Date of Award

Spring 5-2013

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Curriculum, Instruction, and Special Education

Committee Chair

Shuyan Wang

Committee Chair Department

Curriculum, Instruction, and Special Education

Committee Member 2

Taralynn S. Hartsell

Committee Member 2 Department

Curriculum, Instruction, and Special Education

Committee Member 3

James T. Johnson

Committee Member 4

Kathleen R. Masters

Committee Member 4 Department



The evolution of health information technology continues to reform the delivery of efficient, safe, and equitable healthcare in the United States. One such example is the emergence of electronic health records (EHRs) and the discerning emphasis placed on using this technology in meaningful ways. While the integration of EHRs into daily practice impacts all healthcare professionals, nurses remain a prominent driver in the successful adoption and usage of these systems. It is therefore imperative to understand the impact of nurses’ technology attitudes and skills on the level of EHR adoption in Mississippi.

This quantitative study examined the technology attitudes and skills of rural health clinic nurses on the level of adoption and meaningful use (as defined by CMS) of electronic health records. Approximately 44 rural health clinic nurses (or those serving in a rural health clinic nursing capacity) participated in a survey that solicited demographic information, healthcare facility information, electronic health record information; and information regarding the technology skills, and technology attitudes of the respective participant. The findings show no significant relationships between current stage of EHR meaningful use and rural health clinic practice ownership; nor do factors that impede or facilitate the diffusion process significantly differ by practice ownership. Findings also indicate that the technology attitude of a nurse is not significantly impacted by (1) the age of the nurse, (2) the number of years of nursing experience, or (3) the current stage of EHR meaningful use at the nurses’ respective rural health clinic.

Results of the study indicate that Mississippi’s rural health clinics are at varying levels of EHR meaningful use with some clinics still at a level of no adoption. In addition, technology attitudes of rural health clinic nurses still remain low. As evidenced by technology attitude scores, clinic nurses lack confidence in using technology and in the technology itself. Training should be focused on the application of health information technologies to increase nurses’ self-confidence and understanding of effective use. Further, administrators and practice owners should involve nurses throughout the adoption lifecycle to ensure nurses are a vital component in the development and integration of EHRs.