Background/Objective: Researchers set out to develop reliable, valid instruments for nurses to self-assess nursing informatics (NI) competencies at the basic and advanced levels. The focus of the research presented in this article is measurement of competencies at the advanced level, which includes Level 3, the informatics specialist and Level 4, the informatics innovator. Informatics competencies are critical in the technology-rich healthcare delivery system. Nurse leaders experienced in informatics need to be prepared to consistently mentor nurses to use health information technology (HIT) in ways that foster continual growth in nursing informatics competencies. This article addresses the research problem, the concept of competency, previous work on NI assessment, instrument development, and pilot results. Methods: Resulting items from round one and two were reworded to reflect measurable behaviors then subjected to a third round of reviews to establish content validity, using the content validity index (CVI). The Nursing Informatics Competency Assessment L3/L4 (NICA-L3/L4) © instrument development began with a synthesis of seminal and current literature. Participants were asked to rate themselves in one of the categories for each item: beginner or N/A, comfortable, proficient or expert. The NICA-L3/L4© instrument was piloted following Institutional Review Board (IRB) approval using a purposeful, convenience sample from the NI community. Results: For NICA-L3/L4©, the CVIs demonstrated strong content validity and the Chronbach's alpha showed high internal consistency. The initial data from both the Delphi and pilot studies indicated the need for self-assessment of NI competencies. Conclusion: Results of this study indicate that continued education in NI is necessary to reach the level of nurse innovator, a Level 4 competency. As the healthcare system continues to rely on electronic means of gathering, storing, and retrieving data, self-assessment of informatics competencies is key to providing a benchmark for the identification of skills that require further development.

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Information technology use in healthcare delivery mandates a prepared workforce. The initial Health Information Technology Competencies tool resulted from a 2-year transatlantic effort by experts from the US and European Union to identify approaches to develop skills and knowledge needed by healthcare workers. It was determined that competencies must be identified before strategies are established, resulting in a searchable database of more than 1000 competencies representing five domains, five skill levels, and more than 250 roles. Health Information Technology Competencies is available at no cost and supports role- or competency-based queries. Health Information Technology Competencies developers suggest its use for curriculum planning, job descriptions, and professional development.The Chamberlain College of Nursing informatics research team examined Health Information Technology Competencies for its possible application to our research and our curricular development, comparing it originally with the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools, which examine informatics competencies at four levels of nursing practice. Additional analysis involved the 2015 Nursing Informatics: Scope and Standards of Practice. Informatics is a Health Information Technology Competencies domain, so clear delineation of nursing-informatics competencies was expected. Researchers found TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 differed from Health Information Technology Competencies 2016 in focus, definitions, ascribed competencies, and defined levels of expertise. When Health Information Technology Competencies 2017 was compared against the nursing informatics scope and standards, researchers found an increase in the number of informatics competencies but not to a significant degree. This is not surprising, given that Health Information Technology Competencies includes all healthcare workers, while the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools and the American Nurses Association Nursing Informatics: Scope and Standards of Practice are nurse specific. No clear cross mapping across these tools and the standards of nursing informatics practice exists. Further examination and review are needed to translate Health Information Technology Competencies as a viable tool for nursing informatics use in the US.

This collaborative study sought to describe technology used by AORN members at work, inclusive of radio-frequency identification or barcode scanning (RFID), data collection tools (DATA), workflow or dashboard management tools (DASHBOARD), and environmental services/room decontamination technologies (ENVIRON), and to identify the perceived effects of each technology on workflow efficiency (WFE) and quality patient care (QPC). The 462 respondents to the AORN Technology in the OR survey reported use of technology (USE) in all categories. Eleven of 17 RFID items had a strong positive correlation between the designated USE item and the perceived effect on WFE and QPC. Five of the most-used technology items were found in the DATA category. Two of the five related to Intraoperative Nursing Documentation and the use of the Perioperative Nursing Data Set. The other three related to Imaging Integration for Radiology Equipment, Video Camera Systems, and Fiber-optic Systems. All three elements explored in the DASHBOARD category (ie, Patient Update, OR Case, OR Efficiency) demonstrated approximately 50% or greater perceived effectiveness in WFE and QPC. There was a low reported use of ENVIRON technologies, resulting in limited WFE and QPC data for this category.

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