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The Canadian Health Outcomes for Better Information and Care (C-HOBIC) project introduced systematic use of standardized clinical nursing terminology for patient assessments. Implemented so far in three Canadian provinces, C-HOBIC comprises an innovative model for large-scale capture of standardized nursing-sensitive clinical outcomes data within electronic health records (EHRs). To support this activity, nursing assessment and outcomes concepts were mapped to the International Classification for Nursing Practice (ICNP(R)). By comparing serial data on a patient across multiple time points, the C-HOBIC model can generate nursing-sensitive patient outcome reports. A principle benefit of the C-HOBIC model is that it provides nurses with information critical to planning for and evaluating patient care. Inclusion of nursing information in either provincial databases or EHRs in three Canadian provinces promotes continuity of patient care across sectors of the healthcare systems in those provinces and also facilitates aggregation and analysis by administrators and policy makers. The C-HOBIC model provides standardized, consistent, interoperable clinical information that reflects nursing practice throughout the Canadian healthcare System. [ABSTRACT FROM AUTHOR]

Background: Clinical practice settings have increasingly become dependent on the use of digital or eHealth technologies such as electronic health records. It is vitally important to support nurses in adapting to digitalized health care systems; however, little is known about nursing graduates' experiences as they transition to the workplace., Objective: This study aims to (1) describe newly qualified nurses' experiences with digital health in the workplace, and (2) identify strategies that could help support new graduates' transition and practice with digital health., Methods: An exploratory descriptive qualitative design was used. A total of 14 nurses from Eastern and Western Canada participated in semistructured interviews and data were analyzed using inductive content analysis., Results: Three themes were identified: (1) experiences before becoming a registered nurse, (2) experiences upon joining the workplace, and (3) suggestions for bridging the gap in transition to digital health practice. Findings revealed more similarities than differences between participants with respect to gaps in digital health education, technology-related challenges, and their influence on nursing practice., Conclusions: Digital health is the foundation of contemporary health care; therefore, comprehensive education during nursing school and throughout professional nursing practice, as well as organizational support and policy, are critical pillars. Health systems investing in digital health technologies must create supportive work environments for nurses to thrive in technologically rich environments and increase their capacity to deliver the digital health future., (©Manal Kleib, Antonia Arnaert, Lynn M Nagle, Rebecca Sugars, Daniel da Costa. Originally published in JMIR Medical Education (https://mededu.jmir.org), 19.08.2024.)

Background: Regulatory and professional nursing associations have an important role in ensuring that nurses provide safe, competent, and ethical care and are capable of adapting to emerging phenomena that influence society and population health needs. Telehealth and more recently virtual care are 2 digital health modalities that have gained momentum during the COVID-19 pandemic. Telehealth refers to telecommunications and digital communication technologies used to deliver health care, support health care provider and patient education, and facilitate self-care. Virtual care facilitates the delivery of health care services via any remote communication between patients and health care providers and among health care providers, either synchronously or asynchronously, through information and communication technologies. Despite nurses' adaptability to delivering virtual care, many have also reported challenges., Objective: This study aims to describe resources about virtual care, digital health, and nursing informatics (ie, practice guidelines and fact sheets) available to Canadian nurses through their regulatory and professional associations., Methods: An environmental scan was conducted between March and July 2023. The websites of nursing regulatory bodies across 13 Canadian provinces and territories and relevant nursing and a few nonnursing professional associations were searched. Data were extracted from the websites of these organizations to map out educational materials, training opportunities, and guidelines made available for nurses to learn and adapt to the ongoing digitalization of the health care system. Information from each source was summarized and analyzed using an inductive content analysis approach to identify categories and themes. The Virtual Health Competency Framework was applied to support the analysis process., Results: Seven themes were identified: (1) types of resources available about virtual care, (2) terminologies used in virtual care resources, (3) currency of virtual care resources identified, (4) requirements for providing virtual care between provinces, (5) resources through professional nursing associations and other relevant organizations, (6) regulatory guidance versus competency in virtual care, and (7) resources about digital health and nursing informatics. Results also revealed that practice guidance for delivering telehealth existed before the COVID-19 pandemic, but it was further expanded during the pandemic. Differences were noted across available resources with respect to terms used (eg, telenursing, telehealth, or virtual care), types of documents (eg, guideline vs fact sheet), and the depth of information shared. Only 2 associations provided comprehensive telenursing practice guidelines. Resources relative to digital health and nursing informatics exist, but variations between provinces were also noted., Conclusions: The use of telehealth and virtual care services is becoming mainstream in Canadian health care. Despite variations across jurisdictions, the existing nursing practice guidance resources for delivering telehealth and virtual care are substantial and can serve as a beginning step for developing a standardized set of practice requirements or competencies to inform nursing practice and the education of future nurses., (©Manal Kleib, Antonia Arnaert, Lynn M Nagle, Elizabeth Mirekuwaa Darko, Sobia Idrees, Daniel da Costa, Shamsa Ali. Originally published in JMIR Medical Education (https://mededu.jmir.org), 13.08.2024.)

Background: As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution., Objective: In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels., Methods: This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded., Results: A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice., Conclusions: There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement., International Registered Report Identifier (irrid): RR2-10.11124/JBIES-22-00266., (©Manal Kleib, Antonia Arnaert, Lynn M Nagle, Shamsa Ali, Sobia Idrees, Daniel da Costa, Megan Kennedy, Elizabeth Mirekuwaa Darko. Originally published in JMIR Nursing (https://nursing.jmir.org), 17.07.2024.)

Objective: The objective of this review is to collate and analyze literature reporting on digital health education and training courses, or other pedagogical interventions, for nursing students at the undergraduate and graduate level to identify gaps and inform the development of future educational interventions., Introduction: In this era of technology-driven health care, upskilling and/or reskilling the nursing workforce is urgently needed for nurses to lead the digital health future and improve patient care. While informatics competency frameworks serve to inform nursing education and practice, they do not address the entire digital health spectrum., Inclusion Criteria: This review will include research studies, theoretical/discussion papers, and reports, as well as gray literature from relevant sources published in the last 10 years. Opinion pieces, editorials, conference proceedings, and papers published in languages other than English will be excluded., Methods: The JBI methodology for scoping reviews will be followed. Searches will be conducted in Embase, CINAHL, ERIC, MEDLINE, Scopus, and Education Research Complete to retrieve potentially relevant studies. Hand searches of reference lists of included studies will be conducted. Two reviewers will independently screen records against predefined eligibility criteria and consult a third reviewer if conflicts arise. Decisions will be documented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Quantitative data will be analyzed using descriptive statistics. Content analysis will be applied to qualitative data to identify categories and themes. Findings will be synthesized and reported in tables and narrative format., Review Registration Number: Open Science Framework osf.io/42eug., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 JBI.)

In 2020, we conducted a mixed methods study comprised of a cross-sectional survey in which we applied a modified version of the 21-item Canadian Nurse Informatics Competency Assessment Scale and one-on-one interviews to explore self-perceived nursing informatics competency and readiness for future digital health practice. A total of 221 senior-level students in BScN programs in western Canada participated. This article reports on results related to the factor structure and internal consistency reliability of the 26-item (version 2) of the Canadian Nurse Informatics Competency Assessment Scale. Exploratory principal component analysis with the varimax rotation revealed a four-component structure, explaining 55.10% of the variance. All items on the Canadian Nurse Informatics Competency Assessment Scale 2 had good loadings, except item 7, which did not load to any domain but was retained based on an evaluation of the α value and item relevance to nursing practice. A few items shifted to different domains. The overall reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 was ( α = .916) and its subscales: information and knowledge management ( α = .814), professional and regulatory accountability ( α = .741), and use of information and communication technology ( α = .895). This study provided preliminary evidence for the factor structure and reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 among nursing students. Further testing is recommended., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Research continues to show significant gaps in nursing graduates' preparedness in digital health., Purpose: The aim of this study was to explore nursing students' self-perceived nursing informatics competency and preparedness in digital health, describe learning opportunities available, and identify perceived learning barriers and facilitators to developing informatics competency., Methods: A sequential mixed-methods design, using a cross-sectional survey and interviews, was used. Senior undergraduate students (n = 221) in BScN programs in a Western Canadian Province participated., Results: Participants self-reported being somewhat competent in nursing informatics. Three themes were identified: struggling to make sense of informatics nursing practice; learning experiences; and preparedness for future practice., Conclusion: Addressing inconsistencies in informatics education is an urgent priority so that nursing graduates are competent upon joining the workforce. Implications for nursing education, practice, and policy are discussed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)

This is the final issue of the Canadian Journal of Nursing Leadership (CJNL) for 2021, and the final issue for this editor-in-chief. It is with some reluctance that I step away from this role, but I am a firm believer in knowing when your expiry date is pending. When I took over CJNL from Dorothy Pringle in 2010, the task seemed daunting - what big shoes I had to fill - and almost immediately, imposter syndrome took hold of my psyche. But clearly, I forged ahead, and more than 10 years later, I have reflected on my editorial tenure, but more about that later., (Copyright © 2021 Longwoods Publishing.)

The use of health information technologies continues to grow, especially with the increase in virtual care in response to COVID-19. As the largest health professional group in Canada, nurses are key stakeholders and their active engagement is essential for the meaningful adoption and use of digital health technologies to support patient care. Nurse leaders in particular are uniquely positioned to inform key technology decisions; therefore, enhancing their informatics capacity is paramount to the success of digital health initiatives and investments. The purpose of this commentary is to reflect on current projects relevant to the development of informatics competencies for nurse leaders in the Canadian context and offer our perspectives on ways to enhance current and future nurse leaders' readiness for participation in digital health initiatives. Addressing the digital health knowledge and abilities of nurse leaders will improve their capacity to champion and lead transformative health system changes through digital innovation.

In the last issue of the Canadian Journal of Nursing Leadership, authors provided numerous examples of nurse leaders making efforts to address the mental health of nurses in the midst of the pandemic. I personally thank guest editor Joan Almost for leading the collation of the issue and the authors who took the time to share their strategies and learnings. Unfortunately, we are not out of the woods yet, and I hope this collection of papers will continue to provide guidance to our readers for many months to come., (Copyright © 2021 Longwoods Publishing.)

After a year of living a masked, isolated, virtual existence, there is much reflection among healthcare decision makers and providers around the world. What have we done well? What could we have done better? And more importantly, how will we ensure that our learnings inform decisions and actions the next time? In this latest installment of crisis leadership papers, authors address the toll exacted upon our profession thus far. Although profound, the psychological sequelae of the COVID-19 pandemic are directly related to a number of pre-existing conditions that have been festering below the surface for several years. In particular, blame for the state of health inequities, ageism, staff shortages and workplace violence cannot be ascribed to the pandemic. Rather, each has been exacerbated because of it., (Copyright © 2021 Longwoods Publishing.)

The intensity of the COVID-19 pandemic has tested the mettle of political, healthcare and public health leaders over the past year. Amid the unfolding events, healthcare leaders, including many nurses, have been pivoting, innovating, collaborating, safeguarding, inspiring and navigating - all the while informing the creation of an effective playbook to wage a counterassault for all of us. Despite all efforts, this previously unseen opponent has been unrelenting. Having been in the eye of the storm during the severe acute respiratory syndrome (SARS) outbreak, my memories of the events remain vivid. It was a time rife with uncertainty and fear, forcing the creation of a playbook on the basis of the best evidence and common sense but without the benefit of a precedent. Over the course of several months, our leadership was challenged by efforts to contain the virus and mitigate the very real possibility of a globally emerging pandemic. However, SARS was but a microcosm of the present situation. The COVID-19 pandemic is not like any other crisis we have experienced in our collective lifetime. We can only imagine the toll of this pandemic when it is finally over. It will be measured in terms of post-pandemic posttraumatic stress disorder, deaths from COVID-19 and delayed care, and deaths by suicide among healthcare workers and citizens; in the end, it will not be trivial. Those contributing to the COVID-19 playbook have given their all, and we should be eternally grateful to every single one of them., (Copyright © 2020 Longwoods Publishing.)

In the 1958 musical South Pacific, the character Nelly Forbush trills a song of optimism and hope amid the darkness of World War II (South Pacific Enterprises and Logan 1958). The chipper message of this fictional navy nurse might well be welcome amid the negative timbre of the pervasive political, cultural and societal upheaval that we are experiencing today - not to mention the burden of a global pandemic. The tune delivers the message of a so-called "cockeyed optimist," staying positive while many are not and being buoyed by the anticipation of brighter, sunny days ahead (South Pacific Enterprises and Logan 1958). COVID-19 has unloaded countless blows to virtually every aspect of the life we once knew; surely, this is enough to leave any cockeyed optimist reeling. Where do we find the strength of character to prevail during times like this? Somehow, good leaders do; finding creativity, courage and conviction to make the most of a bad situation, they rise above it. They show optimism in the face of fear, the unknown and circumstances beyond their control. Instilling abiding trust in their followers, they lead out of the abyss, shining light on new possibilities and opportunities., (Copyright © 2020 Longwoods Publishing.)

Over the past few months, in a world closed to face-to-face service delivery and social interaction, we have adapted and, for the most part, realized the importance of being apart to keep us all safe. In the face of the pandemic, we saw emergency department (ED) visits and hospitalizations for all but the most urgent injuries and illnesses drop dramatically. The number of people who failed to seek timely treatment because of fear of exposure to the contagion will never be known. But this also raises the question of how the thousands of non-emergent cases seeking care in Canada's EDs in pre-pandemic times have managed over these past months. Has anyone realized that once and for all, policy needs to mandate changes to ensure appropriate ED utilization?, (Copyright © 2020 Longwoods Publishing.)

Amid the profile of Medical Assistance in Dying (MAID) and a prevailing interest to support living until death, discussions of appropriate care and care settings for dying abound. The when and how of easing the passage from this corporeal being to a state of other being, whatever you believe that to be, has been focal in healthcare discussions in recent years. I remember a time when the notion of "palliative care" was somewhat novel, in later years when a family member was the recipient of excellent end-of-life care, but still many recent instances in which we, "the system" fail to ensure that that final life journey is aligned (as much as possible) with a person's final wishes. Alas, a 2013 survey by the Canadian Institute for Health Information (CIHI) showed that a majority of Canadians preferred to die at home, but few (15%) died outside of a hospital (CIHI 2018)., (Copyright © 2019 Longwoods Publishing.)

Background: Nurse leaders in senior leadership positions in various parts of the world can play an important role in the acquisition, implementation and use of health information technologies. To date, international research related to nurse leader informatics competencies has been carried out in specific healthcare delivery contexts with very specific health information technology environments. In this body of literature, the definition of a 'nurse leader' has not been clearly defined. As a result, it is challenging for senior nurse leaders in leadership and management positions in other countries to apply this research to their unique contexts., Purpose: The objective of this study was to obtain consensus on the informatics competencies of priority to senior Canadian nurse leaders. The goal of completing this work was to adapt and validate a set of nurse leader informatics competencies to be endorsed and supported nationally., Methods: This study used a modified Delphi technique with a panel of nurse leaders with significant informatics knowledge from across Canada. Three rounds of information gathering were completed electronically. In Round 1, participants were provided a series of 26 potential competency statements obtained from a review of the literature; they were asked to comment on the clarity and wording of each statement. Two statements were eliminated after Round 1 due to redundancy. In Rounds 2 and 3, participants rated the remaining competency statements on a 7-point Likert scale for relative priority to nurse leaders., Results: A total of 25, 24 and 23 participants completed the survey in Rounds 1, 2 and 3 respectively. Consensus was achieved at the end of Round 3 with the inclusion of 24 competency statements. All of the statements had a mean of 5 or greater on a 7-point Likert scale (1=low priority and 7=high priority)., Conclusions: The study participants agreed upon 24 informatics competency statements of priority to Canadian nurse leaders. These competencies will be presented to senior national nursing leaders and nursing informatics organizations for endorsement. Inspired by work completed in the United States, the authors plan to develop a self-assessment instrument for use by Canadian nurse leaders using the identified competency statements. Future anticipated work includes identifying and creating resources for nurse leaders to develop these important informatics competencies., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Review Question: How are nursing informatics competencies defined or assessed in the literature?

Within Canada, nurses' scope of practice is varied between jurisdictions, often poorly understood and way too often defined on the basis of tasks. Nurse leaders generally recognize that defining the practice of nurses solely on the basis of tasks only serves to devalue the critical thinking and evidence-base of the profession. But nurses themselves have also frequently fallen into the trap of delineating their practice in terms of tasks and time. An unfortunate outcome of this task orientation is a lack of appreciation for the full breadth of nurses' knowledge and scope of practice capabilities. In the extreme, (as I recently read in a letter to the editor) this leads to the conclusion that one doesn't need a university education to be a nurse - hospital-based training schools did the job just fine., (Copyright © 2019 Longwoods Publishing.)

The evolving nature of Canada's healthcare system has necessitated a corresponding evolution of leadership informed by contemporary theoretical perspectives. It has long been recognized that the leadership capabilities, knowledge and skills of the past are no longer sufficient to manage and lead amidst the complexities of today's healthcare system. Events of this millennium have challenged the most talented of leaders to thrive and lead in the face of managing: unprecedented critical incidents and technological advances; a multigenerational, multicultural and interprofessional workforce; shifting scopes of practice and spans of control, never-ending fiscal constraints; and new legislative changes to mention but a few., (Copyright © 2018 Longwoods Publishing.)

A registered nurse of questionable professional competence, with a dodgy employment record, a history of mental illness and substance abuse, remains employed and ultimately murders eight vulnerable seniors, attempts to murder four others, and assaults another two over the course of a decade. At least those are the ones for which Elizabeth Wettlaufer offered a confession. Like most nurses and citizens, I was horrified by the revelation of multiple homicides at the hand of one of us. How could such a confluence of incompetence, mental illness and addiction, and willful murder go undetected for so long by so many?, (Copyright © 2018 Longwoods Publishing.)

The editor-in-chief discusses the central theme of this issue of the Canadian Journal of Nursing Leadership - advancing quality and safety in healthcare. As she explains, authors in this issue represent a range of perspectives and highlight nursing leadership strategies, competencies, and obligations to ensure quality and safety in Canadian healthcare organizations., (Copyright © 2018 Longwoods Publishing.)

The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse groups, understand the social and cultural reality of the client, family, and community, develop expertise to implement culturally acceptable strategies to provide nursing care, and identify and use resources acceptable to the client (Andrews and Boyle 2002)., (© 2018 Longwoods Publishing.)

The scope of nursing informatics practice has been evolving over the course of the last 5 decades, expanding to address the needs of health care organizations and in response to the evolution of technology. In parallel, the educational preparation of nursing informatics specialists has become more formalized and shaped by the requisite competencies of the role. In this chapter, the authors describe the evolution of nursing informatics roles, scope and focus of practice, and anticipated role responsibilities and opportunities for the future. Further, implications and considerations for the future are presented.

Editor-in-Chief, Lynn Nagle, recently talked to the new CEO of the Canadian Nurses Association, Michael Villeneuve about his leadership plans and goals., (Copyright © 2017 Longwoods Publishing.)

Over the course of the last two decades, much progress has been made in the approaches to the care of people with mental health and addiction challenges. Yet there is still more work to do in terms of advocacy and the provision of meaningful and effective support for these individuals., (© 2017 Longwoods Publishing.)

Internationally, countries are challenged to prepare nurses for a future that has ever increasing use of technology and where information management is a central part of professional nursing practice. There has been a growing trend to move nursing to competency-based education, especially for those students undertaking their first nursing qualification. This first nursing qualification may be linked to pre-registration, pre-licensure or undergraduate education; the term used depending on the country. The authors are drawn from the International Medical Informatics Association special interest group, Nursing Informatics (IMIA-NI) Education Working Group and represent New Zealand, the United States of America, England, Australia, Finland and Canada.

The editor-in-chief asks: with strong evidence in favour of collaborative practice, why has it not yet been adopted across the system? What is holding it back?, (Copyright © 2017 Longwoods Publishing.)

Discussions of seniors with complex co-morbid conditions "clogging up" or "blocking" acute care beds have been persistent over the last two decades. In reality, many of these hospital admissions are likely avoidable with the allocation of appropriate resources to manage their care in the community. While promises of enhanced community-based care and support have been touted for years, the solutions have been inadequate, and continue to fall short of the mark. Notwithstanding the likely need for more long-term residential care beds in the face of Canada's aging demographic, it is clear that much more could be done to maintain seniors in their own homes or within residential care facilities - that is to say, out of the hospital!, (© 2017 Longwoods Publishing.)

With the advent of wide scale adoption and use of clinical information systems and other technologies to support the delivery of healthcare services, the inclusion of iterative evaluation is an often overlooked but important component of project management. In this paper, it is proffered that the evaluation process should be an imperative and initiated at the outset of the design and implementation of clinical information systems including any single component of hardware or software. Ideally, methods of evaluation should be multi-faceted, include formative and summative evaluation approaches and include a range of metrics that will provide organizations with insight to process and technology efficiency and effectiveness as well as human and financial impacts.

Aims: The purpose of the study was to examine the relationship between (1) critical care nurses' information-seeking behaviour and the non-routineness of tasks; and (2) the extent to which nurses' perception of their problem-solving abilities when completing patient care tasks, moderate the relationship between information-seeking behaviour and non-routineness of tasks., Methods: A cross-sectional survey design was used. A random sample (n = 177) of critical care nurses working in hospital settings was selected from the College of Nurses of Ontario (CNO) database. Descriptive statistics and multiple regression were used to analyze the data., Results: Previous information-seeking training (p = 0.008), non-routineness of the task (p = 0.018), and the perception of the problem-solving ability domain of personal control (p = 0.040) had positive relationships with information-seeking behaviour., Conclusions: The development of problem-solving skills such as personal control, in addition to information-seeking training is essential so critical care nurses will have the skills to aid their information needs when faced with the completion of non-routine tasks.

Information and communication technologies (ICT) have brought about significant changes to the processes of health care delivery and changed how nurses perform in clinical, administrative, academic, and research settings. Because the potential benefits of ICT are significant, it is critical that new nurses have the knowledge and skills in informatics to provide safe and effective care. Despite the prevalence of technology in our day to day lives, and the potential significant benefits to patients, new nurses may not be prepared to work in this evolving reality. An important step in addressing this need for ICT preparation is to ensure that new graduates are entering the work force ready for technology-enabled care environments. In this paper, we describe the process and outcomes of developing informatics entry-to-practice competencies for adoption by Canadian Schools of Nursing.

Health Outcomes for Better Information and Care (HOBIC), a program funded by the Ontario Ministry of Health and Long-Term Care, introduces a collection of evidence-based clinical outcome measures reflective of nursing care. The authors report on an evaluation of the experiences of nurse early adopters of HOBIC in home care. The findings reveal challenges and nuances associated with the introduction of HOBIC and the use of supporting technologies in the delivery of home nursing care. Future implementation efforts should focus on optimizing the usability of technology and the usefulness of HOBIC in nursing practice. In addition, efforts need to be directed at supporting the full integration and use of HOBIC outcome data by nurses and management personnel to inform practice directions.