Nurse managers, as administrators within their hospital or health facility, need the knowledge and skills to use databases and information systems for the collection and interpretation of statistical data on patient care, including length of stay, staff rosters, patient acuity/dependency, budgets, and resource ordering [11]. Information competency is essential for managers, and it will become more important in the future as more sophisticated clinical information techniques are developed.
In the present study, we found that education level had a significant impact on informatics competencies. One possible reason for this relationship is that those with higher education levels have learned information retrieval and evidence-based nursing systematically. For example, the preparation of a master's thesis requires proficiency in technological skills, including keyboarding, word processing, multimedia presentations, online literature searches, e-mail correspondence, and use of the Internet, which cover many of the informatics skill items in this study.
The results also revealed that a nurse manager's computer and informatics skills were lower than his/her informatics knowledge. Computer skills encompass the use of computer hardware and software and allow for basic technological interface (i.e., the use of e-mail and the Internet, online literature searches, and use of application, such as word processing). Informatics skills are the use of methods, tools, and techniques particular to informatics, while informatics knowledge is the theoretical and conceptual basis for the specialty. For example, informatics skills include techniques and tools used in systems analysis and project management, while informatics knowledge includes familiarity with nursing classification and reasons for systems slowness [5]. The low scores in computer skills and informatics skills should be increased through education or training.
The results indicate that respondents' information related to education or training had a significant impact on their overall informatics competencies. However, more than one-half of the respondents (38) lacked any informatics knowledge and skills education in school or at work. This finding suggests that providing more informatics courses and training in school and at work is important. Academic courses in computer skills, informatics skills, evidenced-based practice, effectiveness research, and nursing administration or operational business management, including a required course in nursing informatics for nurses preparing them for an administrative career, could be developed in tandem with continuing education opportunities offered by academic or health institutions.
Nursing administration experience is a factor that negatively affected informatics competencies scores in this study. In other words, more administrative experience was associated with a lower level of informatics competencies. This is closely connected with China's national conditions, and there are several possible explanations. The respondents with more administrative experience are from an era when computers were used less frequently in school or at work, trained at a secondary level vocational school (the primary training site for nurses in China before 2000), or were affected by conventional thinking and traditional views as their administrative experience grew. Therefore, nurse managers with administrative experience should be targeted for computer and informatics continuing education, which will allow them keeping pace with the rapid development of information technology, particularly in the field of patient safety and care.
4.1. Limitations
There are several limitations to this study. The participants were not randomly selected; therefore, the respondents may not adequately represent the population of interest. The other limitation is that the informatics competencies data was collected through a self-report questionnaire. Consequently, nurse managers could under- or overestimate their informatics competency. However, since the self-ratings were not considered in a performance appraisal, there was little motivation to overestimate. To objectively assess informatics competencies, future studies should use other tools to measure the true level of the participants' informatics competency.
4.2. Conclusion
In a field where technology changes on a daily basis, it is crucial for nurses and nurse managers to stay up-to-date on trends and information [12]. The results of this study confirmed that education level, experience in nursing administration, and information education/training were significant factors affecting informatics competency. Nursing informatics knowledge and skills are essential in modern nursing education (initial and continuing education programs) to ensure that nurses are proficient in technological and cutting-edge clinical applications [13]. Thereby, the nurses and nurse managers are able to offer the highest levels of patient care and safety.