Increasing digitalisation throughout the world is significantly impacting work processes and activities as well as competence requirements for employees. In the context of nursing care, the introduction of ICT-supported documentation and communication systems and mobile end-devices is of particular importance (Daum, 2017). The transmission and documentation of patient care information (PCI) in healthcare institutions, which are essential to ensure continuity and quality of patient care (Daum, 2017; Güttler et al., 2010), are profoundly affected by the introduction of digital devices and digitalisation (e.g., Rouleau et al., 2017). This raises the question of what digital competences nurses need to successfully cope with PCI transmission.

Internationally, various catalogues of digital competences exist (e.g., Becka et al., 2020; Kuhn et al., 2019). Some of these catalogues address a generic population and not specifically nurses and other healthcare professions (Vuorikari et al., 2022). Furthermore, to date, the international catalogues of digital competencies for nurses and healthcare professions have not been formally integrated into Swiss national educational programmes (e.g., Brunner et al., 2018). Switzerland lacks a consensus on basic digital competences in the field of digital health (e.g., Kuhn et al., 2019). This study applied a work analysis approach to identify typical exemplary professional situations of PCI transmission with digital devices in Swiss hospitals and the competencies required to cope successfully with these situations (Volpe et al., in preparation). It is based on the so-called ‘course-of-action’ approach to work analysis (Durand & Poizat, 2015; Theureau, 2006). This is a theoretical tradition of work analysis inspired by Francophone ergonomics (Filliettaz et al., 2015), a key assumption of which is that the design of learning environments and programmes should be based on a detailed understanding of workplace practices and requirements (e.g., Daniellou, 2005; Durand & Poizat, 2015; Guerin et al., 2007). To analyse real work practices and identify typical situations of PCI transmission, the researchers applied a video ethnography approach, which was performed with on-site observations and video recordings of the professional activities of 24 nurses in six hospitals. Subsequently, the nurses were invited to participate in individual self-confrontation interviews. During these interviews, the nurses were shown video footage of their professional practices and asked to identify the meaningful aspects of their lived experiences using a semiotic approach. Each video clip consisted of a selection (made by the research group) of observed situations relevant to the PCI transmission theme.

The researchers identified six key moments in the transmission and documentation of PCI with digital devices, represented by selected and validated situations and a set of digital competences that the nurses applied or would have been required to successfully deal with these situations.

The results of this study are of high practical relevance, as they can guide the development of nursing competency frameworks and the conception of training content that closely mimics real work situations. They contribute to the existing literature by concretizing the existing international catalogues of digital competences.

This ethnographic research was conducted in six hospital wards (four in the German-speaking part and two in the Italian-speaking part of Switzerland) and involved 24 nurses. This research was rooted in a work analysis approach within the French ergonomics tradition, specifically the ‘Course of Action’ research programme (Durand & Poizat, 2015; Theureau, 2006; Varela et al., 1991). The initial familiarisation phase involved context analysis through desk research, semi-structured interviews and questionnaires administered to head nursing managers, ward nursing managers and IT managers in each participating hospital. Prior to the video ethnography data collection, the researchers were also present in each ward for 6–7 days without a camera to familiarise themselves with the field. During data collection, the researchers observed and video-recorded the nurses’ professional activities using wearable devices to capture videos during three shifts per nurse.The researchers then conducted a self-confrontation interview with each nurse, which involved showing videos of their nursing activities and inviting them to explain what was meaningful to them (Poizat & Martin, 2020). Data processing involved transcribing the self-confrontation interviews, including verbal and non-verbal aspects.Synchronisation protocols aligned the observed situations with the corresponding interview transcriptions. Semiological analysis applied to the protocols included a deconstruction phase to identify significant activities for the nurses. These activities were analysed using a six-component matrix (hexadic sign) inspired by Peirce’s (1994) three experience categories.To identify nurses’ digital competences, i.e., their digital knowledge, skills and attitudes, the focus was on three of the six components: unit of experience, situated knowledge and engagement. Then we identified typical aspects of each person’s experience and compared these aspects among participating nurses. This allowed for specifying the transversal aspects of their experiences. The analysis of situated knowledge allowed the identification of a considerable amount of knowledge actualised in context, considering both the insights expressed by nursing staff during the self-confrontation interviews and what was expressed as actual actions in the units of experience (which included methodological knowledge or skills activated in situ). A cross-sectional analysis of comments made by nurses during the self-confrontation interviews and the analysis of the engagements revealed a set of attitudes and values concerning collaborative dimensions among colleagues, interactions with patients and interactions with digital tools. Finally, once the nursing digital competences were identified, alignment with the existing macro area of digital competences was applied via the Digital Competence Framework for Citizens (Vuorikari et al., 2022).

The observed situations of PCI transmission with digital devices were classified into four categories: communication with patients, intraprofessional communication, interprofessional communication and nursing documentation. Within these categories, six key moments of PCI transmission with digital devices represented by selected and validated situations were identified: (a) medication administration, (b) shift handover, (c) patient admission, transfer and discharge, (d) physician–nurse rounds, (e) reading PCI and (f) inserting/editing PCI. Semiological analyses of the observations and self-confrontation interviews revealed a catalogue of situated digital competences, including knowledge, skills and attitudes that the nurses mobilised to successfully deal with the situations of transmission and documentation of PCI with digital devices. An example of such a situated digital competence in a shift handover situation is: The nurse can filter anamnesis patient data in the clinical information system (CIS) to enhance intra-professional collaboration within the team. To achieve this, the nurse needs to (a) know the Electronic Health Record modules (knowledge), (b) be able to locate information and assess the workload for each patient (skills) and (c) foster interprofessional collaboration (attitudes). This situated digital competence is aligned with the following digital competence macro areas of the Digital Competence Framework for Citizens (Vuorikari et al., 2022): (a) information and data literacy, (b) communication and collaboration.

Becka, D., Bräutigam, C., & Evans, M. (2020). " Digitale Kompetenz" in der Pflege: Ergebnisse eines internationalen Literaturreviews und Herausforderungen beruflicher Bildung (No. 08/2020). Forschung Aktuell. Brunner, M., McGregor, D., Keep, M., Janssen, A., Spallek, H., Quinn, D., ... Solman, A. (2018). An eHealth capabilities framework for graduates and health professionals: Mixed-methods study. Journal of Medical Internet Research, 20(5), e10229. Daniellou, F. (2005). The French-speaking ergonomists' approach to work activity: cross-influences of field intervention and conceptual models. Theoretical issues in ergonomics science, 6(5), 409-427. Daum, M. (2017). Digitalisierung und Technisierung der Pflege in Deutschland. DAA-Stiftung, Bildung und Beruf, Hamburg. Durand, M., & Poizat, G. (2015). An activity-centred approach to work analysis and the design of vocational training situations. In L. Filliettaz & S. Billett (Eds.), Francophone perspectives of learning through work: Conceptions, traditions and practices (pp. 221–240). Springer. Filliettaz, L., Billett, S., Bourgeois, E., Durand, M., & Poizat, G. (2015). Conceptualising and connecting Francophone perspectives on learning through and for work. Francophone perspectives of learning through work: Conceptions, traditions and practices, 19-48. Guérin, F., Laville, A., Daniellou, F., Duraffourg, J., & Kerguelen, A. (2007). Understanding and transforming work: the practice of ergonomics. Lyon: Anact. Güttler, K., Schoska, M., & Görres, S. (2010). Pflegedokumentation mit IT-Systemen. Eine Symbiose von Wissenschaft, Technik und Praxis. Bern: Hans Huber Verlag. Kuhn, S., Ammann, D., Cichon, I., Ehlers, J., Guttormsen, S., Hülsken-Giesler, M., Kaap-Fröhlich, S., Kickbusch, I., Pelikan, J., Reber, K., Ritschl, H., & Wilbacher, I. (2019). Wie revolutioniert die digitale Transformation die Bildung der Berufe im Gesundheitswesen? Careum Working Paper 8. Zürich: Careum Stiftung. Peirce, C. S. (1994). Collected papers of charles sanders peirce (Vol. 1). Harvard University Press. Poizat, G., & Martin, J. S. (2020). The course-of-action research program: historical and conceptual landmarks. Activités, 17(17-2). Rouleau, G., Gagnon, M. P., Côté, J., Payne-Gagnon, J., Hudson, E., & Dubois, C. A. (2017). Impact of information and communication technologies on nursing care: Results of an overview of systematic reviews. Journal of Medical Internet Research, 19(4), e122. Theureau, J. (2006). Le cours d’action: Méthode développée. Octarès. Varela, F. J., Thompson, E., & Rosch, E. (1991). The embodied mind: Cognitive science and human experience. MIT Press. Vuorikari Rina, R., Kluzer, S., & Punie, Y. (2022). DigComp 2.2: The Digital Competence Framework for Citizens-With new examples of knowledge, skills and attitudes (No. JRC128415). Joint Research Centre (Seville site).