Journal of Nursing Education

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

Melinda McCannon, EdD

Abstract

ABSTRACT

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 nursingspecific software, such as bedside charting and computeractivated 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.

Abstract

ABSTRACT

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 nursingspecific software, such as bedside charting and computeractivated 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.

Preparing nursing students for practice in the 21st century must include information technology in undergraduate nursing curricula. Historically in nursing, informatics was a specialized area studied at the graduate level. However, the current health care environment demands information technology skills at all levels of nursing practice. New graduates of undergraduate nursing programs are moving into a decidedly technical world when they seek their first nursing positions, and the education they receive to prepare them for these positions must include the skills necessary to work in this highly computerized environment Ellis & Hartley, 2001). However, many undergraduate nursing programs do not require any information technology courses in their curricula.

It is essential for nursing education programs to critically evaluate the skills needed at nurses' time of entry into the work force. With the supply of nurses failing to meet the projected demand, nurses need to be competent in the initial job skills required because current work environments do not provide nor promote lengthy orientation for new employees. The current nationwide nursing shortage is projected to increase to 29% by 2020 (U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, National Center for Health Workforce Analysis, 2002).

In addition, the average age of graduates of associate degree programs, the largest source of new RNs, is 33 (U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, National Center for Health Workforce Analysis, 2002), and generally, these nontraditional students are not as computer savvy as traditional students. Recent high school graduates have the benefit of computers being available throughout their elementary and high school education.

PURPOSE

Due to the current nursing shortage, not all nurses choose to pursue graduate degrees in specialty areas, such as informatics. Nurses with undergraduate degrees initially can achieve moderate salaries, and little incentive exists to encourage nurses to advance their educational backgrounds. However, it is essential for RNs to be familiar

with information technology skills because these skills are required daily in all health care settings. This study was conducted to determine the information technology skills nursing administrators consider critical for new nurses entering the work force.

LITERATURE REVIEW

According to Russell and Alpay (2000), a substantial number of nurses have not yet acquired adequate knowledge of information technology. To combat this problem, the National League for Nursing (2002) made "infusing technology into concepts, structures, and processes of nursing education" (p. 1) one of the nursing education research priorities to ensure nursing graduates' competency for 21st century practice.

Several studies have addressed various issues of incorporating information technology into the nursing profession. Hobbs (2002) conducted a review and analysis of the literature measuring nurses' computer competencies. Instruments primarily measured computer knowledge, attitudes, and skills. However, methodological disparity among the studies made it difficult to draw any generalizations. For example, samples ranged from 15 to 497 participants, and the populations differed greatly (e.g., clinical nurses, sophomore and senior nursing students, faculty). The review documented that cognitive competencies included basic computer operations and word processing; attitude competencies included satisfaction with the operating system and belief it was the better system available; and skill competencies included basic operations, word processing, use of tables and graphs, use of e-mail, and ability to browse the Internet.

In 1997, Saranto and Leino-Kilpi used the Delphi technique to identify and describe the computer skills required in nursing. For the findings to be included in the study, consensus had to be reached among 15 experts from four groups (i.e., clinical nurse managers, patients, nurse educators, student nurses). The authors found that the experts reached consensus on four content areas. The first area was system security, which included understanding the importance of passwords and knowing the laws concerning data security and patients' rights. The second area of consensus was the ability to resolve error issues, including awareness of viruses and knowing the meanings of different error messages. The third area of consensus was obstacles and prerequisites of automated data processing, which included developing a positive attitude toward computers and being familiar with ergonomie recommendations. The fourth area of consensus was the ability to use hospital information systems, including using these systems to retrieve patient information and to generate nursing care plans.

Another study on nursing and information technology focused on the information technology knowledge, attitudes, and experience of two groups of nursing students when they entered their university courses (one in 1997, one in 1998) (Sinclair & Gardner, 1999). The researchers asked each group to complete a questionnaire, which included answering biographical data questions, a selfassessment of competence, a knowledge of computers competence test, and an information technology attitude scale. In terms of perceived information technology competence, the researchers found no significant differences between the two groups in the percentages of students who claimed to have low, medium, or high competence in applications such as word processing, spreadsheets, and databases.

In the knowledge of computers part of the question- ^ naire, the groups were asked to complete a 16-item multiple-choice test. The score for the combined groups was ? nearly 60% of the 16 maximum, which bolstered the moderate self-perceptions of competence expressed by the groups (Sinclair & Gardner, 1999). For the attitude assessment section, the groups completed a 20-item attitude scale. No significant differences were found between the ^ two groups. The high mean score of the two groups showed positive motivation toward using computers. Using this information, the researchers recommended baseline information technology competence be identified and all courses have the clear objective of raising students' confidence in using computers (Sinclair & Gardner, 1999).

Russell and Alpay*s (2000) study focused on the activities for which nurses used computers, how they used the computers, and their training needs. Questionnaires were sent to 225 nurses in England. The authors discovered the main use of computers was maintenance of medical records (Russell & Alpay, 2000). Half of the nurses used computers for managing appointments and for clinical coding. Half of the nurses reported they used computers continually during their shifts, and half of the nurses wanted more time available to spend using computers. Training in basic infor- _ mation technology skills appeared to be minimal because less than 5% of the nurses had received training in any of the categories investigated, including word processing, email, and the Internet.

An interesting note about these three studies is they are all internationally based studies. One study was conducted in Finland, and the other two studies were conducted in England. ?? date, no study has focused on the information technology skills of U.S. nurses. However, according to Simpson (2000), for nursing to thrive, it "had better embrace information technology and begin shaping it to nursing's changing needs" (p. 144).

RESEARCH QUESTIONS

The questions that guided this study were:

* What types of software skills are critical for new nurses entering the work force?

* Is knowledge of nursing-specific software critical for new nurses entering the work force?

* Is being able to navigate a Windows operating system critical for new nurses entering the work force?

* Is being able to search the Internet for information critical for new nurses entering the work force?

* Is being able to use e-mail critical for new nurses entering the work force?

Table

TABLE 1Ability to Search Databases for Medical Information

TABLE 1

Ability to Search Databases for Medical Information

Table

TABLE 2Knowledge of Nursing-Specific Software

TABLE 2

Knowledge of Nursing-Specific Software

METHOD

Sample

The sample (N = 752) was obtained from 2,000 randomly selected members of the American Organization of Nurse Executives. These members were selected as the population because they are the individuals who are most likely to hire new nurses and to understand the information technology skills these nurses should have when entering the work force.

Instrument

Using information from information technology and nursing sources, the authors developed a questionnaire that was pilot tested by nursing administrators in the local area to establish content validity. Suggested changes were incorporated. The instrument included 14 information technology questions and 3 demographic questions. The information technology questions measured skills related to creating simple and advanced word processing documents, spreadsheets, presentations, and databases. Other questions focused on competent search and retrieval of database data, understanding a Windows operating system, efficiently managing file properties, interfacing proficiently with nurse-specific software, and using the Internet, e-mail, and calendar software. Demographic questions included respondents' number of years in their position, facility location, and facility size, based on the actual number of full-time nurses. The questionnaire used a 5-point Likert scale, ranging from 1 = "not needed" to 5 = "critical skill."

Procedure

Permission to use the name list for research purposes was obtained from the American Organization of Nurse Executives. No formal internal review board was available at the affiliated institution. A list of 2,000 randomly selected members of the American Organization of Nurse Executives was purchased for this research study. Questionnaires were mailed in mid-spring 2002, and a stamped, self-addressed return envelope was enclosed. Eighteen questionnaires were returned as undeliverable. Seven hundred fifty-two usable questionnaires were returned, for a response rate of 38%. The data were entered, and less than 1% data-entry error was identified during data cleaning procedures. Data were analyzed using descriptive statistics.

RESULTS

Demographic data revealed 58% of respondents had 1 to 10 years of experience. Forty-four percent of respondents worked in urban medical settings; 29% of the respondents worked in suburban medical settings; and 24% of the respondents worked in rural medical settings. Three percent of the data were missing in this category.

What Types of Software Skills Are Critical for New Nurses Entering the Work Force?

Nursing administrators reported that the ability to search databases for medical information (e.g., laboratory reports) is critical for new nurses (Table 1).

Is Knowledge of Nursing-Specific Software Critical for New Nurses Entering the Work Force?

As expected, respondents reported that being able to effectively and efficiently use nursing-specific software, including bedside charting and computer-activated medicine dispensers, is critical for new nurses (Table 2).

Is Being Able to Navigate a Windows Operating System Critical for New Nurses Entering the Work Force?

Two questions addressed the importance of using a Windows operating system. One question focused on knowing basic Windows operations such as maximizing and minimizing screens. Another question focused on using the file management properties to organize information. Respondents indicated only the ability to use basic Windows operations was critical (Table 3).

Is Being Able to Search the Internet for Information Critical for New Nurses Entering the Work Force?

This question did not attempt to address whether nurses would be searching for nursing or general information but simply asked whether the ability to search the Internet was important. The nursing administrators responded that this skill is critical for new nurses in the work force (Table 4).

\ Is Being Able to Use E-Mail Critical for New Nurses Entering the Work Force?

Table

TABLE 3Ability to Navigate a Windows Operating System

TABLE 3

Ability to Navigate a Windows Operating System

Table

TABLE 4Ability to Search the Internet for Information

TABLE 4

Ability to Search the Internet for Information

Table

TABLE 5Ability to Use E-mail

TABLE 5

Ability to Use E-mail

Currently, face-to-face interpersonal communication skills are emphasized in nursing curricula. Although email use is common in business, the authors were interested in discovering whether this form of communication was considered critical for new nurses. AU respondents, except those working in rural settings, considered using e-mail critical for new nurses (Table 5).

Is Being Able to Use Calendar Software Critical for New Nurses Entering the Work Force?

Another skill emphasized in nursing curricula is organization. With use of personal digital assistants and computerized calendar software increasing in the business world, the authors wanted to know whether using this type of software was critical for new nurses. Respondents reported using calendar software to stay organized was not a critical skill needed by new nurses.

CONCLUSIONS

From these findings, one can conclude that integrating information technology content into undergraduate nursing curricula is imperative to help nursing students gain the necessary skills for successful employment. Students need both traditional computer skills, such as searching databases, and specialized computer skills, such as bedside charting. Possessing these skills will allow new nurses to better help their patients.

Because these findings indicate a general college computer course may not be the most beneficial for nursing students, there is an opportunity for nursing faculty to collaborate with information technology faculty to create a specialized course for nursing students. The course should include general computer concepts (e.g., database creation and queries), information retrieval using the Internet, and effective and efficient use of e-mail. The course then could address specialized nursing software, including bedside charting, order entry, patient records, and computerized medication dispensing. This course could be team-taught by nursing faculty and information technology faculty, or part of the subject matter could be offered online. Students who learn these skills can reinforce their knowledge through actual practice during their clinical experiences.

RECOMMENDATIONS

The authors recommend additional studies be developed to survey nurses who have entered the field in the past year to determine the computer skills they consider critical. Those results should be compared with the results of this study. In addition, a follow up of both surveys (i.e., nurses and nursing administrators) should be conducted in 3 to 5 years to continue to determine and evaluate the technological advances in and demands of health care environments.

REFERENCES

  • Ellis, J.R., & Hartley, C.L. (2001). Nursing in today's world: Challenges, issues, and trends. Philadelphia: Lippincott.
  • Hobbs, S. (2002). Measuring ourees' computer competency: An analysis of published instruments. Computers, Informatics, Nursing, 20(2), 63-73.
  • National League for Nursing. (2002). Nursing education research priorities. Retrieved May 11, 2002, from httpy/www.nhi.org/aboutnhi/research.htm
  • Rusell, A., & Alpay, L. (2000). Practice nurses' training in information technology: Report on an empirical investigation. Health Informatics Journal, 6, 142-146.
  • Saranto, K, & Leino-Kilpi, H. (1997). Computer literacy in nursing: Developing the information technology syllabus in nursing education. Journal of Advanced Nursing, 25, 377-385.
  • Simpson, R.L. (2000), Need to know: Essential survival skills for the information age. Nursing Administration Quarterly, 25, 142-147.
  • Sinclair, M., & Gardner, J. (1999). Planning for information technology key skill« in nurse education. Journal of Advanced Nursing, 30, 1441-1450.
  • U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, National Center for Health Workforce Analysis. (2002). Projected supply, demand, and shortages of registered nurses: 2000-2020. Retrieved May 15, 2002, from http://www.bhpr.hrsa. gov/healthworkforce/rnproject/report.htm

TABLE 1

Ability to Search Databases for Medical Information

TABLE 2

Knowledge of Nursing-Specific Software

TABLE 3

Ability to Navigate a Windows Operating System

TABLE 4

Ability to Search the Internet for Information

TABLE 5

Ability to Use E-mail

10.3928/0148-4834-20030801-04

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