TABLE OF CONTENTS
Title page i
Approval page ii
Certification page iii
Dedication iv
Acknowledgements v
Table of Contents vi
List of Tables ix
Abstract x
CHAPTER ONE: INTRODUCTION 1
Background of the study 1
Statement of the problem 7
Purpose of the Study 8
Research Questions 9
Significance of the Study 9
Scope of the Study 10
CHAPTER TWO: REVIEW OF LITERATURE 11
Conceptual frame work
Concept of nurse and nursing 11
Concept of Information 14
Concept of Information Needs 16
Concept of ICT utilization competencies 17
Information needs of Nurses 20
Sources of information to Nurses 22
ICT competencies required by Nurses 25
ICT utilization competencies possessed by Nurses 29
Challenges facing Nurses in acquiring ICT competencies 31
Strategies that can be used to overcome the challenges 34
Review of Related Empirical Studies 36
Summary of literature review 44
CHAPTER THREE: RESEARCH METHOD 46
Design of the Study 46
Area of the Study 46
Population of the Study 47
Sample and Sampling Technique 47
Instrument for Data Collection 47
Validation of the Instrument 48
Method of Data Collection 48
Method of Data Analysis 49
CHAPTER FOUR: RESULTS 50
CHAPTER FIVE: DISCUSSION AND CONCLUSION 62
Discussion of Findings 62
Implications of the study 67
Recommendations 68
Limitations of the Study 69
Suggestions for Further Research 69
Conclusion 69
REFERENCES 71
APPENDICES
Appendix 1 Questionnaire 75
Appendix 2 Population of the study 81
Appendix 3 Sample Table 82
Appendix 4 Observation Checklist 83
LIST OF TABLES
Page
Table 1: Information needs of nurses 51
Table 2: Sources of Information to nurses 53
Table 3: ICT Competencies required by Nurses 55
Table 4: ICT Utilization competencies possessed by nurses 56
Table 5: Challenges facing nurses in acquiring ICT competencies 57
Table 6: Strategies for Overcoming the Challenges 59
ABSTRACT
The study investigated the ICT utilization competencies for meeting the information needs of nurses in three hospitals in Enugu State. Six specific objectives guided the study and sought to find out the information needs of nurses, sources of information to nurses, ICT competencies required by nurses, ICT utilization competencies possessed by nurses, challenges facing nurses in acquiring ICT competencies, and strategies for overcoming the challenges. Descriptive survey design was employed while the population was 717 nurses. A sample of 359 nurses was used while proportionate sampling technique was employed to select the sample. Questionnaire and observation checklist were used for data collection. Frequency, percentages and mean were used to analyze the data generated. The study revealed that nurses need information on nursing process, patient care generally, how to avoid contracting diseases from patients etc to function maximally. Print resources, electronic resources and other resource are sources of information available to nurses; ICT utilization competencies of nurses were not very high; insufficient computers and its accessories, and difficulty in accessing foreign journals and materials were major challenges facing nurses in acquiring ICT competencies. It equally revealed that establishment of information centers, assisting nurses to have access to foreign journals; provision of computer with internet accessories; and provision of fund by the government were the major strategies to overcome the challenges. The study recommended that access to information should be provided to nurses; provision of adequate computers and its accessories; information resources in different formats especially electronic resources should also be provided to nurses for effective nursing services.
CHAPTER ONE
INTRODUCTION:
Background of the study
A hospital offers considerable advantages to both patient and society. A Hospital is an institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured. W.H.O as cited in free on-line dictionary, states that hospitals are socio-medical organizations which functions are curative, preventive, patient services and training of health workers in biosocial research. (Free online Dictionary). It is a place where sick people are looked after by doctors and nurses. It is originally referred to places of hospitality. Hospitals usually are distinguished from other types of medical facilities by their ability to admit and care for in-patients (i.e. people that are admitted and stay over night or for several days or weeks or months) while the others often are described as clinics since they deal with out-patients only. Hospitals are categorized under: general hospitals, district hospitals, specialized hospitals, private/mission hospitals etc.
Hospitals are largely staffed by professional physicians, surgeons and nurses and other workers. Hospital workers help in the administration of a hospital. They work in different departments of the hospital like administrative, clinical, laboratory, pharmaceutical, finance department etc. Nurses differ from other health professionals like doctors, physician assistants (PA), optometrists, physical therapists, pediatrists etc. The differences include in areas of specialization, years in education/experience, duties, working environment, societal perception, authority, salary / income, dress codes etc. Doctors go through many years of training and education to even get in the door and then spend some time working their way up the medical ladder. Doctors perform such tasks like surgical operations unlike nurses. Nurses prepare patients to see doctors (Herbert, 2007).
Nursing is a health profession which provides care to people throughout the continuum of life. It is a career which allows an individual to combine his/her interest in science with his /her desire to help and care for others. A nurse is a healthcare professional who is focused on caring for individuals, families, and communities, ensuring that they attain, maintain, or recover optimal health and functioning. He/she is a person who is qualified in the art and science of nursing and meets certain prescribed standards of education and clinical competence (Udeh, 2008 citing Bailliere and Tindall). Nurses are among health professionals that are directly involved in the treatment and management of patients and other patient-related information. According to Ufere (2008), a nurse can be defined as a person who nourishes, fosters and protects. A person who is prepared to care for the sick, injured and aged.
Nurses practice in different areas including hospitals, home care, private medical practices, public health, clinics, corporations, schools, military service, occupational health and education, etc. Nurses work with other health care professionals to provide services to the public. For nurses to achieve all these protocols in their profession, they need current information.
Information is valuable in all aspects of human development. It helps to facilitate growth and change in a society. Ozioko (2010) citing Morale states that information is knowledge in the form of facts and opinions, which are transmitted through a medium from one person to another. It could be in terms of tools, processes or knowledge. Olorundare (2006) sees information ‘as fact or details about something”. Information has become the most important element for progress in society. To thrive well in this information explosion era, one needs a variety of information, no matter how well versed one is in a field or profession. It plays a significant role in our professional and personal lives. People in different sectors need information to work properly in their fields, including the health sector. Information is a very crucial tool for health professionals especially nurses and how they acquire and use information are key determinants of their performances.
Nurses like other professionals need a wide range of information in order to meet up with the demands of routine nursing practices. Such demands include direct patient care needs related to the disease/ recovery cycle, patients’ family requests, routine teaching, colleagues’ requests, personal development and the likes. The importance of health information to nurses can never be over emphasized. Health information is the information that supports clinical and healthcare business decision-making. When health information is accessed, managed and utilized by health professionals especially nurses, it allows a more accurate and timely exchange of patient data and information to improve decision making – ultimately improving patient care and the hospital’s image. Health information is becoming a solution to the increasingly high patient challenges, and the constantly changing health care services. Nurses successfully carry out their responsibilities through information gathered about their clients. They need such information like patient care- related information, doctors’ orders, policies and patient education. In addition, nurses need information to keep themselves up-to-date in their field of work and solve some work-related problems like time shifts, vase knowledge on treatment protocols /regimen, diagnosis/etiology, disease, adverse effects of drug therapy, etc. (Nwagwu and Oshiname, 2009).
With the increasing use of information, prescriptions and information therapy in evidence-based practices (EBP), clinical nurses regularly need and source information in support of patient care. Patients value information related to their illnesses and treatments. Therefore, it is important that nurses develop and master information acquisition skills so that they can access and find information resources they can offer directly to patients and care givers. Quality patient information promotes active patient participation in health care decision- making and helps to improve patients’ psychological well-being and overall fitness. Receiving symptom-linked information resources about expected recovery experience improves compliance with prescribed care routine and reduces emotional distress during recovery. Hence, information is very important in all levels of nursing practices.
Information need is an individual or group’s desire to locate and obtain information to satisfy a conscious or unconscious need. Information needs are related to, but distinct from information requirements. It arises when a person recognizes a gap in his/her state of knowledge and wishes to resolve that uncertainty. According to Devadason and Lingman (1997), the understanding of information needs of various professional groups is essential as it helps in the planning implementation, and operation of the information system and services in work settings. Information needs are prevalent in nursing practice. They represent a potential source of medical errors or correctness depending on the availability or non-availability of information.
ICTs are products of current advancements in computer technology. It is the processing and communication of information by the micro computer or computerized devices via the interconnected networks (information supper high way) (Ogugua, 2004). ICT has gradually made in-road into all levels of management, in which nursing profession is not an exception. The need to adopt a culture in nursing that promotes acceptance and use of information technology has been identified as important parallel initiative to nursing informatics competences and educational strategies. Strategies for achieving nursing informatics competences in the work place include in-service training, intranet ready modules, access to on-line resources, and opportunities for continuing education. Ellis (2012) citing Smedley stated that information and communication technologies (ICT) are transforming health services and systems, changing the way that professionals especially nurses deliver patient care.
Before the emergence of Information and Communication Technologies (ICTs) nurses had access to information through conventional methods but today ICT has broadened the scope. These conventional methods are still in use today. Devadason and Lingman (1997) enumerated different methods nurses source information before the information and communication technologies as thus: consulting with experts in the subject field, conversation with colleagues, attending conferences, seminars, and workshops, general books and textbooks, Research reports, bibliographies, Newspapers and magazines, proceedings, library catalogue, serendipity (e.g. while searching on a specific topic, you find valuable information on an entirely different topic), current awareness services of libraries, reviewed articles, publishers catalogue and flyers etc. Some of these methods used by nurses to access information are limited by space thereby limiting the wider coverage of nurses and nursing profession. But these days, all the above information resources are now complimented by electronic formats/methods, which can only be accessible through internet and online databases.
The aim of E-health is to enable the delivery of better health care to the communities by providing a modern, integrated and effective technology platform. It is also aimed at improving the access and integrity of information through new systems and technology and in doing so, anticipate the following benefits: improved patient safety; increased quality of clinical care; reduction in the duplication of certain clinical tests and investigations; fewer medical errors and adverse events; more effective use of medicines; and reduced length of hospital stays (Ellis, 2012). Some examples of ICT-based information resources to health professionals as identified by Watts and Ibegbulam (2006) and Dee and Stanley (2005) are: Medline, e-TALC CD-ROM, International Network for the Availability of scientific publications-INASP, Health links, Meds cape, HINARI- Health inter network access to research initiative, National Library of Medicine –NLM’s Pub med, TOXNET, CINAHL, MEDLINE Plus, National Cancer Institute –NCI’s cancer.gov database etc. These online databases help to provide full text and up-to-date information for health professionals. From the above discussion, it is clear that the integration of ICTs in nursing profession will immensely improve the output of nurses and the profession to the society. The output will be mostly pronounced when nurses have the required skills and competencies to accessing the information using ICT. Hence, the need for ICT utilization competence on the part of nurses.
ICT utilization is the presentation and distribution of instructional content (information) through web environment (Egomo et’al, 2012). Nurses need ICT utilization competencies to be able to access the needed information. Competency is the capability of an individual to put the acquired knowledge and skills into action with a measurable and desired result. It is action oriented towards achieving expected results. Competency is described by Encarth cited in Olaitan and Alaribe (2010) as ability to do something well measured against a standard especially ability acquired through experience or training. Lustri (2007) citing Zarifian, defines competency as an individual’s capacity to take initiative, to do more than what is expected, to understand and control new emerging situations and to be responsible for decisions, hence achieving recognition. Competency encompasses individual’s knowledge, abilities, qualities, experiences, etc, all put together to bring about desired work performance. Competencies have been defined as the skills and attitudes required to do a job effectively from the point of view of both the performer and the observer. The unique competencies of nurses include: developing manageable technological skills i.e. know how to use available technology creatively in order to achieve the greatest benefit and pleasure from their work, competency in IT skills which can be used for researching resources, accessing information, connecting to experts, communicating ideas and results and packaging the knowledge for use especially as it relates to their patients.
The three (3) hospitals under study includes: Bishop Shannahan Hospital Nsukka (BSHN), University of Nigeria Teaching Hospital Enugu (UNTH), and Nsukka General Hospital (NGH). BSHN is a mission/private hospital under the Catholic Diocese of Nsukka housing a nursing school called Bishop Shannahan Nursing School Nsukka. UNTH is a government hospital (federal) with nine (9) training schools/ programme. Nsukka General Hospital is also a government hospital (State). The hospitals render services to the clients through provision of in-patient and out-patient services. The utilization of ICT among nurses in Nigeria and under developing countries is low unlike in developed countries where the ICT utilization competencies of nurses is higher. The ICT utilization among nurses in these hospitals under study may not be different from what is obtainable in the developing countries. Hence, the need for this study.
