1. Value-based Teaching: A Grounded Theory of Internalizing Accountability in Teaching Documentation Monte’ Karen Koerber-Timmons PhD, RN, CNE, NEA-BC, CCRN, RN-BC

2. OBJECTIVES Analyze components of the newly revised Code of Ethics for Nurses with Interpretive Statements for generation of specific proposals on linking empowerment with documentation to transform nursing practice, leadership, and education. Discuss the results of a research study on Value-based Teaching- A Grounded Theory of Internalizing Accountability in Teaching Documentation, with special emphasis on findings of “Empowerment”. Identify the role of nurse educators with empowering success in documentation throughout the nursing curriculum and in empowering through leadership with inclusion of stakeholders in documentation. Explain the significance to leadership and nursing education for prioritizing the importance of documentation to bridge the gap in connecting classroom and clinical experiences. Examine recommendations for further studies related to documentation. 2

3. Electronic Health Record (EHR) American Nurses Association [ANA]. (2009). Position statement: Electronic Health Record (EHR).

4. Electronic Health Record (EHR) American Nurses Association [ANA] (2010). Principles for nursing documentation: Guidance for registered nurses. Nursing Documentation Principle 1: Documentation Characteristics

5. Electronic Health Record (EHR) American Nurses Association [ANA]. (2015). Code of ethics for nurses with interpretive statements. Provision 4.1- Authority, Accountability, and Responsibility Provision 4.2- Accountability for Nursing Judgments, Decisions, and Actions Provision 5.4- Preservation of Integrity

6. Dr. Barney Glaser- GTI 6

7. Introduction EMPOWERING SUCCESS IN DOCUMENTATION: A GROUNDED THEORY OF INTERNALIZING ACCOUNTABILITY 7

8. Problem and Purpose Problem: Nursing student and nurse educator access to electronic systems in health care settings as part of a nursing student’s clinical experience Nursing student opportunity for full immersion with electronic health record documentation Nurse educator transition from paper-based to an electronic format of documentation Purpose: Issues and strategies Explanatory theory of teaching nursing documentation 8

9. Gap in the Literature Limited research how nurse educator’s teach nursing documentation to nursing students while transitioning from a paper-based to an electronic format. No classic grounded theory research the process of internalizing accountability in teaching documentation. 9

10. Research Method and Design Qualitative Classic Grounded Theory- A general method that differs from other qualitative methods: Provides systematic collection and analysis of data Is focused on the data Allows for the discovery of: the participant’s main concern how the participants resolve their main concern a substantive grounded theory 10

11. Research Questions R1 - How do nurse educators manage main concerns of issues and strategies related to teaching effective patient care documentation to nursing students using paper-based and electronic health record technology? R2 - How do the nurse educators work to overcome the concerns? R3 – What new theory explains nurse educator teaching of nursing documentation and its negative or positive influences of student learning of the competency? 11

12. Results Figure 1. Components and Properties of the Process of Internalizing Accountability with (Negative (-) or Positive (+) Influences of Student Learning the Competency of Nursing Documentation Model of Value-based Teaching: A Grounded Theory of Internalizing Accountability in Teaching Documentation 12

13. Significance to Leadership and Nursing Education Supports gaps in the literature- teaching nursing documentation (lack of grounded theory studies) Quality and Safety Education for Nurses (QSEN)- academic and clinical sites Preceptored model evaluation-connect clinical and classroom experiences National Student Nurses Association (NSNA) and professional organization awareness Graduate nursing program- Education and Administration 13

14. Recommendations for Further Studies Accountability- Disciplines outside of the nursing profession Clinical preceptors, as extenders in the teaching role Research with teaching nursing documentation in a preceptored versus non-preceptored model Documentation in nursing schools outside of the U.S. Exploratory qualitative research studies Quantitative studies (quasi-experimental, time series design); Mixed method approach Nurse educator workload studies Studies- paper-format documentation when electronic method is unavailable 14

15. THANK YOU 15

16. Questions What questions do you have? Contact: mkkoerbertimmons@gmail.com (903) 452-3004 16