INTRODUCTION:

Introduction to stethoscope in the 1800s met great resistance among clinicians, who considered it invasive and contrary to current clinical practice. In 1834, the times of London quoted a British physician’s opinion of the stethoscope: “that it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.”

Today, few clinicians could imagine providing clinical care without aid of a stethoscope.The tool has become so integrated with their practice that most clinicians consider it part of their standards uniforms, wearing it proudly as a symbol of their knowledge and professional standing.

Similarly, in the 21^st century health information technology (HIT) has met resistance among some clinicians. Nonetheless, it’s fundamentally changing the skills and behaviors required in the workplace. Nowhere is this change more profound than among the 3.1 million nurses, who make up the largest segment of the U.S health care workforce.

Since the earliest days of technology adoption in health care, nursing informatics professionals have been at the forefront of leading change. Early pioneers included nurses who effectively combined the science of nursing with computer and information science to support the clinical workflow, adding value to the organization as they began their journey to join the digital revolution.In 1992, the American nurses association formally recognized nursing informatics as a specialty. Since then, the field has grown and the demand for nursing informatics professionals has been increasing at unprecedented rates. According to the HIMSS (Health care information and management system society) 2011 Clinical Transformation Survey, “Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice pattern that deliver inefficient or less effective result and embraces a common goal of patient safety, clinicaloutcomes, and quality care through process redesign and IT implementation. By effectively blending people, processes, and technology, clinical transformation occurs across facilities, departments and clinical field of expertise.”^1,2

STATEMENT OF PROBLEM:

A Study to assess theLevel of Knowledge and attitude among staff nurses on Nursing Informatics in KVM Super Specialty Hospital , Cherthala with a view to develop a Self-Instructional Module.

OBJECTIVES OF THE STUDY:

· Assess the level of knowledgeof staff nurses on nursing informatics.

· Assess the level of attitude of staff nurses on nursing informatics.

· Find out the association between the level of knowledge on nursing informatics among staff nurses with the selected demographic variable

· Find out the association between the level of attitude on nursing informatics among staff nurses with the selected demographic variable.

· Find out the correlation between the knowledge and attitude on nursing informatics among staff nurses.

· To develop a Self-Instructional module on nursing informatics nursing informatics among staff nurses.

REVIEW OF LITERATURE:

For the present study, related literature was reviewed on the selected studies related to the level of knowledge on evidence based nursing practice through health technology, A cross sectional study was conducted among 398 registered nurses and student nurses regarding the use of advanced mobile devices in nursing practice. Results showed that the majority of the participants replied that an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. furthermore, the advanced mobile device was regarded to improve the safety and quality of health care and to increase confidence .in order to continuously improve the safety and quality of health care , advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.²

A descriptive research was conducted on assessment and comparison of Nurses attitude towards computer application in nursing practice by a standardized tool P.A.T.C.H (Pretest for Attitudes Toward Computers in Healthcare) among Staff Nurses working in Private Hospital and Government Hospital were selected by using convenient sampling technique. Total sample size is forty. Prochaska Diclemente’s Stage of Change Model theory was applied for the present study. Study findings shows, according to P.A.T.C.H. Scale Private Staff Nurses had 5% of the limited awareness, 40% of them had realistic view, 50% of them had enthusiastic view and 5% of them had idealistic view about computer application in nursing practice. Government Staff Nurses had 35% realistic view, 55% of them had enthusiastic view and 10% of them had idealistic view. Among the Private staff Nurses 59% of them had positive attitude, 20% of them had negative attitude and 21% of them were expressed that no opinion. Among the Government Staff Nurses 59.5% of them had positive attitude, 15% of them were had negative attitude and 25.5% of them were expressed as no opinion. It shows that there is no association between attitude and age, sex, education, Year of experience, Income, Type of family, religion, marital status and Place of residence. There is association between attitude and Source of information. Overall finding of the study shows that there is no much difference between private and government staff nurses towards computer application in nursing practice. They must be educated regarding current trends and recent advancement by using information technology.³

A cross-sectional investigatory study was carried out to assess the attitudes of public health nurses (PHNs) towards Web-based distance learning in health centers in Taiwan. The population included in this study was 2398 PHNs from 369 health centers, random sampling method was used. Finally, 329 PHNs completed the questionnaire, with a response rate of 84.0%. Data were collected by mailing the questionnaire. The findings reveal that a positive attitude toward web-based learning (mean+/-SD=55.02+/-6.39). PHNs who worked at village health centers, a service population less than 10,000, PHNs who had access to computer facility and on-line hardware in health centers and with better computer competence revealed more positive attitudes (p<0.01). The study suggests that, Web-based learning is an important new way of in-service education.⁴

METHODS AND PROCEDURES:

Research Approach;

Quantitative

Research Design:

Descriptive-Cross Sectional survey design.

Setting:

The study was conducted in KVM super specialtyHospital, Cherthala

Population:

Allstaff nurses who has qualified and registered in Kerala Nursing Council as a Registered Nurse And Midwife.

Sample:

All staff nurses who are all available and interested to participate in the study during the data collection period were included with inclusion criteria.

Sampling Size:

50 Nurses who were working in the KVM Super Specialty Hospital, Cherthala.

Sampling Technique:

Non Probability -Convenient sampling technique.

Tools:

The data was collected in three section as follows :

Section A: It consist of Demographic variables such as age, gender , professional education, year of experience, marital status, current working area and previous information

Section B: The structured questionnaires on the level of knowledge on nursing informatics was used. It has 15 items.

Section C-P.A.T.C.H (Pretest for Attitudes Toward Computers in Healthcare) standardized scale was used as a tool. It is a Five point Likert scale with 20 items which bring the attitude of health care professionals towards application of computers in health care set up.⁶

Section D: In thissection, information booklet on the nursing informatics was mentioned in the following aspects like definition, electronic recording , intranet , internet, text messaging, smart phones , Personal digital devices and mobile phones .^5,6.

Content Validity:

Developed questionnaire for the study was given to the experts for critiquing to ensure validity and after approval and endorsement.it was administered to the staff nurses.

Method of Data Collection Procedure:

Phase 1: Permission obtained from the Chief medical officer and nursing superintendent of KVM super specialty hospital, Cherthala

Phase 2: Informed consent obtained from the participants before conducting the study. Explained about the purpose of the study.

Phase 3: Administered the structured questionnaire about demographic data ,structured questionnaire used to assess the knowledge of the staff nurses on nursing informatics and PATCH scale to assess the attitude of the staff nurses on nursing informatics .

Phase 4: Provided Self Instructional Module after obtaining the data to all the staff nurses

Data Analysis:

Both descriptive and inferential statistics were used. Chi square test was used to find out the association between attitude and selected demographic variables.

Table 1: Association between the level of knowledge on nursing informatics among staff nurses with the selected demographic variable

		Level of Knowledge			χ²	df	*p-value*
		Poor	Average	Total	χ²	df	*p-value*
Age	21 - 25 yrs	2	4	6	0.07	3	>0.05
	26 - 30 yrs	9	16	25
	31 - 35 yrs	5	8	13
	Above 35 yrs	2	4	6
	Total	18	32	50
Marital status	Single	1	1	2	0.18	1	>0.05
	Married	17	31	48
	Total	18	32	50
Professional qualification	GNM	15	22	37	1.27	1	>0.05
	BSc.(N)	3	10	13
	Total	18	32	50
Years of experience	< 1 yr	1	0	1	2.8	3	>0.05
	1 - 3 yrs	8	12	20
	3 - 6 yrs	5	8	13
	> 6 yrs	4	12	16
	Total	18	32	50
Area of current working	ICU	6	8	14	2.41	3	>0.05
	Medical ward	4	8	12
	OT	1	0	1
	Others	7	16	23
	Total	18	32	50
Previous exposure to this topic	Yes	1	13	14	7.03	1	<0.05*
	No	17	19	36
	Total	18	32	50

The above table 1 shows that , at the level of 0.05 , previous exposure to the topic has the significant association with the level of knowledge on nursing informatics . There is no significant association between the level of knowledge on nursinginformatics and demographic variables like age , gender , martial status , professional qualification, total years of experiences and area of current working.

There is no significant association between the level of attitude on nursing informatics among staff nurses with the selected demographic variable like age , gender , martial status , professional qualification , total years of experiences area of current working and previous exposure to the topic.

Table 2: The Correlation between the level knowledge and attitude on nursing informatics among staff nurses N= 50

Variables

Pearson Correlation

Significance

(p-value)

Knowledge and Attitude

0.708

p < 0.05*

The table 2 showed a significant positive correlation which means that as knowledge increases, attitude is leaning towards positive. The following scatter diagram also interprets this.

Figure 4: The correlation between the level of knowledge and attitude on nursing informatics among staff nurses

CONCLUSION:

The study concludes that , about 64 % of the staff nurses had the average knowledge on the nursing informatics and 80% had the positive attitude towards the nursing informatics. The chi square on the association between the level of knowledge on the staff nurses on nursing informatics shows that previous exposure to the topic has the significant association with the knowledge on nursing informatics. There is no significant association between the level of attitude on nursing informatics and demographical variables like age, gender, marital status, professional qualification, total years of experiences area of current working and previous exposure to the topic. There is a significant positive correlation between the level of knowledge and attitude on nursing informatics among staff nurses.

RECOMMENDATION:

Similar study can be conducted (i.) To compare the knowledge and attitude of staff nurses on nursing informatics in government and private hospitals (ii.) To assess the skill of staff nurses on health care technology .

The results can be submitted to District Nursing Officer to improve the nursing informatics on health care technology of district hospitals, president of the Kerala TNAI / Registrar Of Kerala Nursing Council to conduct the workshop on nursing informatics on health care technology for all the nurses in the state of Kerala.

CONCLUSION:

We found that the majority of the registered nurses regarded on nursing informatics is a useful tool to improve the nurses knowledge and skill on health care technology and to increase the confidence. Health care personnel must have access to the necessary information and must have effective and collaborative Information Communication Technology (ICT) support to facilitate their daily work and ensure high quality and safety Technology is a crucial ingredients of health care. Further, there are lack of resources of using heath technologies in the hospitals .We believe that nursing informatics is important to facilitate the use of its to support nursing practice. Our findings might help decision makers and developers to meet the challenges of preparing future health care practices to use nursing informatics.

REFERENCES:

1. Mark D. Sugrue, American Nurses Today, Volume 8, Number 11 ,November 2013 .

2. Johansson P, Goran Petersson , Using advanced Mobile Devices In Nursing Practice , Health Informatics Journal, 2014 , Vol 20(3) 220-231.

3. Mrs. P. VadivukkarasiRamanadin, Prof. G. Muthamilselvi, Prof. ManjeetKaur , A Comparative Study to Assess an Attitude towards Computer Application in Nursing Practice among the Staff Nurses,Asian J. Nursing Edu. and Research 3(2): April.-June 2013:82-86.

4. Jones and Bartlett ,Leadership And Management in Nursing ,Jones and Bartlett India Pvt Ltd , New Delhi ,2010

5. Patricia .S.Yair, Leading And Managing In Nursing ,Mosby Missouri , 3rd edition , 1999.

6. www.nursinginformatics .com

Received on 27.06.2017 Modified on 27.09.2017

Asian J. Nursing Education and Research. 2018; 8(2): 215-219.

DOI: 10.5958/2349-2996.2018.00044.7