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Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: a Delphi Study Darlene S

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Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: a Delphi Study Darlene S University of North Dakota UND Scholarly Commons Theses and Dissertations Theses, Dissertations, and Senior Projects January 2013 Nurse Educators' Consensus Opinion On Using An Academic Electronic Health Record: A Delphi Study Darlene S. Hanson Follow this and additional works at: https://commons.und.edu/theses Recommended Citation Hanson, Darlene S., "Nurse Educators' Consensus Opinion On Using An Academic Electronic Health Record: A Delphi Study" (2013). Theses and Dissertations. 1429. https://commons.und.edu/theses/1429 This Dissertation is brought to you for free and open access by the Theses, Dissertations, and Senior Projects at UND Scholarly Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. NURSE EDUCATORS’ CONSENSUS OPINION ON USING AN ACADEMIC ELECTRONIC HEALTH RECORD: A DELPHI STUDY by Darlene S. Hanson Bachelor of Science, Minot State University, 1978 Master of Science, University of North Dakota, 1987 A Dissertation Submitted to the Graduate Faculty of the University of North Dakota In partial fulfillment of the requirements for the degree of Doctor of Philosophy Grand Forks, North Dakota August 2013 Copyright 2013 Darlene S. Hanson ii This dissertation, submitted by Darlene S. Hanson, in partial fulfillment of the requirements for the Degree of Doctor of Philosophy from the University of North Dakota, has been read by the Faculty Advisory Committee under whom the work has been done, and is hereby approved. ____________________________________ Dr, Myrna R. Olson, Chair ____________________________________ Dr. Margaret Zidon ____________________________________ Dr. Kathy Smart ____________________________________ Dr. Steven D. LeMire This dissertation is being submitted by the appointed advisory committee as having met all of the requirements of the Graduate School at the University of North Dakota and is hereby approved. ____________________________________ Dr. Wayne E. Swisher Dean of the Graduate School ____________________________________ Date iii PERMISSION Title Nurse Educators’ Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study Department Teaching and Learning Degree Doctor of Philosophy In presenting this dissertation in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, I agree that the library of this University shall make it freely available for inspection. I further agree that permission for extensive copying for scholarly purposes may be granted by the professor who supervised my dissertation work or, in her absence, by the chairperson of the department or the dean of the Graduate School. It is understood that any copying or publication or other use of this dissertation or any part thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of North Dakota in any scholarly use which may be made of any material in my dissertation. Darlene Hanson June 25, 2013 iv TABLE OF CONTENTS LIST OF TABLES ........................................................................................................... viii ACKNOWLEDGEMENTS ............................................................................................... ix ABSTRACT ....................................................................................................................... xi CHAPTER I. INTRODUCTION .............................................................................................1 Background of the Study .............................................................................1 Statement of the Problem .............................................................................8 Purpose of the Study ....................................................................................9 Rationale for the Study ................................................................................9 Research Questions ....................................................................................10 Theoretical Framework ..............................................................................10 Assumptions ...............................................................................................10 Delimitations ..............................................................................................11 Summary ....................................................................................................11 II. LITERATURE REVIEW ................................................................................12 Diffusion of Innovation..............................................................................12 Critical Dynamics of Innovation Diffusion in Health Care .......................15 Previous Studies of EHR Adoption in Health Care ...................................15 Reported Studies of EHR Adoption in Educational Settings .....................24 v Summary ....................................................................................................28 III. METHODOLOGY ..........................................................................................30 Purpose .......................................................................................................30 Participants .................................................................................................31 The Electronic Health Record Used in This Study ....................................33 Research Methodology ..............................................................................34 Procedures ..................................................................................................35 Data Collection ..........................................................................................37 Survey Instruments ....................................................................................38 Data Analysis .............................................................................................42 Summary ....................................................................................................43 IV. RESULTS ........................................................................................................44 Demographics ............................................................................................44 Research Questions ....................................................................................53 V. DISCUSSION ..................................................................................................67 Study Findings ...........................................................................................67 Conclusions ................................................................................................71 Recommendations ......................................................................................74 Limitations .................................................................................................76 Reflections .................................................................................................77 APPENDICES ...................................................................................................................78 Appendix A. ND Nursing Education Administrators (CUNEA) Letter of Endorsement .....................................................................79 vi Appendix B. Phase 1: IRB Approval ....................................................................80 Appendix C. Phase 1: Informed Consent Form ....................................................82 Appendix D. Phase 1: E-mail Request and Reminder for Survey Participation .....................................................................................85 Appendix E. Phase 2: Protocol Change Form and Approval ...............................87 Appendix F. Phase 2: Informed Consent Form ....................................................89 Appendix G. Phase 2: E-mail Request and Reminder for Survey Participation .....................................................................................91 Appendix H. Phase 3: IRB Protocol Change ........................................................93 Appendix I. Phase 3: Informed Consent Form ....................................................96 Appendix J. Phase 3: E-mail Request and Reminder for Survey Participation .....................................................................................98 Appendix K. Phase 1 Qualtrics Survey ...............................................................100 Appendix L. Phase 2 Qualtrics Survey ...............................................................104 Appendix M. Phase 3 Qualtrics Survey ...............................................................111 REFERENCES ................................................................................................................122 vii LIST OF TABLES Table Page 1. Demographic Information for Phase 1 ...................................................................46 2. Nurse Educators’ Self-Report of Proficiency with Technology ............................47 3. Demographic Information for Phase 2 ...................................................................49 4. Demographic Information for Phase 3 ...................................................................51 5. Phase 1 Themes: Factors That Facilitated an Academic EHR’s Implementation
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