The purpose of this systematic review of literature is to identify the current research available for establishing whether the US nursing population (other than recent graduates) has sufficient competency in the use of informatics knowledge and skills to facilitate the advancement of evidence-based practice and effective utilization of electronic medical record systems and related technologies. A review of the literature relevant to informatics competency and education in the US clinical setting indicated that not only were computer and information nursing competencies not effectively defined until 2002 but also clinical assessment regarding informatics components was predominantly limited between 1999 and 2006 to attitudes and use of online resources. Establishing a baseline of informatics competencies in the existing workforce is vital to forecasting and planning for growth in an expanding electronic healthcare delivery era. Available literature shows that the need remains for nursing job-specific competency development, development of evaluation tools for the informatics competency components, and guidelines for education and evaluation of these competencies in clinical environments. Only then can healthcare organizations properly identify nursing informatics competency needs across the three informatics sciences of nursing science, computer science, and information science. In turn, this will enable them to bring their population up to speed for evidence-based practice and overall informatics skills while improving diversification for contribution across multiple settings.