Nursing Informatics: Using of TIGER Initiative Platform


The introduction of medical informatics dates back to the mid-1970s, though some studies were conducted already in the 1950s. In recent years, several types of research have shown that a large number of fatal events in healthcare structures could have been prevented through the broader use of electronic health records (EHRs) (Nelson & Staggers, 2018). However, the adoption of EHRs is rapidly spreading across the country, driving health care towards intelligent clinical systems. The rate of technological advancement requires adequate levels of expertise in health informatics (HI) to configure, implement, and optimize the EHRs.

Today, HI is a widely recognized profession, which entails interdisciplinary know-how to design, develop, utilize, and apply information technology within the health care environment. Indeed, keeping pace with the advancement of information and communication technology requires a significant effort at an educational level. Recently, several initiatives have been taken to support curricula in informatics nursing educators. This article analyzes the Technology Informatics Guiding Education Reform (TIGER) Initiative, an inter-professional platform aimed at reforming education through effective integration of information technology into training, research, and daily practice in the nursing environment.

Understanding the TIGER Initiative

The notion of informatics competencies in nursing has grown to comprise technologies related to various disciplines and professions, while inter-professionalism is considered an integral part of HI. The increasing complexity of health care and the recommendations for a patient-centered setting call for a reshaping of the system, where IT plays a crucial role to support inter-professional care. While inter-professionalism is oriented towards international recognition and knowledge, study programs and courses need to conform to local requirements (Hübner et al., 2018). TIGER is an initiative aimed at proposing a framework where competencies in informatics are defined and validate globally and integrated with information and practice from local educational realities.

The TIGER Initiative was created in 2004 to identify nursing competencies. In 2012, the TIGER International Committee was instituted to broaden the scope of the initiative and, since 2014, the approach includes other disciplines (Hübner et al., 2018). Today, TIGER is a spread learning platform targeted at empowering educators to promote education reform and create an inter-professional and inter-disciplinary workforce. The TIGER Initiative responds to the specific requirement of informing educators within the planning of nursing curricula and courses (“The TIGER Initiative”, 2019). The ultimate aim is to introduce and implement informatics and technology practices into the daily nursing exercise as well as into research and resource development.

TIGER is split into two main frameworks, each based on a scheme where various competencies are classified and explained according to their relevance through practical case studies. Identification and rating of the core competencies are made through surveys, while a team of international experts provides the empirical inputs about the framework (Hübner et al., 2018). The core competencies areas include technological items such as eHealth and telematics, legal and ethical items such as data protection, IT-related management items, and statistics. The project is targeted at informing clinical nursing, quality management, coordination of interprofessional care, nursing management, and IT management in nursing.

The Use of Informatics and Technology in the Current Healthcare Setting

Initiatives like TIGER respond to the need of providing educators with the tools to enable future nurses to cope with a working environment that is becoming increasingly more complex and challenging. This scenario is not as remote as might seem, but it is already a crucial component in the current healthcare system. The spread of EHRs and electronic medical records (EMRs) implies extensive use of computers, mobile devices, and huge amounts of data available. Nurses are at the crossroad of this flow of information as they need to interface with multiple technological devices. Their role, hence, entails knowledge in informatics, understood as a combination of basic computer skills, information literacy, and information management (Foster & Sethares, 2016). Such a highly technological working environment requires the ability to read various data through strong and independent clinical judgment, management skills, and deep informatics understanding.

The progressive accumulation of clinical data is leading to increased demands for the integration of systems and information. From this perspective, patient involvement is becoming central, driven by the desire for deeper inclusion in the healthcare process and by the rise of social media (Risling, 2016). Blogs, forums, as well as formal and informal patient networks, have widened the access to health information, even if it is recommended that nurses take a leadership role in filtering the flow of info, warning for the misleading messages. The immediate future suggests the adoption of cloud-based systems, which provide a high level of inter-connectivity and boost the teamwork’s effectiveness. In a more remote future, most nurses will be equipped with wearable devices to collect heart rate, blood pressure, weight, and blood glucose, among other data (Risling, 2016). This continually changing scenario justifies and challenges initiatives like TIGER in supporting nurse students to understand future practices.


The spread of informatics in the healthcare setting has highlighted the necessity of empowering nurse educators in delivering effective training and teaching for future nurses. The TIGER Initiative is an inter-professional platform aimed at integrating recognized informatics competencies with local practice. TIGER embodies the understanding that nursing curricula need to be constantly updated to keep pace with the advancement in information technology. From this perspective, the future of the nurse profession seems to be increasingly related to informatics skills, to the ability to read a large amount of clinical data, and to the availability of efficient inter-connected data systems.


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