Author: Lisa Reid
Reid, Lisa, 2025 Developing a distinct body of knowledge on Nursing Informatics: A mixed-methods study, Flinders University, College of Nursing and Health Sciences
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Health care is underpinned by the desire to provide safe, cost effective, efficient and accessible care, that prioritises patient outcomes and uses the latest evidence to inform practice. Over the past 70 years, health care has increasingly used information and communication technologies to improve the safety and efficiency of health care, develop evidence-based practices, provide data to leverage change, inform health care policy, and articulate the role of health care in society. Reflecting this digital revolution in health care, health informatics fields have sought to integrate health information and knowledge with information and communication technologies to promote optimal patient health outcomes. Nursing informatics has the potential to transform patient care through streamlining of care provision, increasing the capacity to predict patient needs, enhancing the quality of nursing care, and elucidating the importance of nursing within the health care setting. However, nurses, despite being the largest workforce within health care, are still not being adequately prepared to use nursing informatics to improve patient care through rapid access to crucial patient data, systematic patient assessment, the reduction of clinical errors, the enhanced use of evidence-based practice, cost-effectiveness and improved patient outcomes and safety.
This study using a mixed-methods approach, underpinned by Dewey’s philosophy of pragmatism, consisted of two distinct phases. A scoping review was conducted to identify contemporary literature that examined the nursing informatics content in undergraduate nursing education. The study integrated findings from a scoping review of 3227 articles with 53 selected sources of evidence and was analysed using frequency counts and qualitative content analysis. Informed by the findings of the scoping review, a classical Delphi study of four rounds explored the experiences of 61 nurse educators, nurse informaticians and experts in nursing informatics and was analysed using reflexive thematic analysis and descriptive statistics. The findings from the scoping review and the Delphi study were integrated with contemporary literature to define nursing informatics and address its significance to nursing practice and to address the integration of nursing informatics into undergraduate nursing curricula. Recommendations for the integration of nursing informatics content into undergraduate nursing curricula, for nursing bodies and nursing leadership and for future research were also detailed.
Key findings emerging from this study included the ongoing deficit in the workforce preparedness of Registered Nurses and limited ongoing digital health education opportunities. A lack of nursing informatics content integrated into undergraduate nursing curricula, in Australia, was identified, with barriers including the associated costs of implementing and maintaining digital health technologies, and a lack of access to digital health technologies on placement and in university settings. A lack of university faculty understanding of nursing informatics was aligned with limited professional development and varying levels of digital literacy. Other barriers included a lack of incentive to include nursing informatics due to minimum standards for registration not addressing the requirement for Registered Nurses to have basic informatics skills and the lack of integration of nursing informatics throughout Australian undergraduate nursing curricula. Recommendations for the integration of nursing informatics content into Australian undergraduate nursing curricula, included the need for a clear understanding of nursing informatics, the development of specific competency standards and increased professional development for university faculty, and the development of an open access repository for nursing informatics education. Access to digital health technologies, in university and on clinical placement, were identified as an essential requirement for nursing students, with recommendations that relationships be established between key stakeholders to facilitate this access. It was also recommended that the development of undergraduate nursing curricula be explicitly linked with relevant professional competency standards, against which educators and universities could measure their own competence and delivery of appropriate information. Digital literacy was identified as an issue, in the development of nursing informatics competency of nursing students, with recommendations for a baseline assessment of digital literacy with ongoing evaluations throughout assessments, and further opportunities to develop these skills throughout their degree studies. Leadership from professional nursing bodies was identified as a determinant in the effective adoption and use of nursing informatics, with recommendations that nursing informatics competency standards for nursing leadership, including those nurses working in professional nursing bodies, be implemented as a priority. Finally, recommendations for future research, included investigating the disparities in gendered responses to the integration of nursing informatics into undergraduate nursing education, investigating the disparities in country of practice responses to the integration of nursing informatics into undergraduate nursing education, and how nurse educators perceive ongoing education opportunities within tertiary institutions.
My original contribution to knowledge was the integration of contemporary literature and the voices of nursing experts to support understanding of current nursing informatics content in undergraduate nursing education. This study provided a snapshot of contemporary nursing informatics understanding and application in undergraduate nursing education and in professional practice. It provided a discussion of enablers, barriers and recommended content for nursing informatics education and the development of digital literacy of all key stakeholders. And it provided recommendations for how these gaps could be addressed to develop workforce readiness and digital competency in both undergraduate nursing students and Registered Nurses
Keywords: Nursing, nursing education, undergraduate nursing, nursing informatics, digital health technologies, informatics
Subject: Nursing thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Nursing and Health Sciences
Supervisor: Dr. Didy Button