Informatics competencies essential to decision making in nursing management

Survey study with specialist nurses in health informatics and management. An electronic questionnaire was built based on the competencies Information Literacy (five categories; 40 abilities) and Information Management (nine categories; 69 abilities) of the TIGER - Technology Informatics Guiding Education Reform - initiative, with the guiding question: Which informatics abilities are essential to decision making in management? Answers were sorted in a Likert scale, ranging from 1 to 5. Rasch analysis was conducted with the software WINSTEPS ^®. Results were presented in logits, with cutoff value zero.

RESULTS

Thirty-two specialists participated, coming from all regions of Brazil. In the information literacy competency, 18 abilities were considered essential and in Information Management, 38; these were sorted according to their degree of essentiality.

CONCLUSION

It is believed that the incorporation of these abilities in teaching can support the education of nurse managers and contribute to evidence-based practice, incorporation of information and communication technologies in health and information management.

Descriptors:
Informatics; Nursing Administration Research; Competency-Based Education

Information literacy	Eigenvalue at 1st contrast	Person reliability	Item reliability
Category 1: Knowledge - Determine the nature and extent of the information needed	< 3	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).
Category 2: Access - Access needed information effectively and efficiently	< 3	0.60	0.16
Category 3: Evaluate information and its sources critically and incorporate selected information into his or her knowledge base and value system	< 3	0.64	0.43
Category 4: Individually or as a member of a group, use information effectively to accomplish a specific purpose	< 3	0.45	0.69
Category 5: Evaluate outcomes of the use of information	< 3	0.39	0.73
Information management
Category 1: Demographic/patient info	< 3	0.70	0.66
Category 2: Consents and authorizations	< 3	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).
Category 3: Medication management	< 3	0.84	0.86
Category 4: Planning care	< 3	0.78	0.85
Category 5: Order/Results management	< 3	0.73	0.85
Category 6: Care documentation	< 3	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).	^* * it was not possible to calculate, most items had extreme answers. Note: (n=32).
Category 7: Decision support	> 3	0.83	0.42
Category 8: Notifications	< 3	0.56	0.82
Category 9: Facilitating communications	< 3	0.51	0.66

Category/Ability	Measure	Infit MnSq	Oufit MnSq
Category 1: Knowledge - Determine the nature and extent of the information needed
Ref. 1.1 Recognize a specific information need	-0.58	0.84	0.77
Category 2: Access - Access needed information effectively and efficiently
Ref. 2.8 Understand that the Internet may be a useful resource for locating, retrieving and transferring information electronically	-0.66	1.20	0.96
Ref. 2.3 Select types of information resources appropriate to a specific information need	-0.56	0.50	0.33
Ref. 2.7 Use online search techniques and tools to locate relevant citations and to further refine the search	-0.29	0.90	1.07
Ref. 2.6 Use search language appropriate to the source, such as a controlled vocabulary, key words, natural language, author and title searches to locate relevant items in print and electronic resources	-0.20	0.70	0.59
Category 3: Evaluate information and its sources critically and incorporate selected information into his or her knowledge base and value system
Ref. 3.11 Integrate the new information into existing body of knowledge	-0.85	1.03	1.01
Ref. 3.5 Understand that the Internet may be a useful resource for locating, retrieving and transferring information electronically	-0.29	1.14	1.13
Ref. 3.6 Use a variety of criteria, such as author's credentials, peer review, and reputation of the publisher, to assess the authority of the source	-0.19	0.79	0.66
Ref. 3.7 Assess the relevance of a source to an information need by examining publication date, purpose, and intended audience	-0.17	1.24	0.86
Ref. 3.8 Recognize omission in the coverage of a topic	-0.01	1.35	1.67
Category 4: Individually or as a member of a group, use information effectively to accomplish a specific purpose
Ref. 4.8 Create a logical argument based on information retrieved	-0.88	0.70	0.60
Ref. 4.5 Organize the information in a logical and useful manner	-0.68	1.79	1.39
Ref. 4.1 Recognize and evaluate documentation for the information source, such as research methodology, bibliography or footnotes	-0.65	0.88	1.02
Ref. 4.4 Recognize and accept the ambiguity of multiple points of view	-0.23	0.85	0.78
Category 5: Evaluate outcomes of the use of information
Ref. 5.5 Understand the ethics of information use, such as knowing how and when to give credit to information and ideas gleaned from others by appropriately citing sources in order to avoid plagiarism	-1.93	0.94	0.41
Ref. 5.6 Respect intellectual property rights by respecting copyright	-1.16	1.16	1.90
Ref. 5.8 Understand the social/political issues affecting information, such as: a) privacy b) privatization and access to government information c) electronic access to information d) the exponential growth of information e) equal access to information	-0.19	1.17	1.53
Ref. 5.1 Describe the criteria used to make decisions and choices at each step of the particular process used	-0.12	1.07	1.20

Category/Ability	Measure	Infit MnSq	Oufit MnSq
Category 1: Demographic/patient info
Ref. 1.1 Identify and Maintain a Patient Record	- 0.71	0.91	0.79
Ref. 1.7 Produce a Summary Record of Care	-0.68	0.86	0.87
Ref. 1.9 Manage Patient History	-0.59	0.75	0.71
Ref. 1.2 Manage Patient Demographics	-0.43	1.28	1.18
Category 2: Consents and Authorizations
Ref. 2.3 Manage Consents and Authorizations	-0.61	1.10	0.94
Category 3: Medication Management
Ref. 3.3 Manage Problem Lists	-2.43	0.75	0.16
Ref. 3.5 Manage Medication Administration	-1.17	0.74	0.20
Ref. 3.2 Manage Medication Lists	-1.08	0.94	1.00
Category 4: Planning Care
Ref. 4.2 Manage Patient-Specific Care and Treatment Plans	-2.41	0.65	0.20
Ref. 4.1 Interact with Guidelines and Protocols for Planning Care	-1.78	2.92	9.90
Ref. 4.3 Interact with Clinical Workflow Tasking	-0.06	0.69	0.53
Category 5: Order/Results Management
Ref. 5.6 Manage Results	-1.60	1.74	1.61
Ref. 5.1 Manage Non-Medication Patient Care Orders	-1.53	0.66	0.72
Ref. 5.2 Manage Orders for Diagnostic Tests	-0.32	0.63	0.52
Ref. 5.3 Manage Orders for Blood Products and Other Biologics	-0.18	0.78	2.12
Category 6: Care Documentation
Ref. 6.1 Manage Patient Clinical Measurements	-0.69	1.00	1.00
Ref. 6.3 Manage Documentation of Clinician Response to Decision Support Prompts	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.
Ref 6.4 Generate and Record Patient-Specific Instructions	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.	^* * The items received maximum score from all specialists, it was not possible to obtain adjustment values.
Category 7: Decision Support
Ref. 7.2 Manage Health Information to Provide Decision Support for Patient Context- Driven assessments	-0.87	0.49	0.59
Ref. 7.5 Interact with decision Support for Standard Care Plans, Guidelines, and Protocols	-0.73	0.77	0.44
Ref. 7.3 Manage Health Information to Provide Decision Support for Identification of Potential Problems and Trends	-0.60	0.68	0.49
Ref. 7.1 Manage Health Information to Provide Decision Support for Standard Assessments	-0.59	0.74	0.38
Ref. 7.20 Interact with decision Support for Safe Blood Administration	-0.50	0.85	1.58
Ref. 7.12 Interact with decision Support for Drug Interaction Checking	-0.50	0.91	2.23
Ref. 7.10 Manage Health Information to Provide Decision Support for Self-Care	-0.39	0.70	0.58
Ref. 7.4 Manage Health Information to Provide Decision Support for Patient and Family Preferences	-0.39	0.90	1.82
Ref. 7.15 Interact with decision Support for Medication and Immunization Administration	-0.28	1.20	0.73
Ref. 7.14 Interact with decision Support for Medication Recommendations	-0.20	1.25	1.01
Ref. 7.16 Interact with decision Support for Non-Medication Ordering	-0.09	0.77	0.69
Ref. 7.13 Interact with decision Support for Patient Specific Dosing and Warnings	-0.09	0.87	0.50
Category 8: Notifications
Ref. 8.6 Manage Health Information to Provide Decision Support for Monitoring Response	-1.16	0.53	0.44
Ref. 8.5 Manage Health Information to Provide Decision Support for Notification and Response regarding population health issues	-0.56	0.74	0.58
Ref. 8.8 Access Healthcare Guidance	-0.33	1.58	1.67
Ref. 8.2 Interact with decision Support for Notifications and Reminders for Preventive Services and Wellness	-0.08	1.00	0.96
Category 9: Facilitating Communications
Ref. 9.4 Facilitate Patient, Family and Care Giver Education	-0.53	0.76	0.72
Ref. 9.1 Facilitate Inter-Provider Communication	-0.53	0.55	0.53
Ref. 9.3 Facilitate Communications Between Provider and Patient and/or the Patient Representative	-0.43	0.82	0.63
Ref. 9.2 Facilitate Provider -Pharmacy Communication	-0.23	1.53	1.43

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Autor correspondente: Rodrigo Jensen. Departamento de Enfermagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" Distrito de Rubião Júnior, s/n. CEP 18618-970 - Botucatu, SP, Brazil.rjensen@fmb.unesp.br