The Paradox of Nursing Informatics Competencies: Implications for Nursing Care Quality in Ghana

Abstract

Introduction: Nursing Informatics Competencies (NIC) have become essential for effective healthcare delivery in the digital era. They encompass informatics skills, computer skills, and informatics knowledge, all of which support accurate documentation, decision-making, and patient-centered care. Despite their importance, limited research has examined how NICs influence the quality of nursing care in Ghana, where digital health integration is still evolving. Methods: This study employed a quantitative cross-sectional survey design, involving 354 registered nurses in the Sekondi-Takoradi Metropolitan Area, Ghana. A structured questionnaire measured NIC domains and quality of nursing care. Data analysis was performed using descriptive statistics, correlation, and multiple regression, with significance set at p ≤ 0.05. Results: Nurses reported high perceptions of quality nursing care (M = 4.13, SD = 0.749). NIC levels were moderate, with informatics skills rated higher than computer skills and informatics knowledge. Correlation analysis revealed significant negative associations between NIC domains and quality of nursing care: informatics skills (r = –0.36, p <0.001), computer skills (r = –0.459, p <0.001), and informatics knowledge (r = –0.511, p <0.001). Regression analysis showed that NIC collectively explained 28.2% of the variance in care quality (R² = 0.282, F(3,353) = 45.796, p ≤0.001). Informatics skills had a positive effect, while computer skills and informatics knowledge negatively predicted care quality. Conclusion: This study shows that while practical informatics skills enhance nursing care, inadequate integration of theoretical and basic computer skills and knowledge may hinder bedside practice. Nursing education should emphasize experiential, competency-based training, and policies must strengthen digital infrastructure to ensure informatics supports rather than disrupts quality care in Ghana.