Discussion – Week 9
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.
To Prepare:
- 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 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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
*Note: Throughout this program, your fellow students are referred to as colleagues.
7 months ago
Paige Collins
RE: Discussion – Week 9
Nurses play a huge role in many things in healthcare. One of those things being deciding the best health information technology system. Nurses are on the frontline and are the main ones using software systems, so involving them in those decisions is vital to make sure that the system being chosen will work well. Getting nurses more involved in technology implementation could also help hospitals embrace new models of care (Burns, 2012). A consequence to not involving nurses in these decisions could include the system not working and making things chaotic. When things become chaotic, it can become unsafe and quality of care could decrease. If nurse leaders don’t have a say in identifying, choosing and evaluating the technology their staff will use, they run the risk of sticking their frontline nurses with insufficient systems that detract from patient care, add to their workload, and generate unnecessary confusion in communication with patients and other healthcare providers (Wolters Kluwer, 2015).
Each step of the SDLC has a purpose and I beleive that nurses need to be involved at each step. In the first step, how the user explained it (Louis, 2011), the user could up sell the technology to make it seem like the best thing ever. If a nurse has reviewed the system then they could share their experience and let others know if it was as good as the company was making it out to be. The second step, how the business analyst understood it, can cause issues due to an analyst not knowing what works on the floor. A nurse knows what sysem works best while in the midst of a chaotic day. The next step, how the dev lead designed it, looks like their are many flaws that were overlooked and would come out when the nurse begins to work in the program. Next is, how the programmer wrote it, this looks like the programmer was trying to get the concept, but did not quit get it. Although it looks good tilted one way doesn’t mean that true value of the program wouldn’t come out later. After that we have, how the project manager described it, which I beleive happens way to often. Things are upsold and made to look better than it actually is. Nurses need software that has quality and is reliable, so they can provide the best care possible. If the program doesn’t sell then there could be no documentation of it. The video now talks about, what operations install. This looks like it was done halfway and is not going to be good. The healthcare facility is then billed for more money than what the program was worth and no way to get out. With no support behind it, the healthcare facillity does not end up with what they actually needed. Inclusion of nurses in these decisions could help make more informed decisions. They know what will work best for them and their team, so they should be involved in decisions like that.
I was not personally involved in any software decisions, but some of the nurses higher than me were. We have used the same system for a long time due to it working. It may be a little old, but it is reliable. I am sure if something came up and there was a new system there would be a lot of thought put into it due to the old system still allowing us to provide adequate quality of care without having to worry what our software system is.
References
Burns, E. (2012). Nurses have an important role to play during technology implementation. https://techtarget.com/searchhealthit/news/2240166948/Nurses-have-an-important-role-to-play-during-technology-implementation
Louis, I. (2011, August 17). Systems develoopment life cycle (SDLC) [Video file]. Retrieved from https://www.youtube.com/watch?v=xtpyjPrpyX8
Wolters Kluwer. (2015). 5 technology decisions that demand nurse involvement. https://wolterskluwer.com/en/expert-insights/5-technolgy-decisions-that-demand-nurse-involement
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Paige,
Thanks for sharing your thoughts. Would you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each phase can impact implementation?
Dr. Mattis
7 months ago
Angel Smith
RE: Discussion – Week 9
Paige,
Great discussion with really important points. I agree that nurses are an essential part of the SDLC process. During a study completed by implementing a new barcode medication administration system it was proven that the involvement of the nurses each phases of the process from beginning of the design until the end of the implementation and evaluation, is essential for success when introducing new systems. Nurses are the frontline workers and the individuals best to provide feedback on what has worked and what has not which in return assists when they give feed back during the development of new technology systems for their workforce (Weckman & Janzen, 2009).
According to McGonigle, D., & Garver Mastrian, K. (2022), the first step when there is to be a development of a new system is to first understand what the problem is as well as what the organization needs. In order to do this effectively it is important to include the frontline workers who are the users of the systems on a daily basis. This provides feedback on current systems as well as system needs.
References
McGonigle, D., & Garver Mastrian, K. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Weckman, H. N., & Janzen, S. K. (2009). The critical nature of early nursing involvement for introducing new technologies. The Online Journal of Issues in Nursing, 14. Retrieved April 27, 2022, from
7 months ago
Madeleine Rodriguez
RE: Discussion – Week 9
Paige,
I am very much in agreement with you that nurses are vital in the SDLC process. Technology frustrations are a huge reason my peers and I have left nursing positions. While nursing roles in technology, such as informatics, are gaining popularity, it adds to the shortage of bedside nurses (Haddad & Toney-Butler, 2020). Technology frustrations are also causing many nurses, especially the older generational nurses, to leave the bedside, thus contributing to the nursing shortage crisis (Haddad & Toney-Butler, 2020). Nurses are essential in the analysis phase of the SDLC process in expressing the organization’s needs (Mcgonigle & Mastrian, 2022). The system should be tailored to the nurses’ needs as they will be the primary users of the system.
References
Haddad, L. M., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Mcgonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
7 months ago
Jessica Cochran
Peer Response #1
Hi Paige, I enjoyed reading your post. It sounds like you have a reliable, efficient electronic medical record which is good, but it also sounds like the software that the company acquired is no longer as efficient as it once was. Potential risks, delivery of care, and feedback from those using the technology are essential (Agency for Healthcare Research and Quality, n.d.-a). As you mentioned understanding the situation and the hospital’s needs should make nurses experts for feedback on solutions and how to address those needs (Agency for Healthcare Research and Quality, n.d.-a).
Consequences of not allowing nurses to contribute to the proposed innovation include poor design (McGonigle & Mastrian, 2022, p. 195). If the design and planning were done prior without the nurse’s input, the project might fail after implementation because nurses use the technology and have a workflow and work with these patients. We are the best people to gain feedback from.
References
Agency for Healthcare Research and Quality. (n.d.-b). Workflow assessment for health it toolkit. https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge (Fifth ed.). Jone and Bartlett Learning.
7 months ago
Janelle McEwen
RE: Discussion – Week 9
The SDLC model plays a critical role in the development of complex systems. Building an appropriate SDLC is difficult for a specific type of information system (IS) design since it involves and requires careful preparation and administration to guarantee the standard and the quality of an end design that delivers a robust, effective, and efficient system that ensures what it is supposed to do (MacTavish & Basapur, 2016). Thus, the involvement of nurses in every step of the SDLC is pertinent to ensure that the usability of the technology is in line with the nurses’ needs. Although you did not engage in the initial process, the constantly adapting nursing informatics innovations to a rapidly changing healthcare environment will give you a chance to participate in the entire continuum of the SDLC (Cato et al., 2020).
References
Cato, K., McGrow, K., & Collins Rossetti, S. (2020). Artificial intelligence implications for nurse leaders. Nursing Management, 11(12), 24–30. https://pdfs.journals.lww.com/nursingmanagement/2020/11000/Transforming_clinical_data_into_wisdom__Artificial.4.pdf
MacTavish, T., & Basapur, S. (2016). A System Development Life Cycle for Persuasive Design for Sustainability. Springer International Publishing, 90(72), 217–228. https://doi.org/10.1007/978-3-319-20306-5
7 months ago
Nahvote Forkom
RE: Discussion – Week 9
Hello Paige. I enjoyed reading through your post since your arguments are concise and straight to the point. I concur with your thoughts, and nurses are one of the vital groups of employees in a healthcare setup since they interact with patients directly during patient care procedures and treatment. It is therefore essential to have them in every step of the SDLC. Technology helps in improving patient care by making the delivery of services efficient. Thus since nurses will be interacting with the adopted systems directly, it is wise to involve them in the SDLC process to walk through the transition process and receive adequate training on how to work with the new system. Having them as active participants in the process allows them to ask the necessary questions about things they may not understand and learn vital debuting procedures when using the systems (Burns, 2012) . Failure to involve them may adversely affect the patient care since the nurses may not work using the newly adopted systems. The frustrations they encounter working with the old systems may be transferred to the patients, thus leading them to have horrible experiences in health care centers.
References
Burns, E. (2012). Nurses have an important role to play during technology implementation. https://techtarget.com/searchhealthit/news/2240166948/Nurses-have-an-important-role-to-play-during-technology-implementation
7 months ago
Susannah Beier
Main post
“Implementing an electronic health record (EHR) can be a difficult task to take on and planning the process is of utmost importance to minimize errors” (Aguirre et al., 2019). In every stage of the system development life cycle, nurses should be included to ensure that the best product is purchased, designed, and implemented. “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 & Mastrian, 2022). Throughout the development and design stages, inclusivity of the nurses can help generate ideas and identify their greatest needs for improvements in workflow. Identifying these needs early on will ensure the end-users, the nurses, will be able to increase their productivity and provide more efficient and safer patient care. In the analysis stage, the nursing informaticist plays a large role in ensuring that the plan for implementation is the most efficient and that the system is functional and meets the required specifications for documentation. In the implementation stage, the nursing informaticist will also be very useful as they are the expert. They can identify any issues with usability and ensure that the other nurses are receiving the appropriate support to continue safe and efficient patient care. Lastly, the evaluation and maintenance stage will be the continued evaluation of the system and ensuring system improvements are made when errors are identified. “Involving nurses who work at the point of care in all phases of introducing a new technology facilitates a smooth transition to using the new technology and increases nurses’ buy-in of the system” (Weckman & Janzen, 2009).
If the nurses are excluded from any one of the stages of the SDLC, the impact can be significant as I have learned from the launching of the new EHR system at my facility. Since the launching of the new EHR system in mid-March, several errors have been discovered with the products’ functionality. The consequences my organization is now dealing with are errors in documentation, decreased productivity, increased patient safety issues, huge delays, and patient and employee dissatisfaction. Patients are seeking care elsewhere because the wait times are so lengthy, and the patients are complaining that the staff are focusing more on figuring out charting then providing patient care. For instance, in my department, the operating room, we have gone from running 7-8 rooms per day to just 2-3 and have decreaed our patient load by 75 percent. Because of the poor design and implementation of the system, providers and nurses alike are attempting to navigate the documentation and figure out what to document and where to document it. The system has created a hostile work environment with a decrease in productivity and dissatisfied employees and patients. Additionally, the patient safety concerns have increased as employees are forgetting that the patient comes first.
References
Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and tools. (n.d.). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822893/
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th
ed.). Jones & Bartlett Learning.
Weckman, H., & Janzen, S. (2009, May). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in
Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Main post
Hello Susannah,
Thanks for sharing your thoughts. Would you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each phase can impact implementation?
Dr. Mattis
7 months ago
Nahvote Forkom
RE: Main post
Susannah, patient safety and care should be a priority for health matters. However, a lack of healthcare involvement in implementing new systems in healthcare facilities such as EHRs can adversely affect service delivery. When healthcare professionals are working with a design they are not conversant with; they will tend to waste more time trying to earn how to utilize the new system rather than attending to the needs of the patients. As you have highlighted in your post, this results in several consequences such as long quest and safety issues. Since the new systems are being adopted to improve efficiency and enable the professionals to deliver efficiently, there is a need for the healthcare professionals to be involved through the entire process of acquiring a new system such that they receive adequate training on how to work using the new system. Thus this will minimize errors and improve the efficiency of service delivery.
References
Weckman, H., & Janzen, S. (2009, May). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in
7 months ago
Shontrice Davis
RE: Main post
Hello, Susannah. I enjoyed reading your discussion this week. Your post was very informative. May healthcare facilities do not realize the impact of not including nurses in all stages of the system development life cycle. Nurses will most likely utilize the system the most. Therefore, their engagement will be important for the success of the system development. They will ensure that the workflow is not disrupted or slowed down (McKay, Vanaskie, 2018). Nurses are one of the most important aspects of healthcare facilities. They are the bridge that connects the clinical world with the technical world (Kousaie, 2012). Hence, it is important for nurses to a part of stages of system development. It is the key to it’s success.
References
McKay, C., & Vanaskie, K. (2018). Partnering for Success: The Role of the Nurse Leader in HealthInformation Technology Implementation for Coordination of Care. Nurse Leader, 16(6), 385–388. https://doi.org/10.1016/j.mnl.2018.07.012
Kousaie, D. (2012). Nurses’ voice a must for IT projects. Nursing Management, 43(4), 8.https://doi.org/10.1097/01.NUMA.0000413100.63748.40
7 months ago
Lashonda Dingle
RE: Main post
Hello Susannah,
I enjoy reading your post. Your post shows that collaboration between nurses and the IT team is vital for the best patient care. I Come from a surgical background (still a PACU nurse PRN). Going from 7-8 to 2-3 running OR rooms and a 75% patient decrease daily is significant. When there is an improper design and a lack of using the proper resources when developing software, errors can occur that may result in poor patient care and a lack of trust in the facility (Verma & Gupta, 2017). There are more options for patients when seeking care in surgical services due to ambulatory surgery centers and even hospital outpatient surgical centers. Therefore, nurses must be included in software development to prevent unnecessary errors. Nurses can understand and communicate using terminology that the patient and healthcare team can understand. Proper wording and terminology are a must when developing software (Fennelly et al., 2020). The EHR should be highly secure but straightforward enough that there is no confusion when documenting or reading reports from other intradisciplinary team members. Great post, Susannah.
Fennelly, O., Cunningham, C., Grogan, L., Cronin, H., O’Shea, C., Roche, M., Lawlor, F., & O’Hare, N. (2020). Successfully implementing a national electronic health record: A rapid umbrella review. International Journal of Medical Informatics, 144, 104281. https://doi.org/10.1016/j.ijmedinf.2020.104281
Verma, M., & Gupta, S. (2017). Software development for nursing: Role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203. https://doi.org/10.5958/2454-2660.2017.00044.8
7 months ago
Shani Mays
RE: Discussion – Week 9 Initial Post
NURS 6051 Week 9 Discussion
According to McGonigle & Mastrian (2022), “The process of developing systems, or the systems development life cycle (SDLC), is an ongoing development with a life cycle. The first step in developing a system is to understand the problems, or business needs. This step is followed by understanding the solution or how to address those needs; developing a plan; implementing the plan; evaluating the implementation; and, finally, performing plan maintenance, plan review, and system destruction”.
Consequences of a healthcare organization not involving nurses in the SDLC
Nurses should be active in each stage of the SDLC because we are an integral part of the delivery of health care our patients receive. Nurses are aware of the daily demands and what is needed to make a health information system more effective. The consequences of not involving nurses in this process could result in the development of a system that is ineffective and does not meet the staff’s needs. Nurses are considered front-line staff when it comes to patient care so we are more knowledgeable when it comes to what type of health information technology will be most effective in improving patient care. Nurse leaders can guide system developers in each stage of development and ensure that plans are developed to identify and address organizational needs.
Potential issues at each stage of the SDLC
How the inclusion of nurses may help address these issues
In the analysis phase, the system’s processes and workflows are established. This phase is meant to discover if the intended requirements provided are met and allows for evaluation of the processes for potential changes. This phase also helps to determine components that need to be added or removed. Nurses can help identify and communicate any workflow issues witnessed in the system.
The implementation phase incorporates the use of coding languages and code designs. This phase also allows for troubleshooting any issues that arise. Nurses can help organize meetings with staff, obtain feedback from nurses, identify potential barriers of the system, make modifications to techniques that evaluate processes, track and monitor the rate at which staff complies with the new system, and measure outcomes.
The testing and maintenance phase is where the system should be tested before it is incorporated into daily use. Testing ensures that the system provides the appropriate output and performs to the level it was designed to. As emphasized by McGonigle & Mastrian (2022), the nurse assists with overseeing the process of integration into the organization. In a maintenance role, the nurse should notify the system developer if required changes are needed.
Potential issues when failing to involve nurses in each stage of SDLC means that their first contact with the system will be at its implementation or go-live phase. Giving the nurse a short time period to obtain a crash course in order to familiarize themselves with its operation, thus slowing up the workflow. Loss of trust in the change process and general frustration which can lead to nursing burnout are other potential issues faced when nurses aren’t included in the process from start to finish. Finally, loss of personal connection to the new system since the nurses’ core beliefs and individual goals may not be aligned with those of the organization (French-Bravo & Crow, 2015).
Input in the selection and planning of new health information technology systems
I personally have never had the opportunity to provide any input in the selection and planning of new health information technology systems in my nursing practice or healthcare organization. The potential impact of not being included in the decision-making process is feeling like the opinions and input of the staff members who will utilize the new health information technology do not matter. Without nurses’ input and expertise, the success rate of the new health information technology would be minimized, and the systems’ benefit would not be recognized and evaluated as a failure. According to a Laureate video presentation by Kevin Johnson, “He highlights the need to acknowledge that the cycle is ongoing and never dine even after its implementation”. Laureate Education Producer, (2018).
Resources
French-Bravo, M. & Crow, G. (2015). Shared Governance: The Role of Buy-In In Bringing About Change. OJIN: The Online Journal of Issues in Nursing, 20(2). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Articles-Previous-Topics/Role-of-Buy-In-In-Change.html
Laureate Education (Producer0. (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
7 months ago
Paige Collins
RE: Discussion – Week 9 Initial Post
Shani,
I completley agree that nurses are essential to making decision regarding SDLC. In the healthcare workplace, technology decisions shouldn’t be made in a vacuum. With proper input and collaboration, nurses and IT profesionals can work together to ensure technology is used to its fullest capacity to better the hospital experience for both patients and providers (Wolters Kluwer, 2015). When implementing a system without nurse involvmenet i agree that it can cause a lot of issues. If it is a system that work then the nurses are finding that out when it is almost to late. It is important for early intervention so things can be tweeked just in case. Nurses occupy a unique plaace in the delivery of care. They often have the most direct patient contact and they are involved in several different stages of treatment. For these reasons, nurses at a recent conference said they need to play an active role in their organization’s technology implementation initiatives (Burns, 2012).
References
Burns, E. (2012). Nurses have an important role to play during technology implementation. https://techtarget.com/searchhealthit/news/2240166948/Nurses-have-an-important-role-to-play-during-technology-implementation
Wolters Kluwer. (2015). 5 technology decisions that demand nurse involvement. https://wolterskluwer.com/en/expert-insights/5-technolgy-decisions-that-demand-nurse-involement
7 months ago
Susannah Beier
Response 1
Shani,
Thank you for your discussion post this week on the stages of the SDLC and how nurse inclusivity in each stage can have a positive impact, but not involving them can have the opposite effect. Many organizations will face unfavorable consequences if the end-users of health care technologies are not included in each of the SDLC stages. Like you, I have not had the opportunity to give my input during any of the stages of the SDLC in any of the organizations I’ve previously worked for; however, I’ve seen many other nurses take part in the SDLC and those organizations have had more noticeable positive outcomes then the organization I currently work for who did not include nurses prior to the implementation phase. Technology changes in practice have the potential to create a ripple effect in other aspects of nurses’ workflow leading to unanticipated and undesired consequences (Weckman & Janzen, 2009).
On the other hand, when nurses are included in the process the ripple effect has the potential to be positive. Studies have shown that nurses’ attitudes towards a system can be used as a predictor of the success rate of that system (Parvan et al., 2021). Nurses will appreciate the opportunity to share their ideas and feel that their input matters. They can identify their needs and provide feedback and offer solutions on what changes need to occur to increase their productivity and create a safer environment for the patients. “…it is the nurses who are in the best position to identify the clues needed to resolve underlying systemic issues and offer ideas for possible resolution (Weckman & Janzen, 2009).
References
Parvan, K., Hosseini, F., Jasemi,, M., & Thomson, B. (2021, January). Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: A quasi-experimental study. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789241/#!po=1.61290
Weckman, H., & Janzen, S. (2009, May). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Megan Roesch
RE: Discussion – Week 9 Initial Post
Shani,
Thank you for sharing this week. I enjoyed reading your post very much. I agree with you on the importance of nurses’ involvement in every stage of the System Development Life Cycle (SDLC). Nurses act as leaders during a change in the health information technology system (HITS). They can ensure that workflow is not negatively impacted and that their coworkers’ feedback and opinions are taken into consideration (McKay & Vanaskie, 2018). You mentioned that you have never had an opportunity to provide any input in the selection and planning of new HITS. I haven’t either. I really appreciate that you discussed that nurses who are not involved may feel like their opinions do not matter. I have certainly felt like that. The easy fix for this is involving more, if not all nurses. Nurses are more likely to welcome change if they have a feeling of empowerment (Nagle et al., 2021).
Another potential issue when nurses are not involved is the lack of preparation. 80% of HITS adoption relies on change management, leadership, risk tolerance, and incentives. The remaining 20% is about the technology itself (Murphy, 2010). Without taking this into consideration the implementation of a new HITS can be a failure. For example, as you discussed, introducing a HITS during the go-live/implementation stage of the SDLC springs change on clinicians and does not allow for proper time to educate and train. By having nurses involved from the start, this can be avoided and the healthcare team would be better prepared to participate.
I wanted to discuss the potential issue of poor HITS design because of a lack of nurse involvement. This occurs early in the planning and design phases of the System Development Life Cycle. According to Kousaie, nurses “act as the bridge between clinical and technical staff” (2021). Because of a nurse’s direct experience with the technology systems, they can provide insight on how the HITS impacts their job and patient care. This is useful to ensure that a new technology system creates positive change and doesn’t interfere with patient care.
References
Kousaie, D. (2012). Nurses’ voice a must for IT projects. Nursing Management, 43(4), 8.
https://doi.org/10.1097/01.NUMA.0000413100.63748.40
Nagle, C., Olumuyiwa, O. & Bennett, P. (2021). Valuing nurse and midwifery unit managers’ voices: a
qualitative approach. BMC Nursing, 20(1), 1–9. https://doi.org/10.1186/s12912-021-00680-6
McKay, C., & Vanaskie, K. (2018). Partnering for Success: The Role of the Nurse Leader in Health
Information Technology Implementation for Coordination of Care. Nurse Leader, 16(6), 385–388. https://doi.org/10.1016/j.mnl.2018.07.012
Murphy, J. (2010). Nursing and Technology: A Love/Hate Relationship. Nursing Economic$, 28(6), 405–
408.
7 months ago
Megan Roesch
RE: Discussion – Week 9 Initial Post
PLEASE DISREGARD REFERENCE LIST- HERE IS MY ACTUAL LIST
References
Kousaie, D. (2012). Nurses’ voice a must for IT projects. Nursing Management, 43(4), 8.
https://doi.org/10.1097/01.NUMA.0000413100.63748.40
McKay, C., & Vanaskie, K. (2018). Partnering for Success: The Role of the Nurse Leader in Health
Information Technology Implementation for Coordination of Care. Nurse Leader, 16(6), 385–388. https://doi.org/10.1016/j.mnl.2018.07.012
Murphy, J. (2010). Nursing and Technology: A Love/Hate Relationship. Nursing Economic$, 28(6), 405–
408.
Nagle, C., Olumuyiwa, O. & Bennett, P. (2021). Valuing nurse and midwifery unit managers’ voices: a
qualitative approach. BMC Nursing, 20(1), 1–9. https://doi.org/10.1186/s12912-021-00680-6
7 months ago
Angel Smith
RE: Discussion – Week 9 Initial Post
Shani,
You have made some great points in your discussion. I agree that nurses are very valuable in all stages of the SDLC process. In one study done it was noted that a problem that commonly was occurring was that systems were not user-friendly once the implementation phase started. The best person to know what suits the user would actually be the user, or in this case, the nurse (Verma & Gupta, 2017).
According to McGonigle & Mastrain 2022, it is essential to have the right team to manage the development of a system. This is another reason why the nurses should be involved and be included in that team. Nurses are the frontline workers, the users that utilize the systems in order to provide care to the patients. If a system does not work effectively or even time efficiently how does this provide the best patient outcomes?
References
McGonigle, D., & Garver Mastrian, K. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Verma, M. P., & Gupta, S. (2017). Software development for nursing: role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203–207. Retrieved April 26, 2022, from https://doi.org/10.5958/2454-2660.2017.00044.8
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9 Initial Post
Hello Shani,
Thanks for sharing and I enjoyed reading your post. Nursing as the largest body of healthcare providers are usually at the forefront of any system implementation. The lack of nursing involvement in all phases can lead to significant failure of the system to meet the needs of nursing.
Dr. Mattis
7 months ago
Jacqueline Keener
Week 9 Response 2
Discussion – Week 9 Response 2
Shani,
Thank you for sharing your knowledge and experience with the systems development life cycle (SDLC) in healthcare organizations. I agree that nurses should be an active part of each step in the SDLC process. Since the initial step is to understand the problem, nurses typically participate in associated workflows. This also compliments your explanation of the analysis phase utilizing nurses to identify system problems. Risling, & Risling (2020) explain that nurses have a chance to “establish a more significant presence in this movement.” They also describe that nurses have a strong foundation of skills but lack the necessary SDLC process knowledge and confidence. Two years ago was the first time I was asked to participate in an organizational process on a grand scale. I was humbled and fascinated to see how many people and how much data are analyzed. I enjoyed your inclusion as a nurse of possibly loosing personal connection as a result of nurses not being involved in changes. Staggers et al. (2018) explain that nurses can use their influence and knowledge to impact policies and vocalize issues of usability with IT. Effective collaboration in healthcare is always imperative for improved outcoomes!
Thank you for another thorough and informative discussion week!
Jackie
References
Risling, T. L., & Risling, D. E. (2020). Advancing nursing participation in user-centred
design. Journal of Research in Nursing, 25(3), 226–238. https://doi.org/10.1177/1744987120913590
Staggers, N., Elias, B. L., Makar, E., & Alexander, G. L. (2018). The imperative of
solving nurses’ usability problems with health information technology. JONA: The Journal of Nursing Administration, 48(4), 191-196.
7 months ago
Heather Hill
Response #1 – Week 9
Shani,
Thanks for your post, it was very informative! I agree with what you said about not having the nurses involved in the creation process of a new healthcare technology program basically sets up the implementation step for failure. In the research article I found regarding health program development talks about the importance of user centered development (UCD). Changing an electronic healthcare program can be very stressful and have a negative culture around the process. Health care software will get a more positive outcome by user efficiency, usefulness, and fulfillment when the software is designed with their users’ requirements taken into perspective (Stanziola et. al, 2015). As we found in are required literature this week every phase of the SDLC has great potential to affect each other positively or negatively. During the initial two phases analysis and design, requirements for the health system are found plus the team critically navigates what data is necessary or crucial (McGonigle & Mastrian, 2021).
McGonigle, D., & Mastrian, K. (2021). Nursing Informatics and the Foundation of Knowledge (5th ed.). Jones & Bartlett Learning.
Stanziola, E., Uznayo, M. Q., Ortiz, J. M., Simón, M., Otero, C., Campos, F., & Luna, D. (2015). User-Centered Design of Health Care Software Development: Towards a Cultural Change. Studies in Health Technology & Informatics, 216, 368–371. https://doi.org/10.3233/978-1-61499-564-7-368
7 months ago
Eshley Pinto
Reply 1 Eshley Pinto
7 months ago
Vanessa Grant
RE: Discussion – Week 9
7 months ago
Susannah Beier
Response 2
Hi Vanessa,
Thanks for your discussion post this week and for sharing your thoughts on the impact of excluding nurses in the SDLC. I agree with you that exclusivity of the nurses is not beneficial to an organization as nurses are the end users. “By failing to focus on supporting frontline practitioners in delivering care, they repeatedly fail to enable ordinary day-to-day care” (Hamer & Cipriano, 2013). Nurse involvement is particularly important during the development and design phases of the SDLC as they can identify processes that will create more efficiency and productivity as well as identify those that will be ineffective and cause catastrophic consequences. “During the implementation phase of the SDLC, nurses can help facilitate the transition to new technology and identify any deficiencies in the process, system, or training of staff and offer support and solutions (Weckman & Janzen, 2009). Furthermore, nurses should continue to be actively involved in the later phases to provide both positive and negative feedback. The day-to-day nurse users will be able to provide useful feedback on which processes are working well and which things need improvement to be more efficient and functional.
References
Hamer, S., & Cipriano, P. (2013, November 22). Involving nurses in developing new technology. Nursing Times. https://www.nursingtimes.net/clinical-archive/healthcare-it/involving-nurses-in-developing-new-technology-22-11-2013/
Weckman, H., & Janzen, S. (2009, May). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Susannah Beier
RE: Response 2
Hi Vanessa,
Thanks for your discussion post this week and for sharing your thoughts on the impact of excluding nurses in the SDLC. I agree with you that exclusivity of the nurses is not beneficial to an organization as nurses are the end users. “By failing to focus on supporting frontline practitioners in delivering care, they repeatedly fail to enable ordinary day-to-day care” (Hamer & Cipriano, 2013). Nurse involvement is particularly important during the development and design phases of the SDLC as they can identify processes that will create more efficiency and productivity as well as identify those that will be ineffective and cause catastrophic consequences. “During the implementation phase of the SDLC, nurses can help facilitate the transition to new technology and identify any deficiencies in the process, system, or training of staff and offer support and solutions (Weckman & Janzen, 2009). Furthermore, nurses should continue to be actively involved in the later phases to provide both positive and negative feedback. The day-to-day nurse users will be able to provide useful feedback on which processes are working well and which things need improvement to be more efficient and functional.
References
Hamer, S., & Cipriano, P. (2013, November 22). Involving nurses in developing new technology. Nursing Times. https://www.nursingtimes.net/clinical-archive/healthcare-it/involving-nurses-in-developing-new-technology-22-11-2013/
Weckman, H., & Janzen, S. (2009, May). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Shani Mays
RE: Discussion – Week 9 Response #2
Vanessa,
The systems development life cycle (SDLC) is a standardized approach used to develop and implement information technology (IT). This approach offers a road map for the development of information systems in a very deliberate, structured, and methodological way. This framework is often used across industries to structure best practices for IT development and deployment (McBride & Tietze, 2018).
I agree the implementation phase of the SDLC is an important step in the process. Nurses play an important role in successful implementation. According to Verma & Gupta (2017), “Nurses working in a clinical setting are in a better position to judge whether software is useful and facilitates patient care, or just adds to the burden of formality for the healthcare professionals. Involvement of nurses could also address common problems that may arise due to ill-designed software, as well as ensure better allocation of healthcare resources. The need of nurses to be a part of the software development process has long been recognized. It is important that nurses be involved in selection, development and implementation of any system”. During implementation, nurses contribute insights into the necessary changes in procedures, policies, and workflow. Without their input, the new systems might not function well within the existing organizational culture and practice.
References
McBride, Susan P. R.-B. C. F., & Tietze, Mari P. R. F. F. (2018). Nursing Informatics for the Advanced Practice Nurse, Second Edition : Patient Safety, Quality, Outcomes, and Interprofessionalism: Vol. 2nd ed. Springer Publishing Company.
Verma, Medha Piplani & Gupta, Sandhya. (2017). Software Development for Nursing: Role of Nursing Informatics. Int. J. Nur. Edu. and Research. 5(2): 203-207. http://doi: 10.5958/2454-2660.2017.00044.8
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Vanessa,
“An expanded role for nursing in the strategic planning and implementation of health information technology (health IT) efforts is warranted for many reasons – some pragmatic and others evidence-based. And, not to be overlooked is the basic fact that nurses are trusted by patients and play a significant role in their care1.
Major events (e.g., HITECH act; PPACA) have accelerated the pace and promise of health IT to support improvements in care delivery, efficiency, and population health. They have also raised concerns about the feasibility of moving forward, absent significant workforce re-alignment. Furthermore, the technical, policy, and workflow challenges associated with executing such large-scale health IT transformations are already causing strain which will require the early and active involvement of nurses who can serve as leaders in this transformation.
Dr. Mattis
References
Robert Wood Johnson Foundation. (2022). Early and Often: Engaing Nurses in Health IT. Retrieved form https://www.rwjf.org/en/blog/2011/12/early-and-often-engaging-nurses-in-health-it.html
7 months ago
Heather Hill
Response #2 – Week 9
Vanessa,
Great points about the importance of nurse involvement! I really like how you brought up nurses having the ability to critique even the existing programs not just helping to create new ones. Nurses and providers are the frontline workers and on hand users when it comes to healthcare technology, so not having them involved in the innovation process is detrimental to the patient. Consequences of not allowing nurses to participate in the suggested creation of new healthcare technology results in poor design (McGonigle & Mastrian, 2021). Electronic healthcare programs have increasingly improved over the past decade and will continue to grow with or without our help as providers. RNs and APRNs involvement will help improve patient outcomes and increase patient safety. It has been proven that electronic health records can increase the quality of patient care, improve collaboration of medical care, reduce medication errors, and increase the compliance of employees with guidelines (Tubaishat, 2021).
McGonigle, D., & Mastrian, K. (2021). Nursing Informatics and the Foundation of Knowledge (5th ed.). Jones & Bartlett Learning.
Tubaishat, A. (2021). The Adoption of Electronic Health Records in Primary Healthcare Settings. CIN: Computers, Informatics, Nursing, 39 (12), 883-889. doi: 10.1097/CIN.0000000000000755.
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Vanessa,
Thanks for sharing your thoughts. Would you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each phase can impact implementation?
Dr. Mattis
7 months ago
Vanessa Grant
RE: Discussion – Week 9
Dr. Mattis,
The new seven phases of SDLC include planning, analysis, design, development, testing, implementation, and maintenance.Defining the role of nursing in each of these phases clearly indicates the significance of input from the hospital’s largest user group.t is important both for nurses to understand a new technology, and for technology engineers to understand how the equipment and software will need to interface with the facility’s existing systems.
If they are not included on the planning and/or analysis stage: The plan migh not be compatible with the nurses’ facility’s needs.
If they are not included on the design and/or design stage: Nurses might no be able to understand how the interphase works.
If they are not included on the development stage: The use of the network interphase might be confusing for the nurses and they might not adapt to it easily.
If they are not included on the testing stage: The nurses will not be able to understand if the interphase works correctly.
If they are not included on the implementation stage: Nurses might not be able to use the interphase properly.
If they are not included on the maintenance stage: The nurses will depend on others on how to fix the interphase, not being able to do them themselves (even in times when it is necessary).
7 months ago
Megan Roesch
RE: Discussion – Week 9
Nurses’ involvement in the Systems Development Life Cycle (SDLC) with a new health information technology system (HITS) is crucial for success. The SDLC is composed of planning, analysis, design, implementation, and post implementation. There is potential for avoidable issues to arise in each stage which we will discuss in detail. We will also discuss my personal experience with new health information technology systems in my nursing practice and how inclusion in decision-making can be influential to the process.
The first phase of the SDLC includes planning, analysis, and design. This stage is beneficial to determine current needs and what the goals are by implementing change. Because nurses provide direct patient care they have a valuable perspective. A nurse’s experience ideally should help shape the plan and guide the remaining stages. Nurses can provide perspective on pros and cons to an existing HITS and how it impacts their job and patient care (Oakes, 2015). The consequence of not involving nurses during analysis is a lack of perspective and representation of end users, keeping in mind end users determine the success of healthcare projects (Martikainen, 2020). An issue that can occur during this initial phase is a lack of financial support (Jalghous et al., 2019). HITS can be costly and often are halted or cancelled due to the cost. Nursing staff can support and advocate for a new HITS to better patient care. This can help influence institutions to finance a new information system. Nurses may also use their union for advocacy.
The next stage of the Systems Development Life Cycle is implementation. Implementation includes installation, training, and “Integration of the system into daily work processes” (System development lifecycle, 2016). Again, the involvement of nurses based on their own experience will help in this stage. Nurses can assist by determining the best time to integrate a new health information system. Nurses may also help by training and educating other staff members on the change taking place. Another important role of the nurse in this phase is to obtain feedback, good and bad. That feedback then should be shared with the project team to make appropriate adjustments. The difficulty at this stage is gaining confidence and participation of the healthcare team. Hesitancy is not uncommon when it comes to change. Healthcare workers don’t always favor change, and this is where the nurses who are a part of the project team come in handy. During times of change, strong leadership is vital. The involved nurses have the opportunity to model to their coworkers a willingness to participate as well as a calmness (Boyal & Hewison, 2016). Hesitancy can also be a consequence of not involving nurses at this stage. Without nurses to help train and encourage participation, chaos can occur. Especially with the busyness of a typical day as a healthcare worker, adding a new HITS can lead to frustration and stress. As mentioned above, strong leadership can make all the difference.
The last phase of the SDLC is post implementation and maintenance. After appropriate changes are made, it is time to maintain the HITS. Nurse involvement continues to be imperative. Nurses can offer support to coworkers with frustrations or questions regarding the new health information technology system. They can also report feedback at this stage to make adjustments to better the information system. A challenge at this stage is the potential for dissatisfaction. The end users may not be happy with the change and upset due to it slowing down tasks or charting. Not involving nurses at this stage would be consequential. Similar to the implementation phase, post implementation benefits from strong leadership. Participation can be strongly influenced based on leadership. A potential issue at this stage is failing to anticipate long-term problems associated with the HITS. By having nurses involved, there are more minds on the matter. This means that nurses can provide input on potential future issues and offer suggestions to avoid them.
I have not had any experience with input in selection or planning of new health information technology systems in my nursing practice or healthcare organization. When there have been changes in the past that impacted our HITS, the only group of nurses that were interviewed were a small group of charge nurses. This has led to some frustration within the emergency department unit as many nurses feel their opinion was not represented. I can imagine that the impact of being involved is a positive one. Inclusion allows for greater feedback therefore, better chances at success with a new HITS.
References
Amunpreet Boyal, & Alistair Hewison. (2016). Exploring senior nurses’ experiences of leading
organizational change. Leadership in Health Services, 29(1), 37–51. https://doi.org/10.1108/LHS-03-2015-0005
Jalghoum, Y., Tahtamouni, A., Khasawneh, S., & Al-Madadha, A. (2019). Challenges to
healthcare information systems development: The case of jordan. International Journal of Healthcare Management, 14(2), 447–455.
https://doi.org/10.1080/20479700.2019.1658159
Oakes, M., Frisch, N., Potter, P., & Borycki, E. (2015). Readiness of nurse executives and
leaders to advocate for health information systems supporting nursing. Studies in Health Technology and Informatics, 208, 296–301.
Martikainen, S., Kaipio, J., & Lääveri, T. (2020). End-user participation in health information
systems (his) development: Physicians’ and nurses’ experiences. International Journal of Medical Informatics, 137, 104117. https://doi.org/10.1016/j.ijmedinf.2020.104117
System development lifecycle (sdlc). (2016). Michigan Technological
University. https://www.mtu.edu/it/security/policies-procedures-guidelines/information-security-program/system-development-
lifecycle/#:~:text=Implementation%20includes%20user%20notification%2C%20user,with%20the%20defined%20user%20requirements.
7 months ago
Vanessa Grant
RE: Discussion – Week 9
Hello Megan,
System development life cycle describes the process of planning, generating, developing, testing and implementing these. when a new technology is introduced, before it introduce into the market many people involves in this. people like software engineers, software developers, customers, users, and all stakeholders to the software will be involved in this process (Yourdon, 1988). Proper management of TI helps organizations obtain greater benefits from investments made in TI, helping to manage the service delivery and organization of IT activities within the processes from beginning to end (Murray & Crandall, 2006). Currently the use of TI has become essential for all businesses. Although the organization has personnel, processes and the best technology, it does not guarantee optimal results and utilities. A professional service management, responsible and focused on providing added value is what will bring quality of service to the company.
There are different methodologies for the efficient and effective management of IT services and their alignment with the business, each organization must adopt the set of best practices according to aspects such as size, sector, geographic location, policy and economy of the country in which it is located. The feasibility of the new program is evaluated in pilot testing, the kind of problems and difficulties will be listed, observed, and resolves them. all the parties observe the implementation and execution of these, each one noted the problems or difficulties involved in these and works to find solutions for them (Sangi, 2017).In order to be present in a market that is increasingly competitive, companies are not viable without proper customer service and without providing adequate support for the services offered (this type of reasoning applies to healthcare organizations too). The companies have to bet on the quality of the services, because the way in which the client perceives the quality and the means that exist to keep him satisfied is very important. In response to this situation, to ensure efficient IT service management (Usman & Nonyelum, 2018), 2018). Thanks to the control and subsequent continuous improvement of the service, using good practices as well as each of the SDLC phase objectives described in this section with the key results, for instance, a description of the recommended tasks, and a summary of the related control objectives for effective management may have positive repercussions throughout the process (Brewer & Dittman, 2018).
It hink it is essential for the project manager to establish and monitor the control objectives in each phase of SDLC while executing projects besides integrating the nurses in the process. The control objectives help to provide a clear statement of the desired results or purpose and should be used throughout the entire SDLC process as well as having the provision of IT-based Services and IT Infrastructure management.
References:
Brewer, J. L., & Dittman, K. C. (2018). Methods of IT project management. Purdue University Press.
Murray, M. J., & Crandall, R. E. (2006). IT offshore outsourcing requires a project management approach. SAM Advanced Management Journal, 71(1), 4. .
Sangi, S., Ilkan, M., & Tokgöz, H. Incorporating information security into IT project management (a proposed framework). IJCCIE 4 (1), 219–226 (2017).
Usman, A. S., & Nonyelum, O. F. (2018). Application of the Systems Development Life Cycle (SDLC) in 21 st Century Military Sector. IUP Journal of Information Technology, 14(1).
Yourdon, E. (1988). Managing the system life cycle. Englewood Cliffs: Yourdon Press.
7 months ago
Nellie Kiminta
RE: Peer response #2
Thank you, Meghan, for your discussion post. I agree with your discussion that nurses must be included in the implementation of the Systems Development Life Cycle (SDLC). Nurses are playing an increasingly important role in transforming the face of healthcare (Crisp et al., 2018). Through the help of nurse informaticists, nurses can be well-equipped to assess if a product is functional and beneficial to patients or whether it adds significantly to the burden of bureaucracy for healthcare professionals. Nurse engagement could aid in addressing common problems that arise due to poorly planned software and ensuring efficient utilization of resources in the healthcare system. I like how you discussed the effects of excluding nurses in each implementation stage. Although nurses are crucial in all stages, the one I perceive most vital is the planning, analysis, and design.
The planning, analysis, and design stage are the first stages in the SDLC. According to Okesola et al. (2020), these phases are vital because this is where the project team begins to comprehend what is required from the project and ensures that the project will be completed successfully. The nurses and the project team can meet to discuss the demand in each phase. The information supplied is applied to design the optimum system development goals and objectives. I agree that nurses provide direct patient care, and their opinion is vital. In the requirements description, a nurse outlines the requirements for creating specific outputs, which are then implemented into the system. Their knowledge should ideally assist in developing the strategy and guiding the steps of implementing the SDLC. Nurses’ positions and work are dynamic and challenging to complete. Thus, they need a sound information system that employs technology in various ways of patient care.
References
Crisp, N., Brownie, S., & Refsum, C. (2018). Nursing & Midwifery: The key to the rapid and cost-effective expansion of high-quality universal healthcare.
Okesola, O. J., Adebiyi, A. A., Owoade, A. A., Adeaga, O., Adeyemi, O., & Odun-Ayo, I. (2020, July). Software Requirement in Iterative SDLC Model. In Computer Science On-line Conference (pp. 26-34). Springer, Cham.
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Peer response #2
Hello Nellie,
Thanks for responding to Megan’s post and sharing your insights.
Dr. Mattis
7 months ago
Eshley Pinto
Reply 2 Eshley Pinto
Hi Megan
Your post caught my attention because I feel that I can certainly understand your frustrations. The emergency department functions very differently from the rest of the hospital. When the interviews with only a small group of nurses happened for system evaluation, the issues you might have been facing in the emergency department could have unfortunately, been easily overlooked. I can relate to that frustration because I work in a specialized unit as well, where we use an entirely different branch of the EHR system that the rest of the hospital units utilize. While it doesn’t compare to speaking to the system developers face to face, I have found that within my EHR there is a system feature where you can submit “tickets”. I’ve done this several times and have found it helpful more times than not. After submitting the help request, a system IT person contacts you directly and works to solve the issues that we’ve been experiencing. It takes time but I have noticed some improvements after speaking with them. It’s nice to know that at least someone is listening to your input from the back end. Nurses have a lot to offer for the transformation of digital health, in fact, the nurses have imperative value for advancing and influencing the tools and technology used within healthcare on a daily basis (Risling & Risling, 2020).
Your response was very detailed and informative in describing the phases of HITS development and implementation. HITS are an example of how important EHR’s and advanced technology is within healthcare. Often, nurses working at bedside are assigned to patients who may be confused or poor historians. When we are unable to obtain vital information such as patient history & allergies, we turn to the EHR to dig around and see if it can give us the baseline information needed to deliver safe patient care. There have been numerous times when I have asked patients and their family members if they have any allergies and they tell me that they have no allergies to medications that they recall, however when I cross check with the EHR, I have found listed allergies and the patient/family would respond by saying “oh yes, I forgot about that one”. Without a doubt, majority of nurses have experienced a similar situation. This scenario is a minimal example yet, nurses would take the importance of patient history into account when designing new systems to recommend efficient measures in navigating the EHR and facilitate finding vital pieces of patient information such as patient allergies. “The role of nurse has grown beyond helping the IT folks design electronic medical record (EMR) screens and choose equipment, it is now an integral part of the healthcare delivery and a differentiating factor in the selection, implementation, and evaluation of health IT in order to support safe, high quality, patient-centric care” (Verma & Gupta, 2017).
Eshley
References
Risling, T. L., & Risling, D. E. (2020). Advancing nursing participation in user-centred design. Journal of research in nursing : JRN, 25(3), 226–238. https://doi.org/10.1177/1744987120913590
Verma, M. P., & Gupta, S. (2017). Software development for nursing: Role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203. https://doi.org/10.5958/2454-2660.2017.00044.8
7 months ago
Jorge Trujillo
RE: Discussion – Week 9
7 months ago
Nellie Kiminta
RE: Peer response #1
Thank you, Jorge, for sharing your discussion. I concur with you that nurses are an integral part of health care delivery and should be included in each stage of the SDLC. Your discussion identified the consequences of not including nurses in SDLC implementation. Nurses’ active participation should be a part of the full system development life cycle. They are uniquely positioned to identify their facility’s IT needs, and their suggestions should influence the new programming steps of healthcare information technology development. I agree that not including nurses in this process could lead to the construction of an unproductive system that does not satisfy the demands of the staff and patients (Brennan & Wendt, 2021). I like how you addressed potential problems along the process and how the nurses could help. Apart from unproductive systems from failure to engage nurses, there are several other consequences. For instance, according to Salsabila et al. (2021), early engagement and faith are lost if the nurses’ attention is not captured at an early stage. It will be challenging to strike a balance since the new system introduces competing priorities, which lowers nurses’ morale, leading to frustration and the nurses’ loss of personal connection to the new system.
With these consequences, I agree that nurses should be included in each stage, and their ideas should be taken seriously to reap lasting benefits, including the formation of a special connection as they become committed to assisting patients and striving to improve care, and staying focused when the system is successfully implemented. Though your discussion specifically talks about the consequences of not including nurses during the implantation of SDLC, it is also crucial to identify its effects on patients.
References
Brennan, D., & Wendt, L. (2021). Increasing Quality and Patient Outcomes with Staff Engagement and Shared Governance. OJIN: The Online Journal of Issues in Nursing, 26(2)
Salsabila, R. N., Arif, Y. W. T., Listyorini, P. I., & Athiyah, U. (2021, April). Patient Clinical Data Integration in Integrated Electronic Medical Record System using System Development Life Cycle (SDLC). In International Conference Health, Science And Technology (ICOHETECH) (pp. 20-25).
7 months ago
Steven Owolabi
RE: Discussion – Week 9
Thank you, Jorge, for sharing your thoughts about why it is so important for nurses to be involved in every stage of the SDLC. New health technologies can and have been developed without a nurses input. However, when you measure the success and effectiveness of the technologies developed, those with a nurses input would fair better. These health technologies rely on nurses to implement and maintain, hence when nurses do not understand or have difficulties with implementation, patient care is negatively impacted (Hamer & Cipriano, 2013). Furthermore, when nurses do not feel comfortable or prefer a different method, the usage of that technology will decline, which will also lead to wasted investment and rely on delays with implementation due to additional training needs. Beyond healthcare organizations adopting new technologies, researchers advocate that nursing programs should create opportunities that enhance knowledge and usage of medical devices and innovative technologies (Castner et al., 2016).
Castner, J., Sullivan, S. S., Titus, A. H., & Klingman, K. J. (2016). Strengthening the Role of Nurses in Medical Device Development. Journal of Professional Nursing, 32(4), 300–305. https://doi.org/10.1016/j.profnurs.2016.01.002
Hamer, S., & Cipriano, P. (2013). Involving nurses in developing new technology. Nursing Times, 109(47), 18–19.
7 months ago
Victoria Cortes
RE: Discussion – Week 9
Jorge,
Great post. I enjoyed reading about China’s inclusion of a nurse in the process of the SDLC. I can’t see why nurses were never involved in this process, to begin with? “When the analysis of the EHR requests come from the frontline staff, it reinforces the notion that the clinical informatics team is listening to and supporting EHR enhancements for the personnel who actually use these systems.” (Blahna, 2015.) I was reading in another colleague’s post that staff nurses were so overwhelmed with a system that much of the patient load left because they felt nurses were too distracted. Nurses should be present at every level of the SDLC to ensure this doesn’t happen. “The design, development, and implementation of EHRs must support the needs of patients, nurses, and other clinicians delivering care. The clinical nurse has the responsibility to be this “voice” to the HIT department.” (Daly, P. 2015.) The lack of nurses in the process means that the genuine, personal, human aspect of healthcare will be absent in the systems. This will mean long, complicated, technical nonsense that isn’t necessary when nurses could be spending time caring for and building rapport with their patients.
Daly, P. (2015). Clinical nurses lead the charge with EHR, Nursing: October 2015 – Volume 45 – Issue 10 – p 25-26 doi: 10.1097/01.NURSE.0000471426.47075.d2
Blahna, B. (2015). How nurses can collaborate with EHR design. Nursing: December 2015 – Volume 45 – Issue 12 – p 25-26 doi: 10.1097/01.NURSE.0000473404.97294.02
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Jorge,
Thanks for sharing your thoughts. Would you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each phase can impact implementation?
Dr. Mattis
7 months ago
Angel Smith
RE: Discussion – Week 9
The Inclusion of Nurses in the Systems Development Life Cycle
Implementation is like the opening of a new play. Before implementing a process it takes a lot of work backstage for preparation and this is where healthcare providers would need to be trained prior to the implementation phase, like the video describes as the work behind the stage is done (Walden, 2018).
The process of developing a system, in any organization, also called the SDLC, requires creating the appropriate team members to manage the process (McGonigle & Garver Mastrian, 2022). With any new product such as a new documentation platform it is essential for nurses to participate with the first stages. This would ensure that if there were improvements needed for quality of care they would be able to identify those areas and work with IT to make adjustments (Verma & Gupta, 2017). An example for instance would be if a change was coming in how a nurse scans a medication prior to administration, the nurse can provide input on their current process of workflow and how to prevent any lapse that may incur medication errors.
One potential issue with an early stage of the SDLC process would be the time management of the system and workflow. Including a nurse would help with this because nurses are frontline workers who utilize the systems daily. The input and suggestions from the nurse will impact the time and workflow that best works for them to provide better care to patients.
Last year my organization put in place a new documentation system that our company uses now. I personally was not involved in the decision-making process for the new system, but there are nurses who were involved in other departments. An impact that directly affected those who work with the system daily to document but were not included in the early design stages is that some items included consisted of double documenting in the end. Assessments were put in place with drop down boxes or simple yes or no questions and at the end of the assessment we still were required to add a note including the same things we selected in the assessment. This directly effects our time management with our workflow. The concern was brought to the attention of leadership and is currently being reviewed.
References
McGonigle, D., & Garver Mastrian, K. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Verma, M. P., & Gupta, S. (2017). Software development for nursing: role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203–207. Retrieved April 26, 2022, from https://doi.org/10.5958/2454-2660.2017.00044.8
Walden University, LLC. (Producer). (2018). Systems Implementation [Video file]. Baltimore, MD: Author.
7 months ago
Shani Mays
RE: Discussion – Week 9 Response #1
Angel,
According to Wang et al., (2019), “The System Development Life Cycle (SDLC) is a unidirectional cycle that directs the planning, analysis, design, implementation, and maintenance of a nursing informatics innovation within the Informatics Research Organizing Model (IROM). The IROM incorporates evaluation as an iterative step, implying that evaluation is continuous and diffused at many stages in the innovation process”.
I agree with you that time management of the system and the workflow could be a potential issue in the early planning stage of SDLC. During the planning phase, the problem statement and goals of the implementation are defined, committee structures established, and the organization’s requirements are defined for selecting, implementing, or upgrading an EHR or application, including the implications for regulatory compliance for safe and quality clinical practice (Newbold, 2021). Establishing a committee composed of nurses to research and make recommendations for the project is also considered an important first step.
References
Newbold, S. K. (2021, July 29). System design life cycle: A framework. Retrieved from https://nursekey.com/system-design-life-cycle-a-framework/
Wang, J., Gephart, S. M., Mallow, J., & Bakken, S. (2019). Models of collaboration and dissemination for nursing informatics innovations in the 21st century. Nursing outlook, 67(4), 419–432. https://doi.org/10.1016/j.outlook.2019.02.003
7 months ago
Jacqueline Keener
RE: Discussion – Week 9
Discussion – Week 9 Response 1
Angel,
Thank you for sharing your knowledge of including nurses in all steps of the SDLC process. I think the opening of a new play is a wonderful example of different stages in a process. You highlighted a great part of the process by identifying the importance of the nurse and IT working well together. Collaboration and good communication are important in healthcare. A study by Lee, Lin, & Lee (2019) found that participants suggested including a nurse when implementing handover informatics systems (HISs) to “develop content based on the users’ needs.” Nurses are often the primary users of these implementations, and their input is invaluable. Zuriguel‐Pérez et al. (2018) did identify that a higher education in nursing resulted in higher abilities of critical thinking. There is truly something special about the critical thinking thought process of a nurse and how it develops over time. Evaluating outcomes is crucial to SDLC and nursing so it is natural that nursing would do well getting involved. Wang et al. (2019) illustrate the SDLC and how often in the process an evaluation should initiated. I agree time management and workflows are ideal for nursing input.
Thank you for a great discussion this week, I hope you get an opportunity to get involved in a process like this one time. I feel lucky to have been a part of the process of implementing an organizational upgrade!
Jackie
References
Lee, C.-L., Lin, W.-T., & Lin, S. Y. (2019). Perceptions and Experiences of Hospital Nurses
During Transition to an Electronic Handover Informatics System. CIN: Computers, Informatics, Nursing, 37(11), 591–598. https://doi.org/10.1097/CIN.0000000000000554
Wang, J., Gephart, S. M., Mallow, J., & Bakken, S. (2019). Models of collaboration and
dissemination for nursing informatics innovations in the 21st century. Nursing Outlook, 67(4), 419–432. https://doi.org/10.1016/j.outlook.2019.02.003
Zuriguel‐Pérez, E., Lluch‐Canut, M. T., Agustino‐Rodríguez, S., Gómez‐Martín, M. D. C.,
Roldán‐Merino, J., & Falcó‐Pegueroles, A. (2018). Critical thinking: A comparative analysis between nurse managers and registered nurses. Journal of nursing management, 26(8), 1083-1090.
7 months ago
Megan Roesch
RE: Discussion – Week 9
Angel,
You bring up some thought-provoking points in your post. As you mentioned with medication scanning, nurses have direct experience with the process therefore have valuable input for change. This is the same with any introduction of a new health information technology system (HITS). Nurses’ involvement throughout the System Development Life Cycle (SDLC) is vital for success. During the implementation phase, nurses have the opportunity to act as leaders and preceptors to their healthcare team (Yu-Wen et al., 2012). Nurses can help train others, answer questions, and overall assist in a smooth transition. When nurses encourage feedback, “adaptability is enhanced” (Gong, 2019). This is an important point to remember. Fostering an environment that welcomes change is key.
An issue that can occur during any stage of the SDLC is a lack of coordination between the informatics specialists and healthcare workers. The lack of coordination and communication interrupts workflow. Madhu et al. specifically identifies that a change in informatics has the potential to cause a disruption in critical care settings, which in turn can lead to patient harm and a negative impact on workflow. This is one main reason that nursing involvement in the SDLC is so important. We can avoid this potential mess by involving nurses and increasing coordination and communication.
References
Gong, Z., & Li, T. (2019). Relationship between feedback environment established by mentor
and nurses’ career adaptability: A cross‐sectional study. Journal of Nursing Management, 27(7), 1568–1575. https://doi.org/10.1111/jonm.12847
Reddy, M. C., Gorman, P., & Bardram, J. (2011). Special issue on Supporting Collaboration in
Healthcare Settings: The Role of Informatics. INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS, 80(8), 541–543. https://doi.org/10.1016/j.ijmedinf.2011.05.001
Yu-Wen Fang, Mei-Hua Wang, Ching-Hsiu Hsieh, & Pei-Ling Hiseh. (2012). The development of
competencies for informatics nurse: Survey of nursing educators’ perception. 2012 7th International Conference on Computing and Convergence Technology (ICCCT), Computing and Convergence Technology (ICCCT), 2012 7th International Conference On, 108–112.
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Angel,
Thanks for sharing your thoughts. Would you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each phase can impact implementation?
Dr. Mattis
7 months ago
Brandie Topinka
Week 9 Discussion
Week 9 Discussion
Nurses play an important role in the development of healthcare technology. If nurses are not incorporated in new technology changes it could have a negative impact on patient care. According to Nursing World, incorporating nurses in technology changes have increased compliance of usage upwards to 50% (The Critical Nature of Early Nursing Involvement for Introducing New Technologies, 2009).
The Systems Development Life Cycle (SDLC) has stages of development to incorporate a new technology into healthcare. Incorporating the stages of SDLC can greatly improve the quality of information systems (“A Systems Development Life Cycle Approach to Patient Journey Modeling Projects,” 2007). Let’s discuss the stages and importance of nurses being involved in this process.
Stage 1, 2, & 3: Planning, Analysis, and Design – Nurses should be involved in project planning and coming up with new ideas for technology. Planning, analysis, and design requires brainstorming and ideas on how the projected project will be implemented. Planning for a new technology in healthcare generally identifies that this technology will improve patient satisfaction and care. Nurses are the heart of all healthcare organizations and if they are not contributing to this stage of the SDLC it could mean decreased compliance with the nursing staff and decreased patient satisfaction in the new technology advancement.
Stage 4: Implementation – Implementing the project can help determine it’s effectiveness. If nurses are not involved in this stage it can get approved without proper testing. Putting the plan into action with nursing staff involved will advance healthcare technology and determine how well the technology is working. “The application of modern technology is an essential factor required for the advancement of nursing” (“Nursing and Implementation of Modern Technology,” 2016, para. 6). Technology implementation stage must involve nursing staff to allow them to use and incorporate this into daily practice. The nurses will be able to determine if there is any difficulty with this stage of the process and hopefully catch any problems before the next stage of testing and maintenance. This stage is important for nursing to be involved to ensure it provides proper workflow.
Stage 5: Testing & Maintenance – Testing and maintenance is required for technology to thrive. Without testing and upkeep technology advancements can diminish in credibility. If nurses were not included in this technology development stage we would be missing key components for sustenance. Nurses must give their input on how the technology is working in patient care and give feedback for improvements and fine-tuning.
Before I started at my current office they had recently changed EHR from AllScripts to EPIC. There were many meetings and trainings involving the clinical staff, nursing staff, and providers. Although these programs are not new technology the hospital system made sure the staff was fully trained and ready to take on the new technology and healthcare EHR. EPIC also has frequent upgrades and improvements where nurses are involved in the stages of SDLC to ensure proper function and new workflows.
References
A systems development life cycle approach to patient journey modeling projects. (2007). National library of medicine. https://pubmed.ncbi.nlm.nih.gov/17911847/
Nursing and implementation of modern technology. (2016). Signa Vitae, 12. https://doi.org/10.22514/sv121.102016.3
The critical nature of early nursing involvement for introducing new technologies. (2009). Nursing World. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Vanessa Grant
RE: Week 9 Discussion
Hello Brandie,
Some factors that can help to motivate nurses to participate in the SDLC,is by trying to influence health policy, putting forth a wide array of policy alternatives (McLaughlin & McLaughlin, 2019) others include: philanthropy, professional aspirations (for instance making a career as a nurse activist). A study shows that “Being involved was identified as a facilitator of nurse leaders’ participation in health policy development in Round 1. Involvement included having experience and exposure; being accorded opportunity; being present at all stages of policy development; seeking opportunity for participation and being active participants” (Shariff, 2014). On the other hand some of the barriers that prevent nurses to become advocates are: Conformity (lack of involvement), lack of enabling structures or support and lack of available resources (Shariff, 2014).
Besides that, nurses should constantly continue educating themselves on the latest topics and federal issues and use this information to make a difference. Whether it is as a floor nurse or a public advocate, their voice can influence the health of the community. Being well rounded and working in different settings can broaden the skills of any nurse. Legislators want to hear about the experience of the nurse because it is valuable and can help to improve the healthcare system.
References:
McLaughlin C. P., & McLaughlin C. D., (2019). Health policy analysis: A interdisciplinary approach(3rd ed.). Burlington, MA: Jones and Bartlett.
Shariff N. (2014). Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development. BMC nursing, 13, 20. https://doi.org/10.1186/1472-6955-13-20
7 months ago
Jessica Cochran
Week 9 Main Post
7 months ago
Brandie Topinka
Response #1 to Jessica Cochran
Discussion Response #1
Jessica,
Barcode medication administration (BCMA) has been known to reduce medication errors and improve efficiency (Tolley et al., 2022). The barcode was introduced into the healthcare systems in the late 1970s. Within nine years medication errors were reduced in a Kansas Hospital by 87% just by using barcode scanners. The FDA however, does not require them but highly recommend barcode scanners to improve patient care (Campbell & Josephine, 2020).
It’s clear that the barcode medication scanners are important for patient safety but only if they are working properly. It seems like these scanners always break down or stop working which leaves gaps in medication administration and increases the likelihood of medication errors. Having nurses involved in the scanner technology may help troubleshoot the errors the scanners seem to always encounter. Thanks for allowing me to contribute to you post!
References
Campbell, & Josephine. (2020). Salem press encyclopedia of health. Barcode technology in healthcare. https://doi.org/https://eds.p.ebscohost.com/eds/detail/detail?vid=15&sid=7b2a02f2-e912-40b2-8190-ab66e2b2d101%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=125600406&db=ers
Tolley, C. L., Watson, N. W., Heed, A., Einbeck, J., Medows, S., Wood, L., Campbell, L., & Slight, S. P. (2022). The impact of a novel medication scanner on administration errors in the hospital setting: A before and after feasibility study. BMC Medical Informatics and Decision Making, 22(1). https://doi.org/10.1186/s12911-022-01828-3
7 months ago
Monica Finley
RE: Week 9 Main Post #2
Discussion Reply Week 9 #2 Nursing Informatics
Monica Finley
Jessica,
Informative Post. The facility I work for went from all computerized charting to all electronic medical records. If you did not think for one minute that sent every person that was working in that facility into a tailspin you are wrong. Not one person that I know enjoys change or thrives on change. We must adapt and accept change. The stages of the System Development Life Cycle (SDLC) consist of planning, design, implementation, maintenance, and evaluation (McGonigle & Mastrian, 2022, p. 192). You use this if you are charting on paper, in computer or making and executing a plan.
All Electronic Medical Records have pros and Cons to them. It is very convenient if the electronic medical record keeps all the information up to date and it works all the time. As we all know every computer system does not work 100% all the time. When the computer system is not working this causes mass confusion and chaos for all people that are involved. EMRs are systems that serve as an electronic version of the patient charts in a healthcare provider’s office and contain the medical history of the patient in that one practice, allowing healthcare providers to track data—such as blood pressure or vaccinations—over time, identify which patients are due for checkups, and improve the overall quality of care within the practice. (“Electronic Medical Records: Pros and Cons | Virtru”, 2020). There are many pros and Cons to electronic medical Records, although After researching this article it appears that there are more disadvantages than advantages to Electronic medical Records. One of the major disadvantages is that it is expensive to get the system and then to train the entire facility on the system. One advantage is that you have all your information in one place and you can switch from one screen to another to find the appropriate information that you are looking for.
Digital workflows and cloud-based systems bring plentiful opportunities to healthcare organizations, but they can also carry significant risks for patient confidentiality and HIPAA compliance. EMRs and traditional methods of protection don’t always support the dynamic, rapid care collaboration needed for modern health systems, leaving users frustrated and putting care outcomes at risk. (“Electronic Medical Records: Pros and Cons | Virtru”, 2020)
References
Electronic Medical Records: Pros and Cons | Virtru. (2020). Retrieved 29 April 2022, from https://www.virtru.com/blog/electronic-medical-records-pros-cons/
McGonigle, D., & Mastrian, K. Nursing informatics and the foundation of knowledge. Jones and Bartlett Learning.
7 months ago
Jessica Cochran
Peer response #2
Week 9
Hi Monica, thank you for your response. I have had the electronic medical record (EMR) go down multiple times at work, and it does cause some problems. The significant part about that is being prepared. We all know that technology does not always function the way it should, but when it comes to patient safety and care, we must always have a backup plan. I developed a protocol because of the chaos that I saw the nurses in if the EMR went down. What amused me, though, was this is mental health, so we have always been paper charting, so if the technology does not work, you pull out the paper.
There are many pros and cons of an EMR and scanning devices. You mentioned the cost and the training. That is a con. At the same time, though, businesses have been given the opportunity multiple times to implement more informatics and even supplied with the monies to do so but have dragged their feet on implementing these technologies that have proven to increase safety and patient outcomes (McGonigle & Mastrian, 2022, p. 188). Understanding the situation or the needs of the hospital or company allows an understanding of a solution and how to address those needs (Agency for Healthcare Research and Quality, n.d.-a).
References
Agency for Healthcare Research and Quality. (n.d.-b). Workflow assessment for health its toolkit. https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge (Fifth ed.). Jone and Bartlett Learning.
7 months ago
Nellie Kiminta
RE: Peer response #4
Hello Jessica,
Thank you for your post. The discussion is full of great input and quite informative. I agree that nurses should be included in any technology implementation in the hospital, particularly during an SLDC process. Nurses frequently generate the data needed by advanced analytical techniques, making their data quality crucial. They should ensure that data is reliable and fair hence providing efficient tools is a critical component of a successful analytics program. A hospital that includes nurses in an SLDC process gains various benefits. According to Okesola et al. (2020), every stage in the SLDC is vital. It needs quality data collection from the hospital environment, mainly the patients. Nurses, as caregivers, spend much of their time with a patient, which qualifies them to offer suggestions on how technology might be applied and its effects on patients.
I agree with you that the exemption of nurses during the SLDC process can lead to poor design. Nurses are in an exceptional place to address the service’s fundamental demands, and their principles are crucial for efficient healthcare technology advancement. Thus, their exemption will negatively impact the data collected for the implementation of SLDC. Technology professionals, nurses, and the management team should agree on the implemented technology. This is because technology professionals are masters in their sector and are familiar with the workings of modern technology. At the same time, nurses are experts in their profession, and they identify the current nature of patient care and the frequent contact required between several health care professionals while delivering care. According to Konttila et al. (2019), nurses must comprehend new technology to understand how the equipment will interact with the hospital’s current programs. Involving nurses will result in a better SLDC process, which will allow them to do their jobs more efficiently, leading to a better outcome.
References
Konttila, J., Siira, H., Kyngäs, H., Lahtinen, M., Elo, S., Kääriäinen, M., & Mikkonen, K. (2019). Healthcare professionals’ competence in digitalisation: A systematic review. Journal of clinical nursing, 28(5-6), 745-761.
Okesola, O. J., Adebiyi, A. A., Owoade, A. A., Adeaga, O., Adeyemi, O., & Odun-Ayo, I. (2020, July). Software Requirement in Iterative SDLC Model. In Computer Science On-line Conference (pp. 26-34). Springer, Cham.
7 months ago
Roxanne Velasquez
RE: Discussion – Week 9
The development of each stage of the SDLC when purchasing and implementing a new health information technology system requires the input of various partakers. Nurses are an integral part of the development, in part that they would be the frontline users of the new system. There are consequences to not involving nurses in the planning, designing, implementing, and maintenance/evaluation of the SDLC. “Involving nurses who work at the point of care in all phases of introducing a new technology facilitates a smooth transition to using the new technology and increases nurses’ buy-in of the system” (Weckman & Janzen, 2009). In the planning stage, potential issues that could arise are that the developers could steer away from the purpose of the program, making it more specific to their own views of what the system should involve and how it should perform. By having nurses in the planning stage, the focus of the SDLC will be specific to the customer and well-designed. The design stage could have numerous issues, including external and internal. Some systems, such as the bar code scanner, should be well designed that it will allow a gloved hand to comfortably scan a barcode, also keeping in mind that there are a large population of nurses with small hands. Internaly, the system must be user friendly and easy to navigate. There should also be an easy access to the help desk for issues that could come about. By having a nurse in this phase, the team could ask quesitons on the things they like and dislike on the old system and keep those that they do like and enhancing the ones that they don’t. The implementation of the SDLC is an extensive step and involves installing the software and hardware, ensuring it runs properly, training providers, and developing policies and procedure for the system (Walden University, 2018). There are various issues that could be encountered in this stage, such as system malfunctions, providers find the system complicated, or and legal issues that were not discussed and addressed that could potentially put a halt on the initiation of the SDLC. A nurse would be vital in this stage because they would be very savy on the system because they were a part of the development of it. They would then be a trainer to other healthcare providers. Lastly, the evaluation/maintence stage is where the cycle ends and possibly start. Maintaining updates and getting feedback from the provider on how the system is working for the customers is extremely important. This is the point in which the developers will need to restart the process, such as working out kinks or redesigning a particular part of the system that is creating numerous issues. The nurse would be beneficial in this stage by helping the team to collect feedback from the nurses that she/he could share with the developers. This information is very important to the ongoing evaluation of the system.
I have not had the opportunity to be involved in the selection and planning of a new health information technology system in my nursing practice. The potential impacts of me not being included in the decision-making process is that I am not able to navigate through the new system so easily, also finding that some applications are not user-friendly. It takes up more of my time, ultimately taking time away from patient care. At times, there will be system updates and the formatting or organization will be different. I will then have to spend extra time trying to find the resources I once knew where to locate.
References
Walden University, LLC. (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.
Weckman, H., Janzen, S., (May 31, 2009) “The Critical Nature of Early Nursing Involvement for Introducing New Technologies” OJIN: The Online Journal of Issues in Nursing, Vol. 14, No. 2, Manuscript 2.
7 months ago
Paige Collins
RE: Discussion – Week 9
7 months ago
Roxanne Velasquez
RE: Discussion – Week 9
Hi Paige,
Thank you for your feedback on my post. I agree with you that nurses play an important role in all stages of software development. I would most definitely want to be a part of a new system development. As the saying goes, be a part of the solution, not the problem. Over the years, I’ve often heard negative comments from many nurses in regards to the software that the hospital uses but never have I heard a nurse want to be a part of a solution to fix the problem. The number of ideas and other information that a nurse could bring to the table, especially during the planning stage, could be tremendously useful. The nurses are able to explain the parts of the old system that are useful and the other areas that require more tweaking or to get rid of overall. “Involvement of nurses in initial phases of software development would ensure a better product which is different and more relevant clinically. Nurses need to participate in initial stages to identify improvement areas for quality patient care, where IT can contribute” (Verma & Gupta, 2017)
Medha Piplani Verma, Sandhya Gupta. Software Development for Nursing: Role of Nursing Informatics. Int. J. Nur. Edu. and Research. 2017; 5(2): 203-207. doi: 10.5958/2454-2660.2017.00044.8
7 months ago
Jordan Lozada
RE: Discussion – Week 9
Nurses are the frontline and chief users of electronic health record (EHR) systems, it only makes sense they’d have a major say in EHR design and upgrades. Unfortunately, however, in many facilities, EHR design is left primarily to IT and only minor input is taken into consideration from the nursing staff (Consequences of a Healthcare Organization Not Involving Nurses, 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. The planning, analysis, design, implementation and maintenance phases would not persist because nurses are the primary bodies that are hands-on. If they are not involved in the SDLC process, many errors could occur and a patient may become harmed or potentially die. Involving nurses who work at the point of care in all phases of introducing a new technology facilitates a smooth transition to using the new technology and increases nurses’ buy-in to the system (Weckman, 2009). In a research article I read, they did a study with a new EHR system in a 14-bed ICU unit where nurses and IT worked together to utilize the new system. As a result, Nursing documentation was fully digitized and was significantly improved in quality and efficiency. The wrong data, missing data items, and calculation errors were significantly reduced (Qin, 2017). At my current employment, I did not get any input on choosing the new health information technology. However, I was given extensive training in the new system we switch over to. The impact of not being included in the decision-making of a new system wasn’t too bad. I feel as if our team still succeeded even though we did not choose the system. Given the chance to be involved, I think we still would have ended up with the same EHR system because it seems to be the most popular and user-friendly.
References
Consequences of a Healthcare Organization not Involving Nurses. (2020, September 8). Nursing Experts. Retrieved April 27, 2022, from https://nursingexperts.org/consequences-of-a-healthcare-organization-not-involving-nurses/
Qin, Y. (2017, December 6). The effect of nursing participation in the design of a critical care information system: a case study in a Chinese hospital – BMC Medical Informatics and Decision Making. BioMed Central. Retrieved April 27, 2022, from https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-017-0569-3
Weckman, H. (2009, May 31). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. OJIN. Retrieved April 27, 2022, from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
Hello Jordan,
Thanks for sharing your thoughts. Can you describe the different phases of the SDLC and give examples of how the lack of nursing involvement in each stage can impact.
Dr. Mattis
7 months ago
Madeleine Rodriguez
reply #2
Jordan,
I also was not involved in developing clinical systems in my workplace. However, my organization constantly advises clinicians to reach out to the IT department with recommendations. I have done this numerous times with no response or noticeable changes. Most of the changes add additional steps and duplication. You and I are not alone in our feelings, and it is estimated that 92% of nurses feel dissatisfied with their current EMR system (Hoover, 2017). Most nurses, 69%, felt their IT department was ineffectual (Hoover, 2017). Nurses must be included in developing new systems to improve patient outcomes, quality care, and nursing satisfaction (Mcgonigle & Mastrian, 2022).
References
Hoover, R. (2017). Benefits of using an electronic health record. Nursing Critical Care, 12(1), 9–10. https://doi.org/10.1097/01.ccn.0000508631.93151.8d
Mcgonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.