Predictors of Nursing Informatics Competency Among Registered Nurses Working in Clinical Settings in Tamil Nadu, India

Background The integration of digital health technologies requires nurses to possess informatics competency to support safe, high-quality care. In India, evidence on factors associated with Nursing Informatics competency among nurses remains limited. This study assessed competency levels and identified independent factors associated with lower competency. Objective To describe professional characteristics, assess Nursing Informatics competency, and identify factors associated with competency using multivariable regression analysis. Methods A quantitative cross-sectional study was conducted among 400 registered nurses working in two government hospitals in Tamil Nadu, India. Participants were recruited using convenience sampling. Data were collected using a questionnaire and the Nursing Informatics Competency Assessment Tool (NICAT), comprising computer literacy, informatics literacy, and informatics management domains. Of 442 nurses approached, 400 completed the questionnaire, yielding a 90.5% response rate. Descriptive statistics, chi-square/Fisher’s exact tests, and binary logistic regression were performed. Results The mean NICAT score was 80.7 ± 25.7 (range 30–150). 44.3% were competent, 24.5% proficient, 8.8% expert, 18.8% advanced beginner, and 3.8% novice. Lower competency was independently associated with 11–20 years (aOR 15.08, 95% CI 1.32–171.89) and > 20 years of clinical experience (aOR 31.12, 95% CI 2.76–350.48), limited HIS use (aOR 4.78, 95% CI 1.04–22.06), beginner EHR experience (aOR 6.12, 95% CI 1.26–29.74), and rare digital-device use (aOR 6.00, 95% CI 1.29–27.97). Conclusion Lower informatics competency was associated with longer clinical experience and limited digital engagement. Targeted competency-based training and workplace exposure to digital health systems are recommended, particularly for experienced nurses.