Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Executive Leadership

First Supervisor

Diane Cooney-Miner


Computerized documentation is not a new concept, but little is known about nurse’s adoption to this innovation and the effects on the nurse practice environment. The purpose of this research was to investigate the impact of an EHR tool on the quality of nursing care delivered. A quantitative, retrospective analysis using an interrupted time series model of a large data set was conducted from 2010 and 2013. The study showed that the use of an integrated EHR tool in nursing practice impacts many quality outcomes such as hospital acquired conditions, costs, and nurse turnover. The study showed with diffusion of innovations that EHR adoption over time can impact quality and cost measures negatively or positively followed by an improved state or return to pre-implementation period. The study added to the existing body of research and contributed to the formation of an evidenced based model to support organizations innovation adoption of an EHR implementation. This study further clarified the practice environment of RNs. The implications for practice include recommendations to include nurses in innovation adoption, modifications of staff models to promote nurse retention during innovation adoption, supportive leadership practices, the use of evidenced based computerized tools, and additional research is necessary to understand the clinical practice environment and nurse satisfaction. The diffusion of innovations, such as the implementation of an integrated EHR, using servant leadership principles to support nursing care delivery, improves the overall performance of acute care hospital environments by enhancing decision making for registered professional nurses.

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