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Foundation Health Care Information and Computer Competencies for Practicing Nurses and Nursing Students
1. Introduction (Ann)
The healthcare delivery environment is dramatically changing and nurses are expected to be able to provide safe, competent care in a highly technical and digital environment. A major theme in this new healthcare arena is the use of information systems and technologies to improve the quality and safety of patient care. Nurses are directly engaged with information systems and technologies as the foundation for evidence based practice, clinical decision support tools, and the electronic health record (EHR). In order for practicing nurses to be able to be responsive to the changes in their practice environment, a new specialty called Nursing Informatics has emerged that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.
While Nursing Informatics is a highly specialized field, there are foundational competencies that ALL practicing nurses should possess in order meet the standards of providing safe, quality, and competent care. The goal of this committee was to identify the basic Nursing Informatics competencies (knowledge, skills, and attitudes) that a nurse should posses to support their practice in all roles and settings.
2. Tie in to TIGER (Sarah)The vision set by the larger TIGER summit in 2006 “is to enable nurses to use informatics tools, principles, theories, and practices to make health care safer, more effective, efficient, patient-centered, timely, and equitable by interweaving enabling technologies transparently into nursing practice and education, making information technology the stethoscope for the 21st century” (TIGER website, 2008). Standard informatics competency development for all levels of nursing development was seen by the larger TIGER summit group as being foundational work to many of the other competency collaboratives including the Education, Staff Development and Leadership Development collaboratives. The Goal of the TIGER Informatics Competencies Collaborative (TICC) was to create comprehensive informatics competencies for all areas of nursing. The objectives of the collaborative were to:
harmonize and set informatics competencies for all levels of nursing education and practice including nursing assistants, associate degree, diploma, undergraduate and graduate-level nurses,
advocate for and support adding informatics competencies into nursing specialty certifications,
include informatics competencies in the scope and standard statements (and like documents) of nursing specialties.
The TICC was also charged with including information literacy and effective use of information resources in their work on competency development.
3. Background of information and computer competencies for nurses (Wanda)a. Including why it’s needed and important
There is a growing conviction that in all hospitals, even in those which are best conducted, there is a great and unnecessary waste of life; In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purpose of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to...if wisely used, these improved statistics would tell us more of the relative value of particular operations and modes of treatment than we have any means of obtaining at present....the truth thus ascertained would enable us to save life and suffering, and to improve the treatment and management of the sick...” (www.f-n-n.com).
Florence Nightingale made the above observations in 1863. Her remarks hold true today. Whether reviewing a patient’s health history, documenting an assessment, or researching evidence based guidelines for patient care, nurses are the consumers, purveyors, and brokers of information. Nurses have always been knowledge workers. To help meet the information needs of nursing, in 1980 Scholes and Barber advocated the application of computer technology to all fields of nursing.
In 1989, seminal work by Graves and Corcoran concentrated on the purpose of the professional nurse’s use of technology, not just on the technology itself. They describe nursing informatics as “... a combination of computer science, information science, and nursing science designed to assist in the management and processing of nursing data, information, and knowledge, to support the practice of nursing and the delivery of nursing care”. By 1992, the American Nurses Association (ANA) recognized Informatics Nurse as a specialty practice and in 1995 the American Nurses Credentialing Center (ANCC) began offering certification exams. furthermore, the 2008 ANA Nursing Informatics Scope and Standards defines nursing informatics as the integration of nursing science, computer and information science, and cognitive science to manage communication and expand the data, information, knowledge and wisdom of nursing practice.
4. The TIGER competency collaborative, description of its members, mission, working approach, process, etc. (Denise)
The Mission of the Tiger Informatics Computer Competencies (TICC) is to deliver a document to TIGER internal and external customers that substantially achieve the goals and objectives of the collaborative. (http://tigercompetencies.pbwiki.com/Tiger+Competencies+info).
This was accomplished using volunteer members who were focused on the goal of contributing to the discipline of nursing by helping to develop a tool that can be used ensure that both practicing nurses and nursing students are prepared to use technology as a tool in their practice.
Each collaborative of the TIGER team, including the TICC use a combination of email, Conference calls, Webinar and WIKI technology to communicate and collaborate.
A Webinar, or "Web seminar," is an online event designed to facilitate communication between a small number of presenters and a large remote audience using the Internet. (https://www1.gotowebinar.com/en_US/webinar/pre/productOverview.tmpl). A WIKI is a kind of free-form website that is easy to edit. PBWIKIS can be made public to allow
anyone to read, and still restrict editing to those who have eth passwords.
In order to organize the different competencies found during a literature review into workable pieces, they were dissected into categories based on a 4-part model.
5. The 4 part model (Wanda)a. The model
Information Management – Proposed: EHR-S or ECDL-Health
Basic Computer Competency – Proposed: ECDL
Information Literacy –Proposed: 1st 3 parts of our information literacy model
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Proposed: TIGER Nursing Competencies Model
February 14, 2008
b.c. General description about the model and how the parts fit together
6. Part 1 - Basic Computer Competencies – ECDL (Denise)
The TIGER Informatics Competencies Team recommends that we adopt and promote the European Computer Drivers License (ECDL) as the training model for Basic Computer Competencies. This model has been adopted and in use by over 7 million users over several years, and has a very well developed and mature training program, work book, and testing process.
The European Computer Driving License (ECDL) is known as International Computer Driving License (ICDL) in the United States and outside of Europe. (http://tigercompetencies.pbwiki.com/Basic+Computer+Competencies?SearchFor=ECDL&sp=1). The ECDL includes 7 vender neutral modules. Module 1 is a theoretical test of computing knowledge at a general level and modules 2-7 are practical skills tests. These modules include:
Concepts of Information Technology (IT) Using the Computer and Managing Files Word Processing Spreadsheets Database Presentation Information and Communication
The international piece, or ICDL has a US component, the ICDLUS, you can read more about this at: http://www2.icdlus.com/icdlus-lms-webclient/
One piece of the ECDL is “Equal Skills”. Equal Skills is an informal introduction to the computer and the internet that is designed for all levels of learners. The materials consist of a workbook, on-line web based exercises, and an optional multi-media computer-based training program. To learn more about Equal Skills, you can visit their website at: http://www.ecdl.ie/eq_about_equalskills.aspx?sm=2
7. Part 2 - Clinical Information Management Competencies – HL7 EHR Functional Descriptors: Direct Care (Brian)
The TICC’s charge is to recommend fundamental/ foundational informatics competencies to all graduating nursing students and practicing nurses.
Information management is the underlying principle upon which Clinical Information Management Competencies are built. Despite lots of discussion about information management, the concept of information management is not generally agreed upon amongst those who use this concept for education, technology and business purposes. What is information management? We have defined information management as a multi-step process consisting of 1) collecting data, 2) processing the data, and 3) presenting and communicating the processed data as information or knowledge.
Information is managed by nurses in a variety of ways, but more and more the preferred or required method to manage information is through information systems. We define an information system as being composed of human and computer elements that work interdependently to process data into information. An underlying concept for both information management and information systems is the data, information, knowledge continuum. Data are discrete, atomic level symbols. An example of data is the number 120. Information is data that is grouped or organized or processed in such a way that the data has meaning, hopefully, but not always, useful meaning. An example of information is a blood pressure of 120/80. Knowledge is information transformed or combined to be truly useful. An example of knowledge is that a blood pressure of 120/80 is dangerously hypertensive in a neonate. (Akoff, 1989; Graves and Corcoran, 1988)
Ours is a wide ranging clinical discipline. Nursing covers clinical and education, management, research as well as other areas. Even those other, not purely clinical areas, often have a clinical component. Thus, the fundamental information management needs of our discipline are clinical.
Putting all of the above together, the most relevant, important and fundamental information management competencies for nurses are those that relate to the most relevant and important clinically related information system of our era: the electronic health record system (EHRS).
An Electronic Health Record System (EHRS) is defined by the Institutes of Medicine as:
“…a system (that) includes (1) longitudinal collection of electronic health information for and about persons, where health information is defined as
information pertaining to the health of an individual or health care provided to an individual; (2) immediate electronic access to person- and population-level information by authorized, and only authorized, users; (3) provision of knowledge and decision-support that enhance the quality, safety, and efficiency of patient care; and (4) support of efficient processes for health care delivery. Critical building blocks of an EHR system are the electronic health records (EHR) maintained by providers (e.g., hospitals, nursing homes, ambulatory settings) and by individuals (also called personal health records).” (Letter Report, 2003)
The most rigorous as well as practical work on enumerating the relevant parts of the EHRS for clinicians was done by HL7’s EHR Technical Committee and was published in February, 2007 as an approved American National Standard (ANSI). The publication is titled ‘The HL7 EHR System Functional Model, Release 1’ and is known as ANSI/HL7 EHR, R1-2007.
ANSI/HL7 EHR, R1-2007’s purpose and scope is:“The HL7 EHR System Functional Model provides a reference list of functions that may be present in an Electronic Health Record System (EHR-S). The function list is described from a user perspective with the intent to enable consistent expression of system functionality. This EHR-S Functional Model, through the creation of Functional Profiles for care settings and realms, enables a standardized description and common understanding of functions sought or available in a given setting (e.g., intensive care, cardiology, office practice in one country or primary care in another country).”
The HL7 EHR System Functional Model has the following components:1. Direct Care2. Supportive3. Information Infrastructure 4. Profiles (which cut across the other 3 components)
See figure X.
Figure X – The HL7 EHR System Functional Model
Practicing nurses and nursing students need not focus on the important supportive and information infrastructure components. These components are more in the prevue of the clinical informatician or information technology
professional. The profiles aspect of the model can likewise be ignored for the purposes of this discussion. It is the direct care component of the HL7 EHR System Functional Model that can serve as a basis of information management competencies for practicing nurses and graduating nursing students.
The direct care component of the HL7 EHR System Functional Model is segmented into three main areas: DC.1 Care Management, DC.2 Clinical Decision Support and DC.3 Operations Management and Communication. See figure y.
Figure y – The Direct Care Component of the HL7 EHR System Functional Model
We used the Direct Care recommended functions of the EHRS and adjusted the verbiage slightly for each function to transform the functions to information management competencies for nurses. (see below)
Using an EHRS, the nurse can:Identify and Maintain a Patient RecordManage Patient DemographicsCapture Data and Documentation from External Clinical SourcesCapture Patient-Originated DataCapture Patient Health Data Derived from Administrative andInteract with Financial Data and DocumentationProduce a Summary Record of CarePresent Ad Hoc Views of the Health RecordManage Patient HistoryManage Patient and Family PreferencesManage Patient Advance DirectivesManage Consents and AuthorizationsManage Allergy, Intolerance and Adverse Reaction ListsManage Medication ListsManage Problem ListsManage Immunization ListsInteract with Guidelines and Protocols for Planning CareManage Patient-Specific Care and Treatment PlansManage Medication Orders as appropriate for her scope of practiceManage Non-Medication Patient Care OrdersManage Orders for Diagnostic TestsManage Orders for Blood Products and Other BiologicsManage ReferralsManage Order SetsManage Medication AdministrationManage Immunization Administration
Manage ResultsManage Patient Clinical MeasurementsManage Clinical Documents and NotesManage Documentation of Clinician Response to Decision Support PromptsGenerate and Record Patient-Specific InstructionsManage Health Information to Provide Decision Support for Standard AssessmentsManage Health Information to Provide Decision Support for Patient Context- Driven assessmentsManage Health Information to Provide Decision Support for Identification of Potential Problems and TrendsManage Health Information to Provide Decision Support for Patient and Family PreferencesInteract with decision Support for Standard Care Plans, Guidelines, ProtocolsInteract with decision Support for Context-Sensitive Care Plans, Guidelines, ProtocolsManage Health Information to Provide Decision Support Consistent Healthcare Management of Patient Groups or PopulationsManage Health Information to Provide Decision Support for Research Protocols Relative to Individual Patient CareManage Health Information to Provide Decision Support for Self-CareInteract with decision support for Medication and Immunization Ordering as appropriate for her scope of practiceInteract with decision Support for Drug Interaction CheckingInteract with decision Support for Patient Specific Dosing and WarningsInteract with decision Support for Medication RecommendationsInteract with decision Support for Medication and Immunization AdministrationInteract with decision Support for Non-Medication OrderingInteract with decision Support for Result InterpretationInteract with decision Support for Referral ProcessInteract with decision Support for Referral RecommendationsInteract with decision Support for Safe Blood AdministrationInteract with decision Support for Accurate Specimen CollectionInteract with decision support that Presents Alerts for Preventive Services and WellnessInteract with decision Support for Notifications and Reminders for Preventive Services and WellnessManage Health Information to Provide Decision Support for Epidemiological Investigations of Clinical Health Within a Population.Manage Health Information to Provide Decision Support for Notification and Response regarding population health issuesManage Health Information to Provide Decision Support for Monitoring Response Notifications Regarding a Specific Patient’s HealthAccess Healthcare GuidanceInteract with Clinical Workflow TaskingInteract with Clinical Task Assignment and RoutingInteract with Clinical Task LinkingInteract with Clinical Task TrackingFacilitate Inter-Provider CommunicationFacilitate Provider -Pharmacy Communication
Facilitate Communications Between Provider and Patient and/or the Patient RepresentativeFacilitate Patient, Family and Care Giver EducationFacilitate Communication with Medical Devices
(Red text in the above list indicates added text to transform a recommended Direct Care function of the EHRS to an information management competency recommended for a nurse to use the EHRS. Black text indicates original wording for the Direct Care function of the EHRS.)
Besides the fact that Direct Care recommended functions of the EHRS were the most complete, comprehensive, relevant and best fit for a list of information management item from which we could derive information management competencies for practicing nurses and graduating nursing students, they are a approved American National Standard of the American National Standard Institute. As such the functions and hence the competencies will be evolved in a rigorous and thoughtful fashion going forward and can serve as a foundation for information management competencies for nurses for years to come.
8. Information Literacy – Information literacy process up to and including assessing veracity of information (Ann)
The Association of Colleges and Research Libraries (2000) defines Information literacy as “a set of abilities allowing individuals to recognize when information is needed and to locate, evaluate and use that information appropriately”. With respect to nursing practice, information literacy is the ability to identify information needed for a specific purpose, locate pertinent information, evaluate the information and apply it correctly (Englebardt & Nelson,2002). Healthcare is bombarded daily with new information regarding treatments, procedures, medications, etc. Nurses must be able to access appropriate resources to provide the evidence necessary to support their practice. The basic information literacy skills that the nurse must possess include the ability to:
Identify of the kind of information that is needed Locate and access specific sources/resources (electronic) Evaluate the quality, content, and appropriateness of the source Appropriately apply the information
9. ECDL Health Concepts – To cover the awareness part of the model (Sarah)The “awareness” concept within the overall Awareness and Attitudes competency category brings professional consciousness and responsibility for learning to the forefront. It is the responsibility of the professional nurse to continue to grow their knowledge base of professional practice and to make connections with other disciplines where relevant. Patients will be best served by an interdisciplinary knowledge base. Nurses need to take responsibility for asking questions and knowing how to find answers. If clear, measureable informatics competencies are set forth for each practicing professional nurse, the nurse can identify when a situation is beyond their competency level, access a tool or colleague who can provide teaching of a particular competency. Once a competency is mastered, it
becomes integrated into a nurse’s practice and that nurse can, in turn become a teacher for others. Professional nursing practice can only advance as much as individual nurses are aware that a knowledge gap exists in their practice, feel empowered to access further learning, and integrate evidence-based competencies into their professional practice to provide safe, effective, efficient, patient-centered, equitable care.
10. Recommendations (Brian)
Information Management – Proposed: EHR-S or ECDL-Health
Proposed: EHR-S Direct Care
o DC.1 (Care Management) DC.1.1 (Record Management)
Functionality Chalkboard (29) Build/update/maintain (1) Manipulate system
o Recall (176, 503)o Process (65, 92, 98, 103, 117, 140, 182, 184, 206,
311, 701, 706, 753, 955)o Edit/Undo (95, 140, 142, 144, 178, 179, 220, 352,
358, 457, 467, 505, 508, 509)o Navigate (356, 440, 446, 461, 462, 466, 495, 496,
502, 505, 511)
DC.1.2 (Manage Patient History) Admission History (447, 448, 591, 595, 949) Admission (24, 45, 310)
o enter admission datao includes quick registration functiono can differentiate the difference between the hospital
information system and a departmental system
DC.1.3 (Preferences, Directives, Consents and Authorizations) Advanced Directives (274)
DC.1.4 (Summary Lists) i.e. Manage Allergy, Intolerance and Adverse Reaction List
DC.1.5 (Manage Assessments) Data types
ADLs (140, 148, 149, 604) I & O (43, 144, 149, 255, 256, 604) EFM (31) Vital signs (50, 78, 81, 147, 255, 256, 360, 450, 529, 547,
558, 593, 604, 711) Medication Administration (50) Physical Assessment (50, 116, 449, 582, 598, 706) PCA/Epidural (52) Blood Transfusion (52) IV (50, 52, 452) Ad Hoc (58, 172, 496, 502) Screening (58, 277, 278) Medication Reconciliation (61, 269, 457) Triage (61, 285) Immunizations (61, 116, 278)
ED forms (62, 65, 319, 320) Pain (78, 147, 529) Allergies (116, 150, 181, 182, 368, 518, 519, 520, 521, 591,
595, 600) Activity (140, 148, 453) Free text (149, 180) Ht/Wt (360, 547, 591, 593, 600) Consult (600) Restraints (604) Calculations (615)
DC.1.6 (Care Plans, Treatment Plans, Guidelines, and Protocols) Care Management
Advanced Directives (274) Education Teaching (320) Admission History (447, 448, 591, 595, 949) Discharge (41, 706, 710, 949) Plan of care (42, 50, 52, 58, 183, 184, 280, 456, 706, 709,
710) ADT (600)
Plan of care (42, 50, 52, 58, 183, 184, 280, 456, 706, 709, 710)
DC.1.7 (Orders and Referrals Management) Find, filter, and view orders (317, 567, 571, 592, 596)
DC.1.8 (Documentation of Care, Measurements and Results) Data types
ADLs (140, 148, 149, 604) I & O (43, 144, 149, 255, 256, 604) EFM (31) Vital signs (50, 78, 81, 147, 255, 256, 360, 450, 529, 547,
558, 593, 604, 711) Medication Administration (50) Physical Assessment (50, 116, 449, 582, 598, 706) PCA/Epidural (52) Blood Transfusion (52) IV (50, 52, 452) Ad Hoc (58, 172, 496, 502) Screening (58, 277, 278) Medication Reconciliation (61, 269, 457) Triage (61, 285) Immunizations (61, 116, 278) ED forms (62, 65, 319, 320) Pain (78, 147, 529) Allergies (116, 150, 181, 182, 368, 518, 519, 520, 521, 591,
595, 600) Activity (140, 148, 453) Free text (149, 180) Ht/Wt (360, 547, 591, 593, 600) Consult (600) Restraints (604) Calculations (615)
DC.1.9 (Generate and Record Patient-Specific Instructions) Education Teaching (320)
o DC.2 (Clinical Decision Support) EFM (30, 46)
Demonstrate how to view patient fetal strips: live, stored, strip view: surveillance setup, FHR notifications, alerts
Find, filter, and view results/reports (53, 219, 289, 317, 362, 363, 367, 567, 571, 573, 592, 596) Labs Radiology Case manager/Social services Physician progress notes H&P
Find, filter, and view clinical data (30, 46, 317, 522, 353, 355, 567, 571) Demographics Clinical notes Allergies Flowsheets eMAR Biomedical device data
Find, filter, and view orders (317, 567, 571, 592, 596)
DC.2.1 (Manage Health Information to Provide Decision Support)
DC.2.2 (Care and Treatment Plans, Guidelines and Protocols) Plan of care (42, 50, 52, 58, 183, 184, 280, 456, 706, 709, 710)
DC.2.3 (Medication and Immunization Management)
DC.2.4 (Orders, Referrals, Results and Care Management) Find, filter, and view orders (317, 567, 571, 592, 596)
DC.2.5 (Support for Health Maintenance: Preventive Care and Wellness)
DC.2.6 (Support for Population Health)
DC.2.7 (Support for Knowledge Access)
o DC.3 (Operations Management and Communication) DC.3.1 (Clinical Workflow Tasking)
Process Flow (322, 753, 923, 936, 955)
DC.3.2 (Support Clinical Communication) i.e. Support for Inter-Provider Communication
Supportiveo S.1 (Clinical Support)
S.1.1 (Registry Notification)
S.1.2 (Donor Management Support)
S.1.3 (Provider Information)
S.1.4 (Patient Directory) i.e. Patient Demographics
S.1.5 (De-Identified Data Request Management)
S.1.6 (Scheduling) Policies and Procedures
Protocols (58, 60, 276, 936)
S.1.7 (Healthcare Resource Availability) Process Flow (322, 753, 923, 936, 955)
S.1.8 (Information View) EFM (30, 46)
Demonstrate how to view patient fetal strips: live, stored, strip view: surveillance setup, FHR notifications, alerts
Find, filter, and view results/reports (53, 219, 289, 317, 362, 363, 367, 567, 571, 573, 592, 596) Labs Radiology Case manager/Social services Physician progress notes H&P
Find, filter, and view clinical data (30, 46, 317, 522, 353, 355, 567, 571) Demographics Clinical notes Allergies Flowsheets eMAR Biomedical device data
Find, filter, and view orders (317, 567, 571, 592, 596)
o S.2 (Measurement, Analysis, Research, and Reports)
o S.3 (Administrative and Financial) S.3.1 (Encounter/Episode of Care Management)
S.3.2 (Information Access for Supplemental Use)
S.3.3 (Administrative Transaction Processing)
S.3.4 (Manage Practitioner/Patient Relationships)
S.3.5 (Subject to Subject Relationship) i.e. Related by Genealogy
S.3.6 (Acuity and Severity) Acuity (931)
S.3.7 (Supportive Function Maintenance) i.e. Patient Education Material Updates
Education Teaching (320)
Information Infrastructureo IN.1 (Security)
IN.1.1 (Entity Authentication) Security (128, 155, 607, 626, 1017)
Knowledge of security requirements Maintain security standards Follows policies and procedures related to security
standards Access (752, 885)
o Understands “necessary access”
IN.1.2 (Entity Authorization) Data Integrity (678, 752, 756)
o Assures integrityo Understands data integrity implications
Security (128, 155, 607, 626, 1017) Knowledge of security requirements Maintain security standards Follows policies and procedures related to security
standards Access (752, 885)
Understands “necessary access”
IN.1.3 (Entity Access Control) Access (752, 885)
Understands “necessary access”
IN.1.4 (Patient Access Management) Rights (732, 909, 1017)
o Describes patient rights
IN.1.5 (Non-Repudiation)
IN.1.6 (Secure Data Exchange) Confidentiality (155, 626, 679, 796, 809, 1017)
Ensure protection and thereby guard confidentiality of protected health information in electronic health records
Follows policies and procedures to protect confidentiality
IN.1.7 (Secure Data Routing)
IN.1.8 (Information Attestation) Legal (756, 885)
Understands legal implications
IN.1.9 (Patient Privacy and Confidentiality) Privacy (155, 607. 626, 1017)
Maintains privacy standards Confidentiality (155, 626, 679, 796, 809, 1017)
Ensure protection and thereby guard confidentiality of protected health information in electronic health records
Follows policies and procedures to protect confidentiality Informed Consent (626)
Follows policies and procedures to supply informed consent
HIPPA (155, 271) Understands the use of the HIPPA statement
o IN.2 (Health Record Information and Management) IN.2.1 (Data Retention, Availability, and Destruction)
IN.2.2 (Auditable Records)
IN.2.3 (Synchronization)
IN.2.4 (Extraction of Health Record Information)
IN.2.5 (Store and Manage Health Record Information)
o IN.3 (Registry and Directory Services)
o IN.4 (Standard Terminologies and Terminology Services)
o IN.5 (Standards-based Interoperability)
o IN.6 (Business Rules Management)
o IN.7 (Workflow Management)
Proposed: ECDL-Health1.1 Concepts
1.1.1 Healthcare Information Systems (HIS)1.1.1.1 Define a Healthcare Information System (HIS) as a system for holding
and updating patient-related information and records, clinically as well as administratively oriented.
1.1.1.2 Understand that a HIS may be made up of patient, personal, or population records.
1.1.1.3 Understand that electronic health records provide for history, diagnosis, documentation, and management plans with respect to individual patients, and testing and procedures that result from these plans.
1.1.1.4 Understand the relationship between population records and personal health records.
1.1.1.5 Appreciate some of the benefits of Healthcare delivery through a HIS such as more reliable, timely information leading to better patient care.
1.1.2 HIS Types1.1.1.1 Understand that HIS are made up of different parts such as: Electronic
Health Record, ordering, imaging, prescribing and laboratory systems, PACS, Ultrasound, results-based, decision-support, multimedia and billing where appropriate.
1.1.1.2 Describe some of the key qualities of a HIS such as: accessible, reliable, rapid access, shared view, up-to-date, accurate, provides for a continuum of care, efficient, and incorporates some important safety features.
1.1.1.3 Identify or know about some of the functions or tools of HIS such as: booking appointments and scheduling, transmission of outputs / results, updating of patient records, giving prescriptions, home healthcare via the internet.
1.1.1.4 Appreciate some of the potential constraints of using a HIS such as: a change in the Healthcare Professional / Patient relationship, loss of subtlety in language and data entry, loss of context of the data capture, ease of use of the patient record.
1.1.1.5 Understand that a HIS supports but does not replace clinical judgment.
1.1.1.6 Understand different kinds of HIS such as: office /department based, local facility based, regionally based, nationally, or internationally based.
1.1.1.7 Understand the implication reliability, security, authorization to view data from your own authorized source rather than an external source.
1.1.1.8 Understand different types of HIS such as: legacy / computer-based / distributed records.
1.2 Due Care1.2.1 Confidentiality
1.2.1.1 Describe the healthcare worker’s responsibilities in relation to patient confidentiality within a HIS: access only to patient information when necessary; access only to items that are need-to-know; access only to information that is right-to-know, awareness of concept of personal accountability.
1.2.1.2 Understand the patient’s right of (implied or explicit), issues such as sensitivity in dealing with patient data in relation to family members and others. Appreciate patient right not-to-know issues.
1.2.1.3 Understand that local legislation gives patients the right to review and amend their own records.
1.2.1.4 Recognise the distinction that system access does not imply authorization to view or use.
1.2.1.5 Understand national requirements in terms of public reporting and management of patient specific data / rules and constraints, public health, notifiable diseases.
1.2.1.6 Understand that there are certain confidentiality risks associated with HIS such as patient specific printed materials, e-mail risks.
1.2.1.7 Appreciate some of the national requirements in terms of patient control of data: opt-in, opt out.
1.2.2 Access Control1.1.1.1 Understand that access control in a HIS is intended to protect patient’s
data and access to HIS is often based on: healthcare worker roles, duties and responsibilities.
1.1.1.2 Understand how access may be based on what the user may know (e.g.: a PIN); what the user has (e.g.: a Card or token) or what they are (e.g.: a biometric scan).
1.1.1.3 List some different kinds of access control techniques such as: biometric, text, tokens, Smart Cards, barcodes etc.
1.1.1.4 Recognise the need to change passwords regularly.
1.2.2.5 Understand why it is important to choose an appropriate password and other mechanisms of authentication and the importance of changing it regularly.
1.2.2.6 Understand that passwords / authentication details should not be shared and that tokens and passwords need to be safeguarded.
1.2.2.7 Recognise the need to observe the password policies of an organisation.
1.2.3 Security1.2.3.1 Describe some of the key principles of security within HIS such as
awareness of systems vulnerability, requirement for formal agreement to organisational security policy.
1.2.3.2 Understand that an organisational security policy has personal, professional, and organisational impacts.
1.2.3.3 Describe some of the principal threats to a HIS such as accidental viewing, unauthorised inquiry, malicious damage, uncontrolled access, risk of transfer of data to external media.
1.2.3.4 List some of the defences against security threats to a HIS.
1.2.3.5 Understand the obligation to report security breaches and threats such as user impersonation, malicious attack, viruses, or worms etc.
1.2.3.6 Understand the concept of data storage and backup and why it is important
1.3 User Skills1.3.1 Navigation
1.3.1.1 Search, locate, and verify a patient record.
1.3.1.2 Recognise the same individual has two records created in the system, and understand authority for merging.
1.3.1.3 Know how to identify the authorship of an entry in a record.
1.3.1.4 Select and view a set of patient records based on some common criteria.
1.3.1.5 Record information accurately about a patient
1.3.1.6 Make the follow-up appointments / treatment schedules for the patient.
1.3.1.7 Recognize different modes (automated) of data entry.
1.3.2 Decision Support1.3.2.1 Understand the difference types of decision support that may be
available such as: alerts, reminders, validation checks etc.
1.3.2.2 Understand personal responsibility, authority to override system validation messages.
1.3.3 Outputs Reports1.3.3.1 Create reports such as a patient list, a care unit census, patient bookings
/ appointments, theatre lists. etc.
1.3.3.2 Create a routine output based on a specific query such as patient results.
1.3.3.3 Select a type of output from a pre-existing report type/template.
1.3.3.4 Select and view a specific report: x-ray, ECG, CT-Scan, blood result etc.
1.3.3.5 Print a report securely. Transmit HIS data and reports securely.
1.4 Policy & Procedure1.4.1 Principles
1.4.1.1 Understand that the patient record is a legal document and no information can be erased
1.4.1.2 Understand that information can be added or amended but not changed
1.4.1.3 Understand who has the authority to create new records, e.g. Births / emergency / temporary records.
1.4.1.4 Understand the audit trail within HIS and the importance thereof.
Source: http://www.ecdl.nhs.uk/resources/ecdl-health-unit/health_unit_syllabus.pdf
Basic Computer Competency – Proposed ECDL
1 Concepts of Information Technology (IT)1.1 General Concepts
1.1.1 Hardware, Software, Information Technology 1.1.1.1 Understand the terms hardware, software, Information Technology (IT)
1.1.2 Types of Computer1.1.2.1 Understand and distinguish between mainframe computer, network
computer, personal computer, laptop, personal digital assistant (PDA) in terms of capacity, speed, cost, and typical users.
1.1.3 Main Parts of a Personal Computer1.1.3.1 Know the main parts of a personal computer such as: central processing
unit (CPU), hard disk, common input and output devices, types of memory. Understand the term peripheral device.
1.1.4 Computer Performance1.1.4.1 Know some of the factors that impact on a computer’s performance such
as: CPU speed, RAM size, and the number of applications running.
1.2 Hardware1.2.1 Central Processing Unit
1.2.1.1 Understand some of the functions of the CPU in terms of calculations, logic control, and immediate access memory. Know that the speed of the CPU is measured in megahertz (MHz) or gigahertz (GHz).
1.2.2 Memory1.2.2.1 Understand different types of computer memory such as: RAM (random-
access memory), ROM (read-only memory) and distinguish between them.
1.2.2.2 Know how computer memory is measured: bit, byte, KB, MB, GB, TB. Relate computer memory measurements to characters, files and directories/folders.
1.2.3 Input Devices
1.2.3.1 Identify some of the main devices for inputting data into a computer such as: mouse, keyboard, trackball, scanner, touchpad, lightpen, joystick, digital camera, and microphone.
1.2.4 Output Devices1.2.4.1 Identify common output devices for displaying the results of processing
carried out by a computer, such as: monitors, screens, printers, plotters, and speakers. Know where these devices are used.
1.2.5 Input/Output Devices1.2.5.1 Understand some devices are both input/output devices such as:
touchscreens.
1.2.6 Storage Devices1.2.6.1 Compare the main types of memory storage devices in terms of speed,
cost and capacity such as: diskette, Zip disk, data cartridges, CD-ROM, internal, external hard disk.
1.2.6.2 Understand the purpose of formatting a disk.
1.3 Software1.3.1 Types of Software
1.3.1.1 Distinguish between operating systems software and applications software. Understand the reasons for software versions.
1.3.2 Operating System Software1.3.2.1 Describe the main functions of an operating system and name some
common operating systems.
1.3.3 Applications Software1.3.3.1 List some common software applications such as: word processing,
spreadsheet, database, Web browsing, desktop publishing, accounting, together with their uses.
1.3.4 Graphical User Interface1.3.4.1 Understand the term Graphical User Interface (GUI).
1.3.5 Systems Development1.3.5.1 Understand how computer-based systems are developed. Know about
the process of analysis, design, programming and testing often used in developing computer-based systems
1.4 Information Networks1.4.1 LAN, WAN
1.4.1.1 Understand the terms, local area network (LAN), wide area network (WAN). Understand the term client/server.
1.4.1.2 List some of the advantages associated with group working such as: sharing printers, applications, and files across a network.
1.4.2 Intranet, Extranet1.4.2.1 Understand what an intranet is and understand the distinction between
the Internet and an intranet.
1.4.2.2 Understand what an extranet is and understand the distinction between an intranet and an extranet.
1.4.3 The Internet1.4.3.1 Understand what the Internet is and know some of its main uses.
1.4.3.2 Understand what the World Wide Web (WWW) is and distinguish it from the Internet.
1.4.4 The Telephone Network in Computing1.4.4.1 Understand the use of the telephone network in computing. Understand
the terms Public Switched Telephone Network (PSTN), Integrated Services Digital Network (ISDN), Asymmetric Digital Subscriber Line (ADSL).
1.4.4.2 Understand the terms analogue, digital, modem, transfer rate, (measured in bps – bits per second).
1.5 The Use of IT in Everyday Life1.5.1 Computers at Work
1.5.1.1 Identify some situations where a computer might be more appropriate than a person for carrying out a task and where not.
1.5.1.2 Know some of the uses of large-scale computer applications in business such as: business administration systems, airline booking systems, insurance claims processing, online banking.
1.5.1.3 Know some of the uses of large-scale computer applications in government such as: public records systems (census, vehicle registration), revenue collection, electronic voting.
1.5.1.4 Know some of the uses of large-scale computer applications in hospitals/healthcare such as: patient records systems, ambulance control systems, diagnostic tools and instruments, specialist surgical equipment.
1.5.1.5 Know some of the uses of computer applications in education such as: student registration and timetabling systems, computer-based training (CBT), distance learning, homework using the Internet.
1.5.2 Electronic World1.5.2.1 Understand the term electronic mail (e-mail) and know its main uses.
1.5.2.2 Understand the term e-Commerce. Understand the concept of purchasing goods and services online, including giving personal details before a transaction can be carried out, payment methods, consumer’s basic right to return unsatisfactory goods.
1.5.2.3 List some of the advantages of purchasing goods and services online, such as: services available 24 hours a day, opportunity to view a wide range of products. List some of the disadvantages of purchasing goods and services online such as: choosing from a virtual store, no human contact, risk of insecure payment methods.
1.6 Health and Safety, Environment1.6.1 Ergonomics
1.6.1.1 Understand what elements and practices can help create a good working environment such as: appropriate positioning of monitors, keyboards and adjustable chairs, use of a mouse mat, use of a monitor filter, provision of adequate lighting and ventilation, frequent breaks away from the computer.
1.6.2 Health Issues1.6.2.1 List some common health problems, which can be associated with using
a computer such as: injuries to wrists caused by prolonged typing, eyestrain caused by screen glare, back problems associated with poor seating or bad posture.
1.6.3 Precautions1.6.3.1 List some safety precautions when using a computer such as: ensuring
power cables are safely secured, power points are not overloaded.
1.6.4 The Environment1.6.4.1 Be aware that recycling printed outputs, recycling printer toner cartridges,
using a monitor that consumes less power while the computer is inactive can help the environment
1.6.4.2 Understand that using electronic documents can help reduce the need for printed materials.
1.7 Security1.7.1 Information Security
1.7.1.1 Understand the term information security and the benefits to an organisation of being proactive in dealing with security risks such as: adopting an information security policy with respect to handling sensitive data, having procedures for reporting security incidents, making staff members aware of their responsibilities with respect to information security.
1.7.1.2 Know about privacy issues associated with computers, such as adopting good password policies. Understand what is meant by user ID and differentiate between user ID and password. Understand the term access rights and know why access rights are important.
1.7.1.3 Know about the purpose and value of backing up data, software to a removable storage device
1.7.1.4 Be aware of possible implications of theft of a laptop computer, PDA, mobile phone such as: possible misuse of confidential files, loss of files, loss of important contact details if not available on a separate source, possible misuse of telephone numbers
1.7.2 Computer Viruses1.7.2.1 Understand the term virus when used in computing and understand that
there are different types of virus. Be aware when and how viruses can enter a computer system
1.7.2.2 Know about anti-virus measures and what to do when a virus infects a computer. Be aware of the limitations of anti-virus software. Understand what ‘disinfecting’ files means
1.7.2.3 Understand good practice when downloading files, accessing file attachments, such as: use of virus scanning software, not opening unrecognised e-mail messages, not opening attachments contained within unrecognised email messages
1.8 Copyright and the Law1.8.1 Copyright
1.8.1.1 Understand the concept of copyright when applied to software, and also to files such as: graphics, text, audio, video. Understand copyright issues involved in downloading information from the Internet
1.8.1.2 Understand copyright issues associated with using and distributing materials stored on removable media such as CD’s, Zip disks, diskettes
1.8.1.3 Know how to check the Product ID number for a software product. Understand the terms shareware, freeware, end-user license agreement.
1.8.2 Data Protection Legislation1.8.2.1 Know about data protection legislation or conventions in your country.
Understand the implications of data protection legislation for data subjects and data holders. Describe some of the uses of personal data.
2 Using the Computer and Managing Files2.1 Computer Environment
2.1.1 First Steps with the Computer2.1.1.1 Start the computer.
2.1.1.2 Shut down the computer using an appropriate routine.
2.1.1.3 Restart the computer using an appropriate routine.
2.1.1.4 Shut down a non-responding application.
2.1.2 Basic Information and Operations2.1.2.1 View the computer’s basic system information: operating system and
version number, installed RAM (random access memory).
2.1.2.2 Change the computer’s desktop configuration: date & time2, volume settings, desktop display options (colour settings, creen pixel resolution, screen saver options).
2.1.2.3 Set, change keyboard language.
2.1.2.4 Format removable disk media: diskette, Zip disk.
2.1.2.5 Install, uninstall a software application.
2.1.2.6 Use keyboard print screen facility and paste contents into a document.
2.1.2.7 Use available Help functions.
2.1.3 Text Editing2.1.3.1 Launch a text editing application. Open, create a file.
2.1.3.2 Save the file to a location on a drive.
2.1.3.3 Close the text editing application.
2.2 Desktop2.2.1 Work with Icons
2.2.1.1 Recognize common desktop icons such as those representing: files, directories/folders, applications, printers, recycle bin/wastebasket.
2.2.1.2 Select and move desktop icons.
2.2.1.3 Open a file, directory/folder, application from the desktop.
2.2.1.4 Create a desktop shortcut icon, desktop menu alias.
2.2.2 Work with Windows2.2.2.1 Identify the different parts of a window: title bar, menu bar, toolbar, status
bar, scroll bar.
2.2.2.2 Collapse, expand, resize, move, close a window.
2.2.2.3 Switch between open windows.
2.3 Managing Files2.3.1 Concepts
2.3.1.1 Understand how an operating system shows drives, folders, files in a hierarchical structure.
2.3.1.2 Know that the devices used by an operating system to store files and folders are the hard disk, diskette, CD-ROM, network drives.
2.3.2 Directories/Folders2.3.2.1 Navigate to a file, folder on a drive.
2.3.2.2 Create a directory/folder and a further subdirectory/sub-folder.
2.3.2.3 Open a window to display directory/folder name, size, location on drive.
2.3.3 Working with Files2.3.3.1 Recognize common file types: word processing files, spreadsheet files,
database files, presentation files, image files, audio files, video files, compressed files, temporary files.
2.3.3.2 Count the number of files, files of a particular type, in a folder (including any files in subfolders).
2.3.3.3 Change file status: read-only/locked, read-write.
2.3.3.4 Sort files by name, size, type, date modified.
2.3.3.5 Understand the importance of maintaining correct file extensions when re-naming files.
2.3.3.6 Re-name files, directories/folders.
2.3.4 Duplicate, Move2.3.4.1 Select a file, directory/folder individually or as a group of adjacent, non-
adjacent files, directories/folders.
2.3.4.2 Duplicate files, directories/folders between directories/folders and between drives.
2.3.4.3 Move files, directories/folders between directories/folders and drives.
2.3.4.4 Understand why making a ‘backup’ copy of files to a removable storage device is important.
2.3.5 Delete, Restore2.3.5.1 Delete files, directories/folders to the recycle bin/wastebasket.
2.3.5.2 Restore files, directories/folders from the recycle bin/wastebasket.
2.3.5.3 Empty the recycle bin/wastebasket.
2.3.6 Searching2.3.6.1 Use the Find tool to locate a file, directory/folder.
2.3.6.2 Search for files by content, date modified, date created, size, wildcards.
2.3.6.3 View list of recently used files.
2.3.7 Compressing Files2.3.7.1 Understand what file compression means.
2.3.7.2 Compress files in a folder on a drive.
2.3.7.3 Extract compressed files from a location on a drive.
2.4 Viruses2.4.1 Concepts
2.4.1.1 Know what a virus is and what the effects of a virus might be.
2.4.1.2 Understand some of the ways a virus can be transmitted onto a computer.
2.4.1.3 Understand the advantages of a virus-scanning application.
2.4.1.4 Understand what ‘disinfecting’ files means.
2.4.2 Handling Viruses2.4.2.1 Use a virus scanning application to scan specific drives, folders, files.
2.4.2.2 Understand why virus-scanning software needs to be updated regularly.
2.5 Print Management2.5.1 Setup
2.5.1.1 Change the default printer from an installed printer list.
2.5.1.2 Install a new printer on the computer.
2.5.2 Print Outputs2.5.2.1 Print a document from a text editing application.
2.5.2.2 View a print job’s progress using a desktop print manager.
2.5.2.3 Pause, re-start, delete a print job using a desktop print manager.
3 Word Processing3.1 Using the Application
3.1.1 3.1.I First Steps with Word Processing3.1.1.1 Open (and close) a word processing application.
3.1.1.2 Open one, several documents.
3.1.1.3 Create a new document (based on default, other available template).
3.1.1.4 Save a document to a location on a drive.
3.1.1.5 Save a document under another name.
3.1.1.6 Save a document in another file type such as: text file, Rich Text Format, HTML, template, software specific file extension, version number.
3.1.1.7 Switch between open documents.
3.1.1.8 Use available Help functions.
3.1.1.9 Close a document.
3.1.2 Adjust Settings3.1.2.1 Change between page view modes.
3.1.2.2 Use magnification/zoom tools.
3.1.2.3 Display, hide built-in toolbars.
3.1.2.4 Display, hide non-printing characters.
3.1.2.5 Modify basic options/preferences in the application: user name, default directory/ folder to open, save documents.
3.2 Main Operations3.2.1 Insert Data
3.2.1.1 Insert text.
3.2.1.2 Insert special characters, symbols.
3.2.2 Select Data3.2.2.1 Select character, word, line, sentence, paragraph, entire body text.
3.2.3 Edit Data3.2.3.1 Edit content by inserting new characters, words within existing text, over-
typing to replace existing text.
3.2.3.2 Use the undo, redo command.
3.2.4 Duplicate, Move, Delete3.2.4.1 Duplicate text within a document, between open documents.
3.2.4.2 Move text within a document, between open documents.
3.2.4.3 Delete text.
3.2.5 Search and Replace3.2.5.1 Use the search command for a specific word, phrase.
3.2.5.2 Use a simple replace command for a specific word, phrase.
3.3 Formatting3.3.1 Text Formatting
3.3.1.1 Change text appearance: font sizes, font types.
3.3.1.2 Apply text formatting such as: bold, italic, underline.
3.3.1.3 Apply subscript, superscript to text.
3.3.1.4 Apply case changes to text.
3.3.1.5 Apply different colours to text.
3.3.1.6 Copy formatting from a piece of text to another piece of text.
3.3.1.7 Apply an existing style to a word, a line, a paragraph.
3.3.1.8 Use automatic hyphenation.
3.3.2 Paragraph Formatting3.3.2.1 Insert, remove paragraph marks.
3.3.2.2 Insert, remove soft carriage return (line break) marks.
3.3.2.3 Align text left, centre, right, justified.
3.3.2.4 Indent paragraphs: left, right, first line, hanging.
3.3.2.5 Apply single, double line spacing within paragraphs.
3.3.2.6 Apply spacing above, below paragraphs.
3.3.2.7 Set, remove and use tabs: left, centre, right, decimal.
3.3.2.8 Apply bullets, numbers to a single level list. Remove bullets, numbers from a single level list.
3.3.2.9 Change between the style of bullets, numbers in a single level list from built-in standard options.
3.3.2.10 Add a top and bottom border, box border and shading to a paragraph.
3.3.3 Document Formatting3.3.3.1 Change document orientation, portrait, landscape. Change paper size.
3.3.3.2 Change margins of entire document, top, bottom, left, right.
3.3.3.3 Insert, delete a page break in a document
3.3.3.4 Add, modify text in Headers, Footers.
3.3.3.5 Add fields in Headers, Footers: date, page number information, file location.
3.3.3.6 Apply automatic page numbering to a document.
3.4 Objects3.4.1 3.4.1 Tables
3.4.1.1 Create a table ready for text insertion.
3.4.1.2 Insert, edit data in a table.
3.4.1.3 Select rows, columns, cells, entire table.
3.4.1.4 Insert, delete, rows and columns.
3.4.1.5 Modify column width, row height.
3.4.1.6 Modify cell border width, style, colour.
3.4.1.7 Add shading to cells.
3.4.2 Pictures Images, Charts3.4.2.1 Insert a picture, an image, a chart into a document.
3.4.2.2 Select a picture, image, chart in a document.
3.4.2.3 Duplicate a picture, image, chart within a document, between open documents.
3.4.2.4 Move a picture, image, chart within a document, to another document.
3.4.2.5 Resize a picture, image, chart.
3.4.2.6 Delete a picture, image, chart.
3.5 Mail Merge3.5.1 Concept and Practice
3.5.1.1 Understand the term mail merge and the concept of merging a data source with a main document such as a letter or a label document.
3.5.1.2 Open, prepare a main document for a mail merge by inserting data fields.
3.5.1.3 Open, prepare a mailing list, other data file, for use in a mail merge.
3.5.1.4 Merge a mailing list with a letter, label document.
3.6 Prepare Outputs3.6.1 Preparation
3.6.1.1 Understand the importance of proofing your document such as: checking the layout, presentation (margins, appropriate font sizes and formats) and spelling.
3.6.1.2 Spell-check a document and make changes such as correcting spelling errors, deleting repeated words.
3.6.1.3 Add words to a built-in custom dictionary.
3.6.1.4 Preview a document.
3.6.2 Printing3.6.2.1 Choose print output options such as: entire document, specific pages,
number of copies.
3.6.2.2 Print a document from an installed printer using defined options, default settings.
4 Spreadsheets4.1 Using the Application
4.1.1 First Steps with Spreadsheets4.1.1.1 Open (and close) a spreadsheet application.
4.1.1.2 Open one, several spreadsheets.
4.1.1.3 Create a new spreadsheet (default template).
4.1.1.4 Save a spreadsheet to a location on a drive.
4.1.1.5 Save a spreadsheet under another name.
4.1.1.6 Save a spreadsheet in another file type such as: text file, HTML, template, software specific file extension, version number.
4.1.1.7 Switch between worksheets, open spreadsheets.
4.1.1.8 Use available Help functions.
4.1.1.9 Close a spreadsheet.
4.1.2 Adjust Settings4.1.2.1 Use magnification/zoom tools.
4.1.2.2 Display, hide built-in toolbars.
4.1.2.3 Freeze, unfreeze row and/or column titles.
4.1.2.4 Modify basic options/preferences in the application: user name, default directory/ folder to open, save spreadsheets.
4.2 Cells4.2.1 Insert Data
4.2.1.1 Enter a number, date, text in a cell.
4.2.2 Select Cells4.2.2.1 Select a cell, range of adjacent cells, range of non-adjacent cells, entire
worksheet.
4.2.2.2 Select a row, range of adjacent rows, range of non-adjacent rows.
4.2.2.3 Select a column, range of adjacent columns, range of non-adjacent columns.
4.2.3 Rows and Columns4.2.3.1 Insert rows, columns in a worksheet.
4.2.3.2 Delete rows, columns in a worksheet.
4.2.3.3 Modify column widths, row heights.
4.2.4 Edit Data4.2.4.1 Insert additional cell content, replace existing cell content.
4.2.4.2 Use the undo, redo command.
4.2.5 Duplicate, Move, Delete4.2.5.1 Duplicate the content of a cell, cell range within a worksheet, between
worksheets, between open spreadsheets.
4.2.5.2 Use the autofill tool/copy handle tool to copy, increment data entries.
4.2.5.3 Move the contents of a cell, cell range within a worksheet, between worksheets, between open spreadsheets.
4.2.5.4 Delete cell contents.
4.2.6 Search and Replace4.2.6.1 Use the search command for specific content in a worksheet.
4.2.6.2 Use the replace command for specific content in a worksheet.
4.2.7 Sort Data4.2.7.1 Sort a cell range by one criterion in ascending, descending numeric
order, ascending, descending alphabetic order.
4.3 Worksheets4.3.1 Handling Worksheets
4.3.1.1 Insert a new worksheet.
4.3.1.2 Rename a worksheet.
4.3.1.3 Delete a worksheet.
4.3.1.4 Duplicate a worksheet within a spreadsheet, between open spreadsheets.
4.3.1.5 Move a worksheet within a spreadsheet, between open spreadsheets.
4.4 Formulas and Functions4.4.1 Arithmetic Formulas
4.4.1.1 Generate formulas using cell references and arithmetic operators (addition, subtraction, multiplication, division).
4.4.1.2 Recognize and understand standard error values associated with using formulas.
4.4.2 Cell Referencing4.4.2.1 Understand and use relative, mixed, absolute cell referencing in
formulas.
4.4.3 Working with Functions4.4.3.1 Generate formulas using sum, average, minimum, maximum, count,
functions.
4.4.3.2 Generate formulas using the logical function if (yielding one of two specific values).
4.5 Formatting4.5.1 Numbers/Dates
4.5.1.1 Format cells to display numbers to a specific number of decimal places, to display numbers with, without commas to indicate thousands.
4.5.1.2 Format cells to display a date style.
4.5.1.3 Format cells to display a currency symbol.
4.5.1.4 Format cells to display numbers as percentages.
4.5.2 Contents4.5.2.1 Change cell content appearance: font sizes, font types.
4.5.2.2 Apply formatting to cell contents such as: bold, italic, underline, double underline.
4.5.2.3 Apply different colours to cell content, cell background.
4.5.2.4 Copy the formatting from a cell, cell range to another cell, cell range.
4.5.2.5 Apply text wrapping to contents within a cell.
4.5.3 Alignment, Border Effects4.5.3.1 Align contents in a cell, cell range: left, center, right, top, bottom.
4.5.3.2 Center a title over a cell range.
4.5.3.3 Adjust cell content orientation.
4.5.3.4 Add border effects to a cell, cell range.
4.6 Charts/ Graphs4.6.1 Using Charts/Graphs
4.6.1.1 Create different types of charts/graphs from spreadsheet data: column chart, bar chart, line chart, pie chart.
4.6.1.2 Add a title, label to the chart/graph. Remove a title, label from the chart/graph.
4.6.1.3 Change the background colour in a chart/ graph.
4.6.1.4 Change the column, bar, line, pie slice colours in the chart/graph.
4.6.1.5 Change the chart/graph type.
4.6.1.6 Duplicate, move charts/graphs within a worksheet, between open spreadsheets.
4.6.1.7 Resize, delete charts/graphs.
4.7 Prepare Outputs4.7.1 Worksheet Setup
4.7.1.1 Change worksheet margins: top, bottom, left, right.
4.7.1.2 Change worksheet orientation: portrait, landscape. Change paper size.
4.7.1.3 Adjust page setup to fit worksheet contents on one page, on a specific number of pages.
4.7.1.4 Add, modify text in Headers, Footers in a worksheet.
4.7.1.5 Insert fields: page numbering information, date, time, file name, worksheet name into Headers, Footers.
4.7.2 Preparation4.7.2.1 Understand the importance of checking spreadsheet calculations and
text before distribution.
4.7.2.2 Preview a worksheet.
4.7.2.3 Turn on, off display of gridlines, display of row and column headings for printing purposes.
4.7.2.4 Apply automatic title row(s) printing on every page of a printed worksheet.
4.7.3 Printing4.7.3.1 Print a cell range from a worksheet an entire worksheet, number of
copies of a worksheet, the entire spreadsheet, a selected chart.
5 Database5.1 Using the Application
5.1.1 Database Concepts5.1.1.1 Understand what a database is.
5.1.1.2 Understand how a database is organised in terms of tables, records, fields, and with field data types, field properties.
5.1.1.3 Understand what a primary key is.
5.1.1.4 Understand what an index is.
5.1.1.5 Understand the purpose of relating tables in a database.
5.1.1.6 Understand the importance of setting rules to ensure relationships between tables are valid.
5.1.2 First Steps with Databases5.1.2.1 Open (and close) a database application.
5.1.2.2 Open, log onto an existing database.
5.1.2.3 Create a new database.
5.1.2.4 Save a database to a location on a drive.
5.1.2.5 Use available Help functions.
5.1.2.6 Close a database.
5.1.3 Adjust Settings5.1.3.1 Change between view modes in a table, form, report.
5.1.3.2 Display, hide built-in toolbars.
5.2 Tables5.2.1 Main Operations
5.2.1.1 Create and save a table and specify fields with their data types.
5.2.1.2 Add, delete records in a table.
5.2.1.3 Add a field to an existing table.
5.2.1.4 Add, modify data in a record
5.2.1.5 Delete data in a record.
5.2.1.6 Use the undo command.
5.2.1.7 Navigate within a table to next record, previous record, first record, last record, specific record.
5.2.1.8 Delete a table.
5.2.1.9 Save and close a table.
5.2.2 Define Keys5.2.2.1 Define a primary key.
5.2.2.2 Index a field with, without duplicates allowed.
5.2.3 Table Design/Layout5.2.3.1 Change field format attributes such as: field size, number format, date
format.
5.2.3.2 Understand consequences of changing field size attributes in a table.
5.2.3.3 Create a simple validation rule for number, text, date/time, currency.
5.2.3.4 Change width of columns in a table.
5.2.3.5 Move a column within a table.
5.2.4 Table Relationships5.2.4.1 Create a one-to-one, one-to-many relationship between tables.
5.2.4.2 Delete relationships between tables.
5.2.4.3 Apply rule(s) to relationships such that fields that join tables are not deleted as long as links to another table exist.
5.3 Forms5.3.1 Working with Forms
5.3.1.1 Open a form.
5.3.1.2 Create and save a form.
5.3.1.3 Use a form to enter, modify, and delete records.
5.3.1.4 Go to next record, previous record, first record, last record, specific record using form display.
5.3.1.5 Add, modify text in Headers, Footers in a form.
5.3.1.6 Delete a form.
5.3.1.7 Save and close a form.
5.4 Retrieving Information5.4.1 Main Operations
5.4.1.1 Use the search command for a specific word, number, and date in a field.
5.4.1.2 Apply a filter to a table, form.
5.4.1.3 Remove a filter from a table, form.
5.4.2 Queries5.4.2.1 Create and save a single table query, two table query using specific
search criteria.
5.4.2.2 Add criteria to a query using any of the following operators: < (Less than), <= (Less than or equals), > (Greater than), >= (Greater than or equals), = (Equals), <> (Not equal to), And, Or.
5.4.2.3 Edit a query by adding, removing criteria.
5.4.2.4 Edit a query: add, remove, move, hide, unhide fields.
5.4.2.5 Run a query.
5.4.2.6 Delete a query.
5.4.2.7 Save and close a query.
5.4.3 Sort Records5.4.3.1 Sort data in a table, form, query output, in ascending, descending
numeric, alphabetic order.
5.5 Reports5.5.1 Working with Reports
5.5.1.1 Create and save a report based on a table, query.
5.5.1.2 Change arrangement of data fields and headings within a report layout
5.5.1.3 Group data under a specific heading (field) in a report in ascending, descending order.
5.5.1.4 Present specific fields in a grouped report by sum, minimum, maximum, average, count, at appropriate break points.
5.5.1.5 Add, modify text in Headers, Footers in a report.
5.5.1.6 Delete a report.
5.5.1.7 Save and close a report.
5.6 Prepare Outputs5.6.1 Prepare to Print
5.6.1.1 Preview a table, form, report.
5.6.1.2 Change report orientation: portrait, landscape. Change paper size.
5.6.2 Print Options5.6.2.1 Print a page, selected record(s), and complete table.
5.6.2.2 Print all records using form layout, specific pages using form layout.
5.6.2.3 Print the result of a query.
5.6.2.4 Print specific page(s) in a report, complete report.
6 Presentation6.1 Using the Application
6.1.1 First Steps with Presentations6.1.1.1 Open (and close) a presentation application.
6.1.1.2 Open one, several presentations.
6.1.1.3 Create a new presentation (default template).
6.1.1.4 Save a presentation to a location on a drive.
6.1.1.5 Save a presentation under another name.
6.1.1.6 Save a presentation in another file type such as: Rich Text Format, template, image file format, software specific file extension, version number.
6.1.1.7 Switch between open presentations.
6.1.1.8 Use available Help functions.
6.1.1.9 Close a presentation.
6.1.2 Adjust Settings6.1.2.1 Use magnification/zoom tools.
6.1.2.2 Display, hide built-in toolbars.
6.1.2.3 Modify basic options/preferences in the application: user name, default directory/ folder to open, save presentations.
6.2 Developing a Presentation6.2.1 Presentation Views
6.2.1.1 Understand the uses of different presentation view modes.
6.2.1.2 Change between presentation view modes.
6.2.2 Slides6.2.2.1 Add a new slide with a specific slide layout such as: title slide, chart and
text, bulleted list, table.
6.2.2.2 Change between built-in slide layouts.
6.2.2.3 Change background colour on specific slide(s), all slides.
6.2.3 Using Design Templates6.2.3.1 Apply an available design template to a presentation.
6.2.3.2 Change between available design templates.
6.2.4 Master Slide6.2.4.1 Insert a picture, image, drawn object into a master slide. Remove a
picture, image, drawn object from a master slide.
6.2.4.2 Add text into Footer of specific slides, all slides in a presentation.
6.2.4.3 Apply automatic slide numbering, automatically updated date, non-updating date into Footer of specific slides, all slides in a presentation.
6.3 Text and Images6.3.1 Text Input Formatting
6.3.1.1 Add text into a presentation in standard, outline view.
6.3.1.2 Edit slide content, notes pages content by inserting new characters, words.
6.3.1.3 Change text appearance: font sizes, font types.
6.3.1.4 Apply text formatting such as: bold, italic, underline.
6.3.1.5 Apply case changes to text.
6.3.1.6 Apply different colours to text.
6.3.1.7 Apply shadow to text.
6.3.1.8 Align text: left, centre, right in a slide.
6.3.1.9 Adjust line spacing before and after bulleted, numbered points.
6.3.1.10 Change between the style of bullets, numbers in a list from built-in standard options.
6.3.1.11 Use the undo, redo command.
6.3.2 Pictures, Images6.3.2.1 Insert a picture into a slide.
6.3.2.2 Insert an image into a slide.
6.3.3 Duplicate, Move, Delete6.3.3.1 Duplicate text, pictures, images within the presentation, between open
presentations.
6.3.3.2 Move text, pictures, images within the presentation, between open presentations.
6.3.3.3 Resize pictures, images in a presentation.
6.3.3.4 Delete text, pictures, images in a slide.
6.4 Charts/ Graphs, Drawn Objects6.4.1 Using Charts/Graphs
6.4.1.1 Input data to create, modify different kinds of built-in charts/graphs in a slide: column, bar, line, pie.
6.4.1.2 Change the background colour in the chart/graph.
6.4.1.3 Change the column, bar, line, pie slice colours in the chart/graph.
6.4.1.4 Change the chart/graph type.
6.4.2 Organisation Charts6.4.2.1 Create an organisation chart with a labeled hierarchy. (Use a built-in
organisation chart feature).
6.4.2.2 Change the hierarchical structure of an organisation chart.
6.4.2.3 Add, remove managers, co-workers, subordinates in an organisation chart.
6.4.3 Drawn Objects6.4.3.1 Add different types of drawn object to a slide: line, free drawn line, arrow,
rectangle, square, circle, text box, and other available shapes.
6.4.3.2 Change drawn object background colour, line colour, line weight, line style.
6.4.3.3 Change arrow start style, arrow finish style.
6.4.3.4 Apply a shadow to a drawn object.
6.4.3.5 Rotate, flip a drawn object.
6.4.3.6 Align a drawn object: left, centre, right, top, bottom of a slide.
6.4.3.7 Resize drawn object, chart within the presentation.
6.4.3.8 Bring an object to the front, back.
6.4.4 Duplicate, Move, Delete6.4.4.1 Duplicate a chart/graph, drawn object within the presentation, between
open presentations.
6.4.4.2 Move a chart/graph, drawn object within the presentation, between open presentations.
6.4.4.3 Delete a chart/graph, drawn object.
6.5 Slide Show Effects6.5.1 Preset Animation
6.5.1.1 Animation effects on text, images.
6.5.2 Transitions6.5.2.1 Add transition effects between slides. Change slide transition effects
between slides.
6.6 Prepare Outputs6.6.1 Preparation
6.6.1.1 Select appropriate output format for slide presentation such as: overhead, handout, 35 mm slides, on-screen show.
6.6.1.2 Spell-check a presentation and make changes such as: correcting spelling errors, deleting repeated words.
6.6.1.3 Add notes for the presenter to slides.
6.6.1.4 Change slide setup, slide orientation to portrait, landscape. Change paper size.
6.6.1.5 Duplicate, move slides within the presentation, between open presentations.
6.6.1.6 Delete a slide, slides.
6.6.2 Printing6.6.2.1 Print entire presentation, specific slides, handouts, notes pages, outline
view of slides, number of copies of a presentation.
6.6.3 Deliver a Presentation6.6.3.1 Hide, show slides.
6.6.3.2 Start a slide show, start a slide show on any slide.
7 Information and Communication7.1 The Internet
7.1.1 Concepts/Terms7.1.1.1 Understand and distinguish between the Internet and the World Wide
Web (WWW).
7.1.1.2 Define and understand the terms: HTTP, URL, hyperlink, ISP, FTP.
7.1.1.3 Understand the make-up and structure of a Web address.
7.1.1.4 Know what a Web Browser is and what it is used for.
7.1.1.5 Know what a Search Engine is and what it is used for.
7.1.1.6 Understand the terms cookie, cache.
7.1.2 Security Considerations7.1.2.1 Know what a protected Web site is, (use of username and password).
7.1.2.2 Know what a digital certificate is.
7.1.2.3 Know what encryption is and why it is used.
7.1.2.4 Be aware of the danger of infecting the computer with a virus from a downloaded file.
7.1.2.5 Be aware of the possibility of being subject to fraud when using a credit card on the Internet.
7.1.2.6 Understand the term firewall.
7.1.3 First Steps with the Web Browser7.1.3.1 Open (and close) a Web browsing application.
7.1.3.2 Change the Web browser Home Page/ Start page.
7.1.3.3 Display a Web page in a new window.
7.1.3.4 Stop a Web page from downloading.
7.1.3.5 Refresh a Web page.
7.1.3.6 Use available Help functions.
7.1.4 Adjust Settings7.1.4.1 Display, hide built-in toolbars.
7.1.4.2 Display, hide images on a Web page.
7.1.4.3 Display previously visited URLs using the browser address bar.
7.1.4.4 Delete browsing history.
7.2 Web Navigation7.2.1 Accessing Web Pages
7.2.1.1 Go to a URL.
7.2.1.2 Activate a hyperlink/image link.
7.2.1.3 Navigate backwards and forwards between previously visited Web pages.
7.2.1.4 Complete a Web-based form and enter information in order to carry out a transaction.
7.2.2 Using Bookmarks7.2.2.1 Bookmark a Web page.
7.2.2.2 Display a bookmarked Web page.
7.2.3 Organizing Bookmarks7.2.3.1 Create a bookmark folder.
7.2.3.2 Add Web pages to a bookmark folder.
7.2.3.3 Delete a bookmark.
7.3 Web Searching7.3.1 Using a Search Engine
7.3.1.1 Select a specific search engine.
7.3.1.2 Carry out a search for specific information using a keyword, phrase.
7.3.1.3 Combine selection criteria in a search.
7.3.1.4 Duplicate text, image, URL from a Web page to a document.
7.3.1.5 Save a Web page to a location on a drive as a txt file, html file.
7.3.1.6 Download text file, image file, sound file, video file, software, from a Web page to a location on a drive.
7.3.2 Preparation7.3.2.1 Preview a Web page.
7.3.2.2 Change Web page orientation: portrait, landscape. Change paper size.
7.3.2.3 Change Web page margins top, bottom, left, right.
7.3.3 Printing7.3.3.1 Choose Web page print output options such as: entire Web page,
specific page(s), specific frame, selected text, number of copies and print.
7.4 Electronic Mail7.4.1 Concepts/Terms
7.4.1.1 Understand the make-up and structure of an e-mail address.
7.4.1.2 Understand the advantages of e-mail systems such as: speed of delivery, low cost, flexibility of using a Web-based e-mail account in different locations.
7.4.1.3 Understand the importance of network etiquette (netiquette) such as: using accurate descriptions in e-mail message subject fields, brevity in e-mail responses, spell checking outgoing e-mail.
7.4.2 Security Considerations7.4.2.1 Be aware of the possibility of receiving unsolicited e-mail.
7.4.2.2 Be aware of the danger of infecting the computer with a virus by opening an unrecognized mail message, an attachment contained within an unrecognized mail message.
7.4.2.3 Know what a digital signature is.
7.4.3 First Steps with E-mail7.4.3.1 Open (and close) an e-mail application.
7.4.3.2 Open a mail inbox for a specified user.
7.4.3.3 Open one, several mail messages.
7.4.3.4 Switch between open messages.
7.4.3.5 Close a mail message.
7.4.3.6 Use available Help functions.
7.4.4 Adjust Settings7.4.4.1 Add, remove message inbox headings such as: sender, subject, date
received.
7.4.4.2 Display, hide built-in toolbars.
7.5 Messaging7.5.1 Read a Message
7.5.1.1 Flag a mail message. Remove a flag mark from a mail message.
7.5.1.2 Mark a message as unread, read.
7.5.1.3 Open and save a file attachment to a location on a drive.
7.5.2 Reply to a Message7.5.2.1 Use the reply, reply to all function.
7.5.2.2 Reply with, without original message insertion.
7.5.3 Send a Message7.5.3.1 Create a new message.
7.5.3.2 Insert a mail address in the ‘To’ field.
7.5.3.3 Copy (Cc), blind copy (Bcc) a message to another address/addresses.
7.5.3.4 Insert a title in the ‘Subject’ field.
7.5.3.5 Use a spell-checking tool if available and make changes such as: correcting spelling errors, deleting repeated words.
7.5.3.6 Attach a file to a message.
7.5.3.7 Send a message with high, low priority.
7.5.3.8 Send a message using a distribution list.
7.5.3.9 Forward a message.
7.5.4 Duplicate, Move, Delete7.5.4.1 Duplicate, move text within a message, or between other active
messages.
7.5.4.2 Duplicate text from another source into a message.
7.5.4.3 Delete text in a message.
7.5.4.4 Delete a file attachment from an outgoing message.
7.6 Mail Management7.6.1 Techniques
7.6.1.1 Recognise some techniques to manage email effectively such as creating and naming folders, moving messages to appropriate folders, deleting unrequired e-mail, using address lists.
7.6.2 Using Address Books7.6.2.1 Create a new address list/distribution list.
7.6.2.2 Add a mail address to an address list.
7.6.2.3 Delete a mail address from an address list.
7.6.2.4 Update an address book from incoming mail.
7.6.3 Organising Messages7.6.3.1 Search for a message by sender, subject, and mail content.
7.6.3.2 Create a new folder for mail.
7.6.3.3 Move messages to a new folder for mail.
7.6.3.4 Sort messages by name, by date.
7.6.3.5 Delete a message.
7.6.3.6 Restore a message from the mail bin/deleted items folder.
7.6.3.7 Empty the mail bin/deleted items folder.
7.6.4 Prepare to Print7.6.4.1 Preview a message.
7.6.4.2 Choose print output options such as: entire message, selected contents of a message, number of copies and print.
Information Literacy – Proposed: 1st three parts of our information literacy model
Information literacyIdentify information needed Scope/complexity (869, 878, 896, 1054, 900, 667, 629) Assess knowledge (782, 1009) Functionality (869, 1038) Critical thinking (956, 891, 1020, 126)
Find needed information Biomedical sources (190, 196, 990)
o glucometero hemodynamic monitoro client monitoring systems
Databases (763, 56, 631, 642, 745, 747)o Micromedexo article indexeso library catalogueso interlibrary loano institutional research libraryo professional associations
Search strategies (882, 634, 639, 640, 708, 363, 641, 667) Internet (1018, 883, 892, 708, 636, 979, 1002, 997, 984)
o clinical guidelineso evidence-based practiceo literature searcho client support groups
Intranet (910, 906) Navigate the information system (1033, 944, 645, 784, 912) Choose appropriate resources (643, 980, 897, 999, 937, 789, 1001)
Appraise information Assess accuracy of information (821, 880, 762) Assess quality of information (828, 633, 644, 893) Synthesize information (395, 699, 998, 654, 647) Interpret information (658, 881, 926, 1048, 655) Make recommendations (822, 651, 646) Manages information (673) Decision analysis and health planning (659, 1000, 924, 1016, 625)
Awareness –Proposed: ECDL Health or Broad Statements
for each EHR-S bucket
Awareness/attitude Understands concepts and processes regarding computer systems and impact on
practice (1015, 859, 857, 852, 853, 954, 657, 671, 392, 969, 970, 123, 779, 9, 781, 649, 652, 792)
o data integrityo ethicso legalitieso economicso professional practice standards/trends/issueso improved quality/safetyo societal/technological trends/issues
Scholarly process (632, 840, 668)o publicationo evidence-based practice
Benefits/limitations of communication technologies and impact on health care (791, 870, 675)
o bulletin/discussion boardso chat roomso wikiso blogso newsgroupso email
Understands the advantages of electronic tools for consumer health (849, 858, 862, 798)o telehealtho home monitoring/alert equipmento medication aides/reminders
Limitations of computerization (726, 729) Change management (764, 727, 898, 728, 946, 951, 827, 1031, 925, 730, 793, 650, 795,
794, 672, 680, 794)o attitudeso organizational learningo lifelong learning
Understands advantages of electronic tools for health care (846, 823, 889, 691, 803)o interneto telehealtho patient educationo management
Understands the importance of the contributions of nurses for clinical information systems (927, 725, 770, 1047, 1053)
