Nurse educator perspectives about knowledge, awareness, skills, and attitudes regarding documentation, as a component of health information technology can offer important data on the links between achieving safe and quality patient outcomes. A classic grounded theory approach was used to explore nurse educator faculty perceptions of issues and strategies related to teaching effective patient care documentation. The current problem with teaching nursing documentation among nurse educators surfaced during the interviews with nurse educators and the specific problem was identified in the study from the views of study participants. This study included two main purposes: (a) to explicate the issues and strategies of nurse educators teaching of nursing documentation while transitioning from paper-based to an electronic health record format, and (b) to generate an explanatory theory of teaching nursing documentation and its negative or positive influences of student learning of the competency. In-depth interviews with observation were conducted among sixteen nurse educators from a baccalaureate nursing program. A grounded theory of internalizing accountability emerged as the core variable/core category through classic grounded theory data collection and analysis in a simultaneous fashion. Four sub-categories and components also emerged and include (a) progressing levels, (b) reflecting on conflicting roles of nurse educators, (c) accepting transitioning, and (d) engaging and empowering through leadership. As a result of the analysis of the study findings, conclusions in this study filled the current gap in the literature through development of a new theory of internalizing accountability with future use in undergraduate and graduate nursing education.
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