A Delphi study to determine informatics competencies for nurses at four levels of practice.

BACKGROUND Despite its obvious need, a current, research-based list of informatics competencies for nurses is not available. OBJECTIVE To produce a research-based master list of informatics competencies for nurses and differentiate these competencies by level of nursing practice. METHODS After a comprehensive literature review and item consolidation, an expert panel defined initial competencies. Subsequently, a three round Delphi study was conducted to validate the items. Participants were expert informatics nurse specialists in the United States of America. RESULTS Of the initial 305 competencies proposed, 281 competencies achieved an 80% or greater agreement for both importance as a competency and appropriateness for the correct practice level. Five competencies were rejected. Six competencies were considered valid competencies but the appropriate level of practice could not be agreed upon. Thirteen competencies did not reach any consensus after the three Delphi rounds. DISCUSSION The Delphi study had a high rate of participation, demonstrating the great level of interest and need for a list of informatics competencies for nurses. Out of the initial 305 competencies, only 24 items were not validated. Respondents commented during each round about whether computer skills should be considered informatics competencies. The authors propose that computer skills, while not high level, are one set of tools within the larger category of informatics competencies. This sample of experts did not deem programming skills as necessary for informatics nurses. This research study is an initial effort to fill the void of valid and reliable informatics competencies. It is the first study to span four levels of nurses, create competencies for both entry-level and experienced informatics nurse specialists, and examine the categories of computer skills, informatics knowledge and informatics skills.