October 6, 2015

Informatics Nursing

Information technology in nursing does not end with electronic medical records or computer order entry services. The highly specialized branch of informatics nursing marries the capabilities of systems analysts with the patient advocacy of registered nurses. The increase and potential uses of technology have a substantial impact on patient care delivery, nursing research and safety. Informatics nurses possess proficiency in developing these technologies, implementing systems that will advance care potential and evaluating for an increase in quality outcomes for patients.

Getting Started

As the healthcare information technology, or HIT, field developed, nurses were inadvertently in the thick of action – opinions led to influence in design and proficiency in use. Nurses could help or ruin the IT implementation process. HIT now includes a number of professionals from analysts and web support to registered nurses who specialize in informatics.

Informatics nurses may initiate their career like any other RN. Nursing school is followed by a licensure examination. At least two years of work experience is needed in the field of IT prior to certification as an expert informatics nurse. Those wishing to get board certified in this area of specialty will also require a bachelor’s in science and a mix of work experience hours in IT and/or education at the graduate level.

Career Choices

Informatics nurses may be working behind the scenes in the thick of technology and software development, or on the nursing floor next to you. Nurses who work with systems analysts help to gather the data supporting the purpose for a new IT system and may influence the function and structure of the software. Other informatics nurses work as educators who assist in launching new programs by providing orientation and support to the actual bedside caregivers. These educators are vital to systems maintenance and success.

Jobs are plentiful for nurses in general – but perhaps even more so for the nurse who marries their passion for technology with that for patient care and advocacy. With a dawning need to be environmentally friendly, healthcare organizations are embracing paperless systems and more efficient ways of getting the same quality end-results for patient care with a smaller carbon footprint. The informatics nurses are invaluable in this process.

IT in Your Hospital

Information technology has a huge impact on the day-to-day functions of any nurse. Hospital and facility orientations now host a specific block of time for IT teaching to newcomers with informatics nurses teaching part or all of this. One of the biggest impacts of the 21st century is the electronic medical record, or EMR for short, although some institutions were using variations of computer charting late in the last century. EMRs have progressed from computer-based software input programs to entire hardware devices, such as notebooks, computers-on-wheels (affectionately known to floor nurses as COWs) and even PDA devices for home healthcare providers.

IT doesn’t end with EMRs — there are many blossoming uses of technology in patient care. Medication delivery systems are computerized in both pharmacies and nursing floor units. Some hospitals have gone green by discarding the paper charge stickers on items used for medical care, such as intravenous catheters or wound dressings, and use a department store-type scanner device to record patient charges. Blood sugar and vital sign machines interface with EMRs so that the patient’s data is automatically downloaded into their medical record – gone are the days of nurses diligently recording these numbers in the paper charts.
Informatics Nurse Certification Exam

Today’s ever-advancing technology has a substantial impact on the healthcare field and patient care. Starting with increasing telecommunications and electronic medical records, progressing to the current day telemedicine practices, technology is a constantly evolving, tangible aid to healthcare. Information technology, or IT, systems have impacted the way in which patients are cared for and the decision-making processes of the nurse. IT has become such an integrated part of healthcare that a nursing specialty has been born from its’ progress: the Informatics Nurse. Informatics nurses are found in hospitals, corporations, doctor’s offices and even as independent contractors. They assess processes of care delivery and use technology to make improvements in quality, safety and efficacy of care. The exam is known as the Informatics Nursing Certification Examination (INCE).Informatics Nurse Certification Exam

The IT sector of healthcare is growing fast and will continue to produce a wealth of job opportunities for Informatics Nurses. The Board Certified Informatics Nurse has completed and passed a certification test that awards this credential as BC, which appears as RN-BC behind the certified nurse’s name. Preparing for, taking and passing a certification examination will highlight your professionalism and drive in nursing. With the keen competition in today’s medical field there is no better way to stand apart from the IT crowd.

The Informatics Nurse certification examination is governed by the ANCC, or the American Nurses’ Credentialing Center. The ANCC is a branch of the American Nurses Association that controls certification and examination for myriad specialties in nursing. A panel of nurse specialists and experts develop examination content from around the world, resulting in a complex 175-question test, 25 of which are pretest questions which are not scored. The IN exam will test you on seven different domains of informatics nursing including system life cycle, human factors, information technology, information management and knowledge generation, professional practice, theories and leadership. Within each domain lie many subcategories, which expound on the content and allow for the development of specific examination questions to test your informatics knowledge.

This test is computer-generated, meaning that you can test anytime of the year after eligibility requirements are met, the application is approved and you have fulfilled payment. The application to sit for the IN certification exam is completed through the ANCC and can be done either online or in writing. The Informatics Nurse Certification Exam is outsourced from the ANCC to Prometrix centers across the country. Each center has specific rules and regulations in regards to testing etiquette; be sure to check with the center you are assigned to prior to test day. These centers can accommodate nurses with disabilities, however be sure to notify them of this prior to your testing date. Due to the cost and difficulty of this exam, it is highly recommended that you do not apply to take the exam until you are comfortable with the content.

Upon completion of the examination you will receive your score – passing or failing – immediately. This is a refreshing change from the paper and pencil tests of yesteryear, when waiting for a passing score could take weeks or even months. You can begin using the credentials awarded (BC) immediately upon receiving a passing score. This achievement should be pronounced on your resume under the category of Certifications and used in your full title whenever your name is signed on a medical document. The certification period lasts for five years after testing with renewal requirements throughout that period. Certified nurses must maintain active in informatics and continuing education hours within their area of specialty. Check with the ANCC for actual hours needed as the requirements change periodically.

Informatics Nursing Certification Exam Eligibility

The Informatics Nursing Certification Examination, or the INCE for short, is a comprehensive test used to identify nurses with experience, education and competence in the growing health information technology field. Nurses who are eligible for and pass this exam are awarded the credentials BC, for Board Certified, which follows their title of Registered Nurse.

Changing Requirements

The eligibility requirements for the INCE are set forth by the American Nurses’ Credentialing Center, or ANCC. Both the credentials awarded as well as the supporting prerequisites change periodically as the field of IT continues to grow and redefine itself. If you are considering taking the IN exam you are encouraged to thoroughly read the eligibility standards of the ANCC before application. Similarly, if you previously held the certification for nursing informatics and let it expire without renewal you are subject to retaking and passing the exam to activate your credentials.

Active RN License and BS

The ANCC regulates the amount of experience and education a nurse must possess prior to applying for the test. At a minimum, you must possess an active and unrestricted RN license. The RN license is obtained through a variety of methods including formal nursing education through a diploma based nursing school, associates in science of nursing through a community college or a bachelor in nursing through a university. Following nursing school you must sit and pass the N-CLEX RN examination to obtain an active RN license. The ANCC only allows nurses with bachelor’s degrees to sit for the INCE. The bachelor degree must be held in the field of nursing or a comparable field, such as science. Those nurses who hold a diploma or associate degree must return to school and obtain their bachelor degree prior to applying for the INCE. The application process requires a copy of your transcripts – you cannot apply for the exam while you are still finishing school.


A nurse must have real-life informatics work experience for exam eligibility. The INCE does not prepare new nurses for the field of information technology; it assesses the knowledge base and competency of experienced nurses within the field, marking them as specialists who will spearhead the continued growth and excellence of informatics. At the minimum nurses must have completed 2,000 hours of work in nursing informatics within the last three years. Experience cannot be scattered throughout your work history – it must be timely, specific to the profession and distinct to informatics. Nurses working full-time in informatics should be able to reach this minimum requirement within one year.

An RN who does not meet the 2,000 hour requirement may still be eligible for examination if they are or were active in a graduate program specializing in information technology. Nurses who have 1,000 hours of informatics work experience in the last three years must also present with at least 12 semester hours of graduate work in this field. Similarly, nurses who do not meet the work experience requirements may be eligible for testing if they have completed at least 200 semester hours in a graduate program specializing in nursing informatics.

Continuing Education Hours

In conjunction with the work experience and/or graduate education, nurses need at least 30 hours of continuing education for INCE eligibility. These CE hours must be documented and specific to nursing informatics, as the ANCC exam application requires a list of all education and how it relates to the field. Similar to the board of nursing, the ANCC may request an audit, or proof of stated CE hours so make sure you have your records straight at home.

INCE Preparation

Once you have ascertained that you meet the eligibility requirements to take the Informatics Nursing Certification Examination, or the INCE, you are ready to start preparing for test day. This time period of preparation and study can be as involved – or not – as you make it. Just remember, if you fail the test there is another fee needed to retake it. These hefty charges will add up; it might be prudent to start off on the right foot and explore your study aid and preparation options.INCE Preparation

ANCC Suggested Preparation

The ANCC is the governing nursing organization responsible for the Informatics Nursing certification. This organization suggests plotting out a specific plan leading up to test day, which starts off since months prior to the actual test date. Study aids, seminars and pretests are suggested to maximize your testing potential. After you apply and pay for the test it can take up to six weeks to get your eligibility to test notice, which can be obtained a little quicker by paying online with credit as opposed to checks through the mail. Delivery of your eligibility notice initiates your 90-day testing window; you have exactly 90 days to schedule and pass the test or your application will drop and you will have to reapply all over again.

Assess Your Knowledge

One common way to study for an examination is to assess your current knowledge base of the material that will be tested. You may do this by reading through the test outline put forth for free on the ANCC web site. Read through each section and its’ subsections carefully while highlighting any areas of weakness – these will represent the areas you will need to really focus on during study hours. Another option is to take a pretest to assess your knowledge base and your comfort level with computer-based testing. The ANCC offers a free sample test specific for informatics in nursing, which is a 25 question representation of the INCE. However, this only represents 16 percent of the real test; doing well on this pretest alone does not signify your ability to pass the real exam.

Study Aids

Study aids for this exam are easy to find, but the overwhelming selection may present a challenge to the nurse preparing for examination. One good place to start is by reviewing the selected reference list presented by the ANCC. This list identifies the 34 texts used to compile the questions for the INCE. Notably, not all of these nursing texts are specifically related to informatics in nursing; a few of the reference texts cover basic nursing principles in leadership, management, education and research. If you need help in every area or only in a few you may purchase review texts, informatics testing manuals, flashcards or CD-ROMs to complement your studies.

Study Groups

Some nurses learn better in a study group or working with peers. The ANCC hosts a telephonic conference schedule where you can join in the virtual study group if you do not have any local resources. You could also check out your hospital or employer’s education department; a study group or outline may already be in progress for this examination.


Nursing specialty organizations sometimes host seminars for exam preparation within their field. The ANCC web site lists national resources for these events, or you could check the American Nursing Informatics Association web site for preparatory seminars and materials. If a live seminar is not an option, you can choose to purchase the online seminar for informatics nursing test preparation through the ANCC. This online learning tool is available for 90 days after you purchase it.

INCE Test Content and Applications

The test content for the Informatics Nursing Certification Examination (INCE) is carefully developed by the American Nurses’ Credentialing Center, or the ANCC, by nurses and professionals within the informatics field. This content is extracted to reflect the experience and competence of those nurses who pass the exam. The 175-question computer-based exam has seven areas of focus with percentages awarded to each section. of the 175 questions, 25 of which are pretest questions which are not scored. Studying the test content outline may help you tailor your preparatory needs prior to exam day.

Out of the seven sections of focus, the largest portion of the INCE focuses on the system life cycle. Understanding and implementing systems is the foundation of informatics nursing. Systems have three basic characteristics: purpose, function and structure. The INCE component on systems covers planning, analysis, design, testing and implementation. Stakeholders are in this section as well, including the go-live, stabilization, evaluation and maintenance of new systems.

Human factors comprise a relatively small portion of the INCE exam. Human factors in nursing informatics revolve around the ergonomics of using technology and the user interface with software. These nurses must know the humanistic side of technology including how nurses and patients will interact with technology and the resulting impacts of implementing its use.

A large percentage of the exam focuses on information technology, or IT. Two entire sections are devoted to IT and information management with knowledge generation. Scientific advancements increase the amount of data, information and knowledge that is available to make decisions in nursing. An example is seen when developing a renal management program for an application in hemodialysis. The patient’s blood lab values are collected and input into software, which includes medications being taken – all in one quick and conclusive report. The INCE will test knowledge of the hardware, software, communications, data representation and securing of important information such as that in the example.

The professional practice, trends and issues section of the INCE covers a host of RN responsibilities and keeps the test relevant. As with any highly specialized professional, informatics nurses must have a firm grasp of the building blocks of their profession. This section may test on content such as scope of practice, responsibilities, procedures and even billing for informatics. Professional practice also incorporates ethical and legal considerations.

Achieving new goals and heights requires knowledge of the past. A portion of the INCE covers models and theories, which represent the origins and historical development of informatics nursing. In addition to testing on informatics theories, this test addresses the many scientific theories that help to support IT as a whole. Theories in the sciences of communication, computers and behavior fall under these testable theories. The behavioral theories can be further subdivided into sections including the concepts of change, organizational behavior and cognitive expressions. Models are included in the test in this section as they help the informatics nurse to grasp intangible concepts.

The final section of the INCE outline is devoted to management and leadership in nursing informatics. This portion of the test covers the basic principles and application of nursing leadership as they pertain to informatics. Technology has the prospective to reach outside the boundaries of nursing competence, but is sometimes viewed as the computerization of existing processes. Strong leaders in informatics nursing can transform change within organizations and positively impact the quality of care connecting nurses and their clients. Project management, policies and planning are tested to reflect the existence of this required knowledge.