01). Lack of training was the most reported barrier to using the Internet (67%) and databases (52%). Overall, 52% of respondents reported wanting Internet training, 64% wanted database training. The percentages requesting training on databases were high among GPs and PNs, but significantly lower for PMs (P = 0.02).

CONCLUSIONS

There are differences in the usage of libraries and electronic resources among the primary care team, and in reported training needs. While the reported levels of usage of the Internet and biomedical databases are encouraging, our study identified a training need. If met, this could increase usage further.

Results of a National Survey Indicating Information Technology Skills Needed by Nurses at Time of Entry Into the Work Force

A national survey was conducted to determine the information technology skills nurse administrators consider critical for new nurses entering the work force. The sample consisted of 2,000 randomly selected members of the American Organization of Nurse Executives. Seven hundred fifty-two usable questionnaires were returned, for a response rate of 38%. The questionnaire used a 5-point Likert scale and consisted of 17 items that assessed various technology skills and demographic information. The questionnaire was developed and pilot tested with content experts to establish content validity. Descriptive analysis of the data revealed that using e-mail effectively, operating basic Windows applications, and searching databases were critical information technology skills. The most critical information technology skill involved knowing nursing-specific software, such as bedside charting and computer-activated medication dispensers. To effectively prepare nursing students with technology skills needed at the time of entry into practice, nursing faculty need to incorporate information technology skills into undergraduate nursing curricula.

Information technology training in primary care: the nurses' voice

Information technology (IT) is now essential to the development and delivery of health services. Healthcare professionals, including nurses, need appropriate educational training to enable them to use IT adequately because care is shared within multiprofessional teams in both hospitals and the community. In particular, primary care nurses have had less access than other health professionals to IT training and fewer opportunities to benefit from IT. Furthermore, there is little evidence in the literature on the current situation of IT training needs and requirements for primary care nurses. The PRACTIS (PRimary care nurses Access to Communications Technology and Informatics Skills) UK-based project has addressed these issues through an empirical investigation to establish a picture of the current primary care situation. This was done using a questionnaire, followed by practicing nurse focus groups. Directions for further work in the IT training of primary care nurses are discussed, together with recommendations to investigate the effect that the organization of the work within primary care groups may have on nurses' use and access to communications technology and informatics skills.