The inclusion of nurses in the systems development life cycle
In the media introduction to this module, it was suggested that you as a nurse have an important role in the Systems Development Life Cycle (SDLC). With a focus on patient care and outcomes, nurses may not always see themselves as contributors to the development of new systems. However, as you may have observed in your own experience, exclusion of nurse contributions when implementing systems can have dire consequences.
In this Discussion, you will consider the role you might play in systems development and the ramifications of not being an active participant in systems development.
- Review the steps of the Systems Development Life Cycle (SDLC) as presented in the Resources.
- Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
- Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology.
By Day 3 of Week 9
Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain the potential impacts of being included or not in the decision-making process. Be specific and provide examples.
By Day 6 of Week 9
Respond to at least two of your colleagues* on two different days, by offering additional thoughts regarding the examples shared, SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.
Discussion one that needs a response in APA 7 format and at least 2-3 references.( Micheal )
The health care industry has met with numerous changes over the years; some of the changes lay emphasis on either the patient, the organization or its employees. Of the numerous changes any given health care institution experiences, the goal of patient safety and patient satisfaction preempts the motive for necessary changes to better serve our patient population while also bearing in mind the effectiveness of the interventions that the organization is implementing. For an institution saddled with the responsibility of rendering health care services to members of its community, it is often faced with the need for constant system development of their life cycle to enhance the efficiency of the services provided while also taking patient safety into consideration. “The first step in developing a system is to understand the problems or business needs. It is followed by understanding the solution or how to address those needs; developing a plan; implementing the plan; evaluating the implementation and finally maintenance” (McGonigle, 2017, p175)
System development life cycle presents as the precursor to the innovations that trigger the much needed difference in terms of efficiency or safety, such changes sometimes suffer the brunt when nurses are excluded in the preliminary phases of planning leading up to its implementation. The consequence of not having nurses weigh in on the intended innovation includes but is not limited to having a poorly designed project since the design and planning was done without the end users input, the project may become obsolete months after its implementation for failing to meet the needs of the nurses with regards to efficiency in patient care and safety considerations. According to a Laureate video presentation by Stuart Speedie, “the goal of health care informatics and technology should be its interoperability.” (Laureate Education Producer, 2018)
In a different light, if the nurses were included as prospective end users of this innovation, ideas generated from the conversation about the intended innovation will be viewed from many perspectives which will in turn make for a better design knowing what the end user desires for the innovation to be mutually beneficial to the institution and the patient population alike. At the institution that I work, the latest innovation was the inclusion of an automated Alaris infusion pump that synchronizes information across the electronic health record platform and the medication pyxis, the nurses did not have any input on the planning or design of this new innovation.
The impact of not being included or consulted prior to designing and implementing this design were as follows; some medications were not compatible with the pump interface and will not accept manual entry this problem in its self constituted a missed medication for the patient hence delaying patient care, the network interface on the electronic health record platform was a bit confusing and needed more than just a day of orientation to say the least, over all the system launch was chaotic and stressful leading to loss of considerable man hours trying to figure things out on the go with little to no assistance especially for nurses working on the night shift. According to a Laureate video presentation by Kevin Johnson, “He highlights the need to acknowledge that the cycle is ongoing and never done even after its implementation.” (Laureate Education Producer, 2018)
Laureate Education (Producer). (2018). Interoperability, Standards, and Security [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learn
Discussion one that needs a response in APA 7 format and at least 2-3 references.( Monica)
Discussion Week 9 Initial Post
Nursing is the largest healthcare profession in the world. According to the American Association of Colleges of Nursing (2020), there is an estimated 3.8 million registered nurses (RN) nationally and 84.5% of those nurses are employed in the healthcare setting. Nurses are so vital to healthcare organizations because they are hands on with rendering care to patients and oversee the overall care that the patient receives. Nurses serve as patient advocates and are involved on every aspect of the patient’s care. They are the integral party with the responsibility to make sure that other healthcare professionals are doing their part to ensure that patients are receiving the safest and best quality of care. High in numbers and with such an intricate role in healthcare, nurses are the heartbeat of the hospitals, therefore it would behoove healthcare organizations to involve nurses in every aspect of care including the Systems Development Life Cycle (SDLC).SDLC is a process of addressing an identified need and putting a plan/system into operation. Phases of the SDLC include planning, analysis, design, implementation, and maintenance (Laureate, 2018). Nurses can contribute greatly to the process of selecting and implementing new health systems because they are hands on and see first-hand the needs of the patients and healthcare systems.
If healthcare administrations fail to include nurses during the SDLC process of purchasing and implementing new information technology system, consequences could be failure to identify pertinent issues (Cleveland, 2019). The planning, analysis, design, implementation, and maintenance phases would not persist because nurses are the primary bodies that are hands-on and they are on the frontlines to witness how the whole process plays out. Nurses play a role that is essential to the success of the system. During the planning process, nurses contribute by identifying needs. They collaborate with multidisciplinary teams to formulate a plan to prosecute. During the analysis and design phases, nursing informaticists play a huge role by assuring that the plan is suitable and of evidence based practices. After the best practices are identified, nurses then, implement by using the system. Over time, evaluation and maintenance is done by the nursing staff. This cycle of evaluation is ongoing with the goal of the system to become more efficient with each evaluation.
About 6 years ago, I was involved in the maintenance and evaluation phase of an information technology tool (Patient Touch) that was launched 2 years prior on the medical surgical floor. The Patient Touch, similar to an iPhone, allows healthcare workers to chart all care and nurses to scan and record medication administration, It is a hand-held scanner that has many protective measures built in, and it allows workers of all entities to pull up useful information in a matter of seconds. It heavily supports evidence-based practice and has produced positive outcomes with patient care. To keep the momentum going, nursing informaticians made rounds monthly to see how using the Patient Touch was going and they asked for feedback on how to improve the tool. I mentioned to them an issue I had with it, while charting the nursing assessment using Patient Touch, there were a lot of assessment pieces that did not apply to medical surgical patients which prolonged time. There were a lot of assessments that ICU utilized, and I asked if there was anyway to eliminate the issue. A couple of months later, the informaticians implemented a division of the units and whatever unit selected, the nursing daily assessment was customized for each unit. This change eliminated a lot of unnecessary assessments that did not apply to medical surgical floor. It made a huge difference with charting and really improve our nurses time management. “Nurses play an active and vital role in electronic healthcare information system acquisition and upgrading project along- side their health informatics and IT colleagues (McLean, Frisch, &Roudsari, 2020). Nurses being involved with the SDLC process is necessary because they are the ones using the systems the most. Without the nurses’ input and expertise, healthcare administrations will miss the mark and the success rate of the tool would be minimized.
AACN. (2020). AACN fact sheet – Nursing. The American Association of Colleges of Nursing (AACN). https://www.aacnnursing.org/News-Information/fact-sheets/Nursing-Fact-Sheet
Cleveland, K. A., Motter, T., & Smith, Y. (2019, May 31). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No2-May-2019/Affordable-Care.html?css=print
Laureate Education (Producer). (2018). Systems implementation [Video file]. Baltimore, MD: Author.
Mclean, A., Frisch, N., & Roudsari, A. (2020, September 21). Nursing’s voice in healthcare IT acquisition decisions. Canadian Journal of Nursing Informatics. https://cjni.net/journal/?p=4248#:~:text=%20Nursing%E2%80%99s%20Voice%20in%20Healthcare%20IT%20Acquisition%20Decisions,senior%20nurse%20executives%20and%20leaders%20develop…%20More%20