Evaluating informatics competency of hemodialysis nurses: A longitudinal study

Zahra  Nemati; Khatereh  Seylani; Maryam  Esmaeili; Toni  Hebda; Maedeh  Amini

doi:10.18502/npt.v13i1.20602

Zahra Nemati Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
Khatereh Seylani Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Maryam Esmaeili Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Toni Hebda College of Nursing, Chamberlain University, Chicago, United States
Maedeh Amini Department of Biostatistics, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/npt.v13i1.20602

Keywords: nursing informatics; nursing informatics competency; hemodialysis nurses; electronic health record; digital literacy

Abstract

Background & Aim: The complexity of chronic kidney disease care necessitates multidisciplinary coordination, making it susceptible to care fragmentation. Electronic Health Records are strategic tools for integrating this care, but their effectiveness depends on the informatics competency of their users, mainly nurses. This study aimed to determine and compare the level of nurses' self-reported informatics competency before and after the deployment of specialized dialysis software in centers affiliated with Tehran University of Medical Sciences.

Materials & Methods: This longitudinal study was conducted in 2024 using a census sample of 51 nurses across seven hemodialysis centers. The standard Persian version of the Nursing Informatics Competency Assessment Tool was administered before and at least one month after software implementation. Data were analyzed using descriptive statistics, the McNemar Test, and the Paired Samples t-test.

Results: A statistically significant positive shift in nurses' categorical competency status (Sufficient vs. Insufficient) was confirmed by the McNemar test (p=.039). Specifically, 8 nurses shifted from Insufficient to Sufficient status post-implementation. Paired Samples t-tests on the subscales revealed a significant improvement in Information Literacy (mean difference: 5.02; p=.001) and Information Management Skills (mean difference: 3.10; p=.003). However, the change in Computer Literacy scores was not statistically significant (mean difference: 1.67; p=.117).

Conclusion: Direct, sustained, hands-on experience with electronic health records systems improves nurses' informatics competency, particularly in information literacy and information management, even without formal curricular education. This study highlights practice-based learning as an effective and viable strategy for cultivating essential informatics skills in technology-driven clinical environments.