Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Ann Teske, PhD, RN

First Committee Member

Barbara Schaffner, PhD, CNP

Second Committee Member

John D. Chovan, PhD, DNP

Third Committee Member

Laura Gaietto, RN, SN


EMR, Mixed Method, Triangulation, Electronic Medical Record

Subject Categories

Medicine and Health Sciences | Nursing Administration | Other Nursing


The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any hospital, their ability to learn, change and adopt new care integration and documentation methods must be supported and enhanced. Benner’s Novice to Expert Model of Skill Acquisition in nursing has direct application in this transition. The purpose of this mixed-method, longitudinal study is to examine the attitudes and beliefs of nurses undergoing the change from a paper documentation system to a computer based system through the lens of Benner’s Novice to Expert Model. Nurses must accept the change to electronic medical records but they must also increase their skill level. Important factors for successful transition to electronic charting include usefulness of the software, methods of implementation as well as length of time after making the change.



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