There was a 67% (67/105) response rate to the questionnaires. There was some variation between nursing groups: the response from practice nurses was 73% (n = 22/30), for district nurses 51% (n = 17/33), for health visitors and midwives 67% (n = 19/28), and other nurses, community psychiatric nurses and managers 64% (9/14).
Computers were readily available to primary care nurses. Over 90% of nurses had access to a personal computer (PC) at work, though for nearly half (45%) this was shared access; home access was even higher – 96%, with very few (12%) describing their access as shared. The remainder had access elsewhere: library, college etc. Not all the computers were connected to the Internet: 11% of those provided a PC at work and 6% at home could not go on line. After taking into account "other" access to the Internet only 3% of primary care nurses lacked access.
The pattern of access to computers, the Internet, and receiving training changed with age. The younger nurses had more access to PCs and the Internet at work, while older nurses had higher levels of access at home, and had received more training. These trends are shown in Table ; only the receipt of more training in nurses 50 and over was statistically significant (Chi-squared test.) There were more striking differences between the different nursing professions. 90.1% of practice nurses had their own computer at work, with the balance of 9.1% having shared access – three-quarters (76.2%) had Internet access via this computer. By way of contrast their community based colleagues had significantly less access – only 56% of district nurses and 17% of health visitors had their own computer. Most had shared access and a few, 6.3% and 8.7% respectively, no access at all (p < 0.001).
Trends in access to computers, the Internet and receipt of training with age
62% of nurses had received some training, although it was often superficial and run in house to provide basic knowledge of how to use the clinical computer system. Some learned from family members, colleagues or were self-taught, in the use of Microsoft Word and Excel. A few respondents received more formal training on the use of Internet for literature searching from a library, evening classes or as part of high education. Open question data shows that the training received are very diverse both in subjects and level of skills:
"...two fifteen minute sessions in 1991 when we first got computers, a second when system was updated"
"...only one day. All other courses since have been at difficult times or locations"
"...not sufficient though"
"...no formal courses, only shown by colleague when I was new in post"
"Protected time for PC training would be most valuable – so often this is hurriedly given during the odd 5-minute break rather than in a training session."
"...adequate training is really necessary and protected time; 10–15 minutes between patients is not adequate."
Respondents were asked to rate their preferred format for ICT training on a 4-point scale: from 0 for least desirable to 3 for highly desirable. The result showed that 'one-to-one' training and workshops were the preferred formats for training, printed manual the least (Table .)
Preferred format for training
The preferred location for the training reflected the format of training requested (Table .) Most wanted training to take place one-to-one in their workplace with those wanting workshops looking to see them held in an education or teaching centre. No age or professional group differences were found for the format or venue of ICT training required.
Preferred location of IT training.
Confidence with computers appeared to be age related, with younger nurses having higher levels of confidence across all the areas of competence than their more senior colleagues. However, only two of these trends, use of spread sheets and electronic patient records (EPR) were found to be statistically significant, see Table ; though the latter is critically important for patient care. Practice nurses had significantly higher levels of confidence in working with the EPR. 95.5% of practice nurses felt confident compared with 53% of district nurses and 44% of health visitors (p < 0.01).
Confidence in the use of IT among primary care nurses
The raw data also suggested that there was a discernable trend in computer usage with age. 90% of nurses age 30 to 39 years used their workplace computer daily, 70% of those 40 to 49, and only 59.3% of those over 50. This trend was not significant, see Table .
Use of computers at work for different age groups of community nurses
Colleagues were the most used source of information across all ages and nursing professions. Older nurses tended to use books and journals from their personal collections, and to use libraries. However, the use of libraries, books and journals is quite low.
Younger nurses seem to use journals at work or electronic resources more. Neither of these trends, shown in Table , were statistically significant. A larger proportion of practice nurses were more confident about using electronic libraries (63%), compared with health visitors (35%), and district nurses (24%); this trend was also not statistically significant.
Sources of information and knowledge for primary care nurses
Nurses summarised their experiences in access information in a number of free text comments:
"don't know where to look", "don't know website address",
"vast amounts of irrelevant articles under same headings",
"I am not as good as I should be with CIHNAL, Medline",
"information not found or not relevant some difficulty sometimes refining the search for specific information"
"lack of training/unable to access information I am looking for quickly enough – quicker to look in a book"
"like trying to get a glass of water from Niagara Falls"