Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Linda Urden, DNSc, RN, CNS, FAAN, Chairperson Laurel Ecoff, PhD., RN, NEA-BC Jonathan Mack, PhD., RN, NP


Diabetes, Electronic Health Record, Pay for Performance, Registered Nurse, Supervisor Feedback, Urgent Care


Diabetes is a deleterious disease affecting millions of Americans. Electronic Health Record (EHR) usage and the numbers of Urgent Cares (UC) in the United States is rising. Some UCs care for sicker patients and are thus staffed by Registered Nurses (RNs). UC RNs may have a strong impact on one of the most deadly diseases in America, yet have been neglected in current research literature.

This descriptive correlational study examined reciprocal relationships between behavioral, environmental, and personal factors related to the quality of care rendered to diabetic patients in the UC using a modified version of Wood and Bandura’s (1989) Triadic Reciprocal Determinism model. Sixty-two UC RNs within a large healthcare organization in Southern California completed three questionnaires: researcher developed demographic, Stronge and Brodt’s (1985) Nurse’s Attitudes Towards Computerization (NATC) and Palomo, Beinart, and Cooper’s (2010) Supervisory Relationship Questionnaire (SRQ). Within the questionnaires, were two open ended questions that underwent thematic analysis. Charting compliance was assessed via auditing ten random diabetic patient EHRs per participant.

Although there were no statistically significant relationships between UC nurse documentation and NATC or SRQ, there was a statistically significant inverse relationship between SRQ and NATC scores. Qualitative analysis of open ended questions uncovered UC RN’s perceptions towards the EHR as well as technical and non-technical factors that impacted EHR usage.

Document Type

Dissertation: USD Users Only