The Inclusion of Nurses in the Systems Development Life Cycle Discussions
The Inclusion of Nurses in the Systems Development Life Cycle Discussions
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 The Inclusion of Nurses in the Systems Development Life Cycle Discussions, SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.
Main Post
The American Nurses Credentialing Center establishes the system design life cycle (SDLC) as four key stages: planning and analyzing, design and construction, application and testing, and ongoing maintenance and evaluation (Newbold, 2021). Healthcare organizations must value nurses as a crucial team member during the SDLC process of purchasing and implementing a new technology system such as an EMR (Mcgonigle & Mastrian, 2022). Dire consequences occur when organizations exclude nurses from assisting or giving opinions about changes within the operation.
In 2018, nurses were recognized as the most prominent occupation within healthcare (Rosseter, 2017). With greater than 3. 8 million registered nurses in the United States, nurses are the leading providers delivering direct patient care within most healthcare organizations (Rosseter, 2017). Nurses are the primary users of the technology systems, and it can cause great difficulty for themselves and their patients if interoperability is not adequate (Walden University, LLC, 2018). When nurses feel they cannot adequately perform their roles and responsibilities due to organizational technology systems, they leave to find more suitable roles with better technology programs (Newbold, 2021).
The first stage of the SDLC includes planning and analyzing (Mcgonigle & Mastrian, 2022). This phase is where the organization must determine the new system’s needs (Mcgonigle & Mastrian, 2022). As previously stated, the nurses are the primary users of systems such as EMR to provide patient care. Therefore, the organization must include nurses to address the actual needs of the system (Mcgonigle & Mastrian, 2022). A planning and analysis team consists of shared governance, including multiple disciplines that brainstorm the concerns, needs, and goals desired from the new system (Mcgonigle & Mastrian, 2022). Excluding the nursing, perspective may result in a system resulting in the same issues as the preceding one if nursing needs cannot be expressed. Therefore, Buy-in from the nursing staff is crucial at this point.
Secondly, the designing and constructing phase of a system focuses on building a program (Mcgonigle & Mastrian, 2022). Nursing shortages are a considerable concern in today’s healthcare world. Meeting the needs of the nurse, patients, and support staff efficiently is of utmost importance. Excluding nurses’ influence on this phase results in a program designed based on a theoretical application versus a real-life situation. An IT team will design the program in a process that makes sense to them, not considering how a nurse juggling patient care and documentation needs the system to function. After utilizing many different EMRs, most nurses can tell the team functionality flaws and positives of previous systems that they would love to incorporate in one new system.
Third, application and testing include implementing the system (Mcgonigle & Mastrian, 2022). Not including nurses, the implementation could result in a disaster during this time. Nurses, such as informatics, contribute largely to this stage by being super users and assisting their co-workers in learning the new program in a smooth transition (Mcgonigle & Mastrian, 2022). Without this nurse’s participation, the transcription process will be long and disheartening for staff. Ultimately, this downtime takes away from patient care activities. An assessment of the system post-implementation allows nurses to provide feedback on changes to be made or any usability concerns (Mcgonigle & Mastrian, 2022).
Lastly, the maintenance and evaluation phase have no value if the primary users are not part of the process (Mcgonigle & Mastrian, 2022). How can one evaluate a system they have never used? Hospitals often update policies, protocols, formularies, order sets, etc. Nurses have the clinical knowledge the other team members on the IT team do not possess. As the organization has updates, the system will need to adjust accordingly (Mcgonigle & Mastrian, 2022).
I have left nursing positions due to organizations making poor technological choices. I imagine that nurses were excluded from many of these phases when purchasing or building these programs. As a nurse, I was never invited to participate in decision-making. I would have stayed in these positions within the organization if my peers had been included in the process. My last position utilized a terrible EMR system that required many steps and duplication. My peers and I made many requests to upper management and provided examples of functional flaws and how this delayed patient care. Excluding nurses from the SDLC process is likely to decline productivity, patient outcomes, and nursing satisfaction in these situations.
References
Mcgonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
Newbold, S. (2021). System Design Life Cycle: A Framework. Nurse Key. https://nursekey.com/system-design-life-cycle-a-framework/
Rosseter, R. (2017). American Association of Colleges of Nursing (AACN) Nursing Fact Sheet. Aacnnursing.org. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet
7 months ago
Nellie Kiminta
RE: Peer response #3
Hi Madeleine,
Thank you for your informative post. The primary role of a nurse is to ensure that each patient receives the direct and proper care that they require, which they do in a variety of ways. Before executing and monitoring their medical plans and treatments, they examine and identify the needs of their patients. Their work has a lot to do with patients. As a result, they understand what is beneficial for them and what can lead to medical difficulties. Nurses play an essential role in the implementation of tools and technology in hospitals because of their position. As a result, I agree with you that nurses must be valued as essential team members during the SDLC process of selecting and installing a new technology system like an electronic medical record (EMR). Each process in SLDC is critical, and any mistakes or assumptions may lead to a negative outcome. Nurses and patients are the most affected groups by poor implementation of SLDC (Kimm et al., 2020). I understand why you opted to leave your position after being exempted from choosing and implementing technology.
After implementing technology, nurses use it to treat patients or update their medical records. If they do not know how the machine operates or when it is not efficient, they have difficulty completing their tasks. Thus, leading to burnout, frustration, or quitting their work (Roth et al., 2021). To stop such consequences, they should be involved in implementing new technology, and their ideas should be heard. Nurses can help hospitals hire and retain nurses by ensuring they are exposed to decision-making participation settings. They can also create an environment that promotes high-quality medical care by improving patient safety. Moreover, even though nurses are affected when they are not involved in decision-making, they should establish common ground with the hospital management and agree on how the facility will be maintained.
References
Kim, J., Macieira, T. G., Meyer, S. L., Ansell, M., Bjarnadottir, R. I., Smith, M. B., … & Keenan, G. M. (2020). Towards implementing SNOMED CT in nursing practice: a scoping review. International Journal of Medical Informatics, 134, 104035.
Roth, C., Berger, S., Krug, K., Mahler, C., & Wensing, M. (2021). Internationally trained nurses and host nurses’ perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: a cross-sectional study. BMC nursing, 20(1), 1-15.
7 months ago
Roxanne Velasquez
RE: Main Post
Hi Madeleine,
Your post was very informative on this topic and an interesting explanation of the different stages of SDLC. I agree that nurses are so important in every stage. Nurses are the most trusted profession, this should be a strong characteristic in selecting a team for a SDLC. Nurses are trained to be very concise with documentation and skills to avoid medication errors. The thoroughness of their developed skills are an asset to the team. The future of nursing is quickly evolving into a world of “flexibility, autonomy, and support”(“The Future of Nursing: A paradigm shifting moment”, 2021). As the forefront users of the healthcare technology, nurse should be adamant about being a part of the development of new software systems. After reading a few posts from my colleagues, most said they were not a part of a SDLC. The question is “why?” I believe we should push to administration to make it mandatory to have nurses in this team of IT professionals. “And, as key staff involved in patient intake and information management efforts, they also know that well-designed IT systems are essential to support their own workflows as well as those of other care providers” (Rein, 2011).
The Future of Nursing: A paradigm shifting moment. (2021). https://www.nursingworld.org/practice-policy/innovation/blog/the-future-of-nursing-a-paradigm-shifting-moment/
Rein, A. (2011). Early and Often: Engaging Nurses in Health IT. https://www.rwjf.org/en/blog/2011/12/early-and-often-engaging-nurses-in-health-it.html
7 months ago
Monica Finley
RE: Discussion – Week 9
Main Discussion Post Week 9 Nursing Informatics
Monica Finley
Systems development life cycle (SDLC). What does this mean? SDLC is a way to deliver efficient and effective information systems that fit with the strategic business plan, which stems from the mission, of the organization. (McGonigle & Mastrian, n.d.). Creating the right team to manage is key to success. Nurses are the ones that understand the flow of nursing and what the patients need. The people that are making the policy’s need to be involved with the care. 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.
The first step in SDLC is to understand the problem s or business needs. After you figure out the problem then you can figure out how to address those situations and what you can do to help make all involved understand. SDLC is a way to deliver efficient and effective information systems that fit with the strategic business plan, which stems from the mission, of the organization. (McGonigle & Mastrian, n.d.). There are many different systems available to follow.
Waterfall model, Rapid prototyping, object-oriented systems development, Dynamic System Development Method, open source software, interoperability, There are many different stages to each of these models. The facility I work for uses Rapid prototyping. It seems they are always in a hurry to purchase and do not do the appropriate research to make sure this is the best product for this facility.
As a nurse you could always use your experience and expertise with the products and pass along the information that you have available so the directors can and will make an appropriate decision to help the facility and the patients that we care for.
References
McGonigle, D., & Mastrian, K. Nursing informatics and the foundation of knowledge. Jones and Bartlett Learning.
Weckman, H., & Janzen, S. (2022). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. Retrieved 26 April 2022, from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No2May09/Nursing-Involvement-and-Technology.html
7 months ago
Jordan Lozada
RE: Discussion – Week 9
Hi Monica,
I enjoyed reading your discussion post, it was very informative. Like you stated above, nurses understand the flow of EHR systems and how to care for their patients. 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). I think if we work together as nurses with eachother and IT, we could have better outcomes for EHR systems. According to an article I read, it stated that nurses will and do adopt new technologies if they have had the opportunity to provide input into the planning and implementation processes by conducting trials of various types of equipment in different clinical settings, and also the evaluation process by which they can confirm whether changes designed to improve the work environment have been effective (Weckman, 2009).
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/
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
Nicole Jane Marwa Nabua
RE: Discussion – Week 9
7 months ago
Nellie Kiminta
RE: Discussion – Week 9
The Inclusion of Nurses in the Systems Development Life Cycle
The involvement of nurses in all stages in the Systems Development Life Cycle (SDLC) when implementing a new health information technology (HIT) system is a crucial buy-in step to change and innovation (Jalghoum et al., 2021). Nurse involvement has become increasingly fundamental for a healthcare organization’s success and positive quality outcomes for the patients. When nurses are not involved in the SDLC process, there will be a loss of trust and competence by the nurses as they will feel their opinions do not matter in the organization. The nurses will be challenged with balancing the options at hand as a new system will likely introduce competing priorities reducing their interest as a result of burnout and frustration (Johnson, 2019). Failure to involve the nurses can result in the loss of engagement (Risling & Risling, 2020). Someone will no longer grab the initial attention of the nurses. Additionally, the nurses will lose their connection to the new HIT system as their beliefs and goals might not align with the organization.
There are potential issues likely to occur at each stage if the nurses are not involved in the implementation of the SDLC process while implementing a new HIT system (Jalghoum et al., 2021). For instance, during the planning phase, the likely issue is a lack of information about the project since there will not be a discussion or sharing of the project goals. In the analysis phase, there will be no reflection on the current procedures involved in the barcode system (Jalghoum et al., 2021). In the design phase, if nurses are not involved will mean a failed model and its process. The most important phase is the implementation phase, in which, if not involved, nurses will not give quality direct care to their patients or become active members in the nursing process (Risling & Risling, 2020). Failure to involve the nurses in the maintenance phase will mean that necessary changes will not be pointed out or enhanced to aid a smooth barcode system.
During the implementation of a new system, there is much thought, prioritization, planning, and implementation. It is frustrating for the hospital management to make decisions for the staff who do not know the necessity of the system to perform their jobs adequately. As McBride & Tietze (2018) describe, nurses should be involved from the planning to maintenance stages of a new system’s project. By including the nurses, the healthcare organization influences quality enhancement, cost management, information management, and patient outcomes. Therefore, it is fundamental to involve the nurses in the planning, analysis, design, and implementation stages to fully understand and efficiently navigate the system.
For instance, in my organization, the management decided to implement a barcode system to help streamline the patient admission process, track their medication, and efficiently identify each patient throughout their entire stay. At first, the organization did not involve the nurses, and only the information technology department was involved. The impact of not involving the nurses in the decision-making process resulted in a lot of confusion in the workplace since most of us did not know how to navigate the system to identify the patient information present in the system. The management had to reevaluate the strategy from the nurses’ feedback and adjust the process accordingly. The involvement of the nurses later after implementing the system wasted the hospital’s time and resources which would have been saved if the management had involved the nurses from the get-go.
In conclusion, the managers in a healthcare organization should ensure nurses are involved in the SDLC process to ensure that the integrity needed is guaranteed in the implemented HIT systems. Involvement of the nurses enhances adjustments to help protect the formation process and ensure there is no delay. Healthcare organizations should understand the significance of involving their nurses in the SDLC processes as it results in a guaranteed benefit to the organization and patient outcomes.
References
Jalghoum, Y., Tahtamouni, A., Khasawneh, S., & Al-Madadha, A. (2021). Challenges to healthcare information systems development: The case of Jordan. International Journal of Healthcare Management, 14(2), 447-455.
Johnson, L. A. (2019). Benefits of End-User Involvement in Project Management for Health Information System Projects: A Scoping Review.
McBride, S., & Tietze, M. (2018). Nursing informatics for the advanced practice nurse: patient safety, quality, outcomes, and interprofessionalism. Springer Publishing Company.
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
7 months ago
Nicole Jane Marwa Nabua
RE: Discussion – Week 9
According to McGonigle & Mastrian (2017), the Systems Development Life Cycle is a continuous series of phases that brings effectiveness and efficiency to an organization that implements a health information system that is expected. There are five phases in SLDC: planning, analysis, design, implementation, and maintenance (Walden University, 2018). Technology continues to advance in response to the needs of our growing population.
In Healthcare, technology has phenomenally impacted patient care services, patient safety, and work productivity, resulting in continuous research. According to the study conducted by Rizvi et al. (2017), poorly designed projects are caused by the exclusion of nurses in the development and planning of the system. Since nurses are primary end-users of systems and are familiar with workflow and processes in clinical settings, their input is essential.
Active participation of nurses in developing and implementing new technological systems is vital to ensure functionality and effectiveness in improving patient care. Every phase of the system development life cycle is essential to enhance efficiency and increase the degree of success in every project implementation with the participation of nurses (McGonigle & Mastrian, 2017). Identifying health technology problems with existing information is part of planning, the first phase of SLDC (McGonigle & Mastrian, 2017). The second phase involves input from the end-users, which requires an analysis of users’ expectations (McGonigle & Mastrian, 2017). Nurses have first-hand experience, and they are knowledgeable when dealing with challenges. Designing and integrating necessary specifications, interfaces, and features is the third phase of SLDC (McGonigle & Mastrian, 2017). The fourth phase of SLDC is implementing the system in the actual setting (McGonigle & Mastrian, 2017). As the primary users of the information systems, proper training and education are necessary to benefit the newly developed system. Finally, the final phase of SLDC is the maintenance of the system’s functionality (McGonigle & Mastrian, 2017). Nurses’ role is vital in developing and implementing a new system since nurses get to experience the challenges and effectiveness of the information system.
In our facility, the latest technological innovation was integrating a mobile vital signs machine that synchronizes the flowchart. The impact of not including nurses’ input during planning, analysis, and application in the SLDC is that some functions are limited. The synchronization of the patient’s vital signs as soon as it was taken saves time and lessens nurses’ workload. But even though nurses were not involved with the planning and design, necessary training and education were required to maximize the full extent of technology capabilities. Therefore, as the primary users of information technology systems, nurses’ active participation in identifying problems and designing new systems is crucial to ensure successful project implementation and fully serve the purpose of improving patient care delivery and increasing work efficiency in health care settings.
References
McGonigle, D. & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Walden University, LLC. (Producer). (2018). Systems Implementation [Video file]. Baltimore, MD: Author.
Rizvi, R. F., Marquard, J.L., Hultman, G.M., Adam, T.J., Harder, K.A., & Melton G.B. (2017). Usability evaluation of electronic health record system around clinical notes usage: An ethnographic study. Applied Clinical Informatics, 8 (4), 1095-1105. https://doi.org/10.4338/ACI-2017-04-RA-0067
7 months ago
Jordan Lozada
RE: Discussion – Week 9
7 months ago
Steven Owolabi
RE: Discussion – Week 9
7 months ago
Monica Finley
RE: Discussion – Week 9
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
7 months ago
Jacqueline Keener
Discussion – Week 9 Initial Post
7 months ago
Steven Owolabi
RE: Jacqueline Keener
Hi Jacqueline,
I agree with you that when nurses are not included in the adoption of health technologies, frustrations grow and can impact patient care. According to Strudwick et al. (2019) nurses are central players in the systems development life cycle from acquisition to implementation and optimization of new health technologies. Hence, the use of “Super Users” empowers nurses to be active in the implementation and training of new technologies. Additionally, there should be diversity in the nurses who are involved in the SDLC process. For example, (Jeskey et al., 2011) found that there were significant differences in usage and benefits of health technologies between day shift and night shift workers. In short, a diverse group of nurses should be involved at every stage of SDLC.
Jeskey, M., Card, E., Nelson, D., Mercaldo, N. D., Sanders, N., Higgins, M. S., Shi, Y., Michaels, D., & Miller, A. (2011). Nurse adoption of continuous patient monitoring on acute post‐surgical units: Managing technology implementation. Journal of Nursing Management, 19(7), 863–875. https://doi.org/10.1111/j.1365-2834.2011.01295.x
Strudwick, G., Nagle, L. M., Morgan, A., Kennedy, M. A., Currie, L. M., Lo, B., & White, P. (2019). Adapting and validating informatics competencies for senior nurse leaders in the Canadian context: Results of a Delphi study. International Journal of Medical Informatics, 129, 211–218. https://doi.org/10.1016/j.ijmedinf.2019.06.012 The Inclusion of Nurses in the Systems Development Life Cycle DiscussionsThe Inclusion of Nurses in the Systems Development Life Cycle Discussions
7 months ago
Heather Hill
Initial Discussion – Week 9
Stage 1 and 2 of the Systems Development Life Cycle (SDLC) include: planning and design which need to incorporate the medical expertise feedback from nurses because without their firsthand knowledge and frontline involvement those steps will be very hard to accurately complete. For example, nurses and all healthcare team members are the most involved with patient care, so contribution in the health program creation is vital. During development of a new health plan system, the layout must incorporate the organization’s active physicians and other healthcare team members in performing a thorough needs assessment (McGonigle & Mastrian, 2021).
Stage 3 of the SDLC is implementation which can be one of the most difficult stages in the process because it comes with change during initiation of a new healthcare system. Without employees having involvement in the implementation piece, such as nurses, they may feel threatened by the change and continue sticking to their old ways especially in fear of change (Granberg et. al, 2021). If the nurse or direct care givers are not involved in the initial steps of the design and planning, how well do you think the implementation step will go over? Here’s an example: An RN that has worked on the med surg floor of the hospital for the past 10 years has always charted her foley catheter care on paper charts and if this RN is not included in the initial steps of the developmental cycle, that same nurse will continue to go back to her old ways and refuse to learn a new way of charting electronically.
Stage 4 and 5 of the SDLC include both the evaluation and maintenance portion. Evaluation is a key component that needs to be taken very seriously to fix any issues users are having which could help protect patient safety. If the nurses or other healthcare members are not included in all the crucial steps to a program development, you will see the result of a waterfall effect. Waterfall effect simply means that the production from each previous step of the process flows directly into or becomes the beginning response for the next step (McGonigle & Mastrian, 2021).
During my time as a labor and delivery nurse we initiated the use of a new labor monitoring system. Four to six weeks prior to the new program going live, a handful of experienced nurses were trained as “super users”. These super users would help train the other staff during the implementation steps which helped ease any frustrations with navigating a new system. All users were required to complete 8 hours of training prior to the go live date. The training course needs to be treated like a real-life scenario and the programmers that created the system cannot assume that users can train themselves without the guidance because operation support is vital in the implementation step (Singletary & Baker, 2019).
Granberg, A., Matérne, M., Lundqvist, L.-O., & Duberg, A. (2021). Navigating change – managers’ experience of implementation processes in disability health care: a qualitative study. BMC Health Services Research, 21(1), 1–11. https://doi.org/10.1186/s12913-021- 06570-6
McGonigle, D., & Mastrian, K. (2021). Nursing Informatics and the Foundation of Knowledge (5th ed.). Jones & Bartlett Learning.
Singletary, V. & Baker, E. (2019). Building Informatics-Savvy Health Departments: The Systems Development Life Cycle. Journal of Public Health Management and Practice, 25 (6), 610-611. doi: 10.1097/PHH.0000000000001086
7 months ago
Shontrice Davis
RE: Discussion – Week 9
7 months ago
Eshley Pinto
Initial Reply Mod 5
7 months ago
Janelle McEwen
RE: Discussion – Week 9
Involving nurses in each stage of the SDLC when acquiring and executing a novel health information technology is critical for the organization success (Weckman & Janzen, 2019). Failing to involve nurses can result in a litany of consequences, including the loss of trust in the change process, and implementers experience and competence; loss of initial engagement as the nurses’ attention is not captured; difficulty to balance options as the new system introduces competing priorities that reduce the nurses’ interest causing frustration and burnout (Qin et al., 2017). Ultimately, the loss of personal connection with the new system since the nurses’ core beliefs and individual goals may not be aligned with those of the organization.
The SDLC stages involve the planning phase, analysis, design, development, testing, integration, and maintanence phases. Challenges can arise at any of the above SDLC stages. Lack of clear communication is a key barrier in the planning and analysis stages, causing confusion among the stakeholders of the information technology tool. All involved parties should clearly communicate with each other to avoid delays or hurdles during the development process (Forbes Technology Council, 2019). The lack of clear communication in the early phases may contribute to late requests in the design phase and delays in the development and piloting stages, since slight alterations in the novel health information technology system will necessitate a complete rework or re-training of the end-users (Forbes Technology Council, 2019). The main impediments often observed in the integration stage is inadequate knowledge of the usability and applicability of health information technology to improve efficiency in clinical settings.
For example, the lack of clear communication about the need to introduce bar-coded medication administration (BCMA) technology in the planning and analysis phases may delay the training necessary for the development phase. Besides, the lack of sufficient knowledge about how to use the BCMA will not only delay but also complicate the piloting and enforcement stages. Besides, improper training is likely to encourage workarounds in the maintenance phase.
Our hospital introduced a new EMR in the last summer and all nurses were included in every phase of decision-making. Nurses serve as agents or champions of change, who can help resolve the ineffective communication by providing inspirational leadership for other clinicians to follow (Shaw et al., 2018). Besides, nurses are equipped with leadership competencies and skills that will enable them to communicate the ultimate goal of technology to inspire others to align their behaviors and missions with the overall vision of the project. Consequently, the inclusion of nurses in decision-making reduces the odds of late requests, delayed implementation and testing, and increase buy-in behaviors.
References
Forbes The Inclusion of Nurses in the Systems Development Life Cycle Discussions Technology Council. (2019, June 5). 12Common software development obstacles and how to tackle them. Forbes. https://www.forbes.com/sites/forbestechcouncil/2019/06/05/12-common-software-development-obstacles-and-how-to-tackle-them/?sh=3db3c195e011
Qin, Y., Zhou, R., Wu, Q., Huang, X., Chen, X., Wang, W., Wang, X., Xu, H., Zheng, J., Qian, S., Bai, C., & Yu, P. (2017). 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, 17(1), 165. https://doi.org/10.1186/s12911-017-0569-3
Shaw, E. K., Howard, J., West, D. R., Crabtree, B. F., Nease, D. E., Tutt, B., & Nutting, P. A. (2018). The role of the champion in primary care change efforts. Journal of the American Board of Family Medicine : JABFM, 25(5), 676–685. https://doi.org/10.3122/jabfm.2012.05.110281.The
Weckman, H., & Janzen, S. (2019). The critical nature of early nursing involvement for introducing new technologies. OJIN: The Online Journal of Issues in Nursing, 14(2). https://doi.org/10.3912/OJIN.VOL14NO02MAN02
7 months ago
Patrick Mattis WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 9
7 months ago
Nahvote Forkom
RE: Discussion – Week 9
It is vital to involve nurses in each stage. SDLC is vital for the smooth transition from an older system to a new technological advancement. Leaving out nurses during the SDLC process results in a number of challenges. To begin with, if the nurses are not engaged, their attention may be lost to other things (Cherry & Jacob, 2016). Delivering while using the new system may become a challenge as the nurses may miss out on important steps in how to work with the new system. This is so since their attention is lost on other things. When nurses are unable to work with the new system, its use is not maximized for the betterment of the services offered and patient care.
Secondly, noninvolvement of the nurses results in a loss of trust between the implementers and the other workforce. The nurses may end up feeling undervalued and sidelined. The implementers may feel the nurses are incompetent to operate the new system. Due to a lack of trust, the resulting conflict of interest causes bad blood between the workforces. The new system comes with a number of new things to be implemented as well as priorities that may be different, requiring the nurses to learn how to operate it (French-Bravo & Crow, 2015). The new expectations bring frustrations to the work force, especially when they can’t navigate around using the new system, resulting in burnout. Another major challenge that may arise is a lack of connection between the nursing fraternity and the new system being implemented. The new system may come up with new strategies that contradict the values previously held by the workforce, and thus this cause may deter them from working towards achieving the goals of the organization.
Nurses’ involvement in each stage of the implementation triggers commitment to the new system. The nurses are additionally likely to be trained in how to work with the new system, thus improving healthcare outcomes (Stanley, 2016). The nurses are additionally committed to ensuring there is smooth transmission through the implementation of the new system. Failing to involve the nurses means they will have less time to familiarize themselves with the new system, which translates to poor performance of the system as many will be unable to work with the new system, which may be more efficient compared to the older system.
Our facility mainly focuses on mental health patients. To ease the follow-up process, we use a telehealth program that is monitored over cell phones. Both the nurses and the patients are able to engage with each other without having to meet up physically. The use of the system has significantly improved healthcare outcomes as patients no longer have to make physical visits to the clinic. Before the purchase and full implementation of the system, all the nurses were briefed and engaged during the transition process. All the employees were trained on how to work with the new system through workshops. Engaging nurses made the transition process go more smoothly because many of them had adequate knowledge and skills on how to use the new system (Stanley, 2016).
References
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
French-Bravo, M., & Crow, G. (2015). Shared governance: The role of buy-in in bringing about
change. Online journal of issues in nursing, 20(2).
Stanley, D. (Ed.). (2016). Clinical leadership in nursing and healthcare: Values into action. John
Wiley & Sons.
7 months ago
Brandie Topinka
Response #2 to Nahvote Forkom
Response #2
Nahvote,
Including nurses with the emerging telehealth visits is very important. Our healthcare administration also included the nurses in the e-learning modules of telehealth and how to help the providers operate and navigate through the program. It was very helpful when we were struggling during the beginning of the covid pandemic. A study was conducted under Health and Human Services (HHS) which determined that 97% of healthcare offices were doing some type of telehealth now since Covid19 (Aspr-tracie-covid-19-and-telehealth-quick-sheet, 2020).
According to Nursing Outlook, telehealth should be incorporated in basic and graduate level nursing courses since we now understand it’s imperative to quality care (Solari-Twadell et al., 2022). Understanding the importance of telehealth and the developing virtual technology nurses need to be involved in the necessary steps to make sure work flows stay smooth and manageable. Thank you for allowing me to contribute to your post!
References
Aspr-tracie-covid-19-and-telehealth-quick-sheet. (2020). https://files.asprtracie.hhs.gov/documents/aspr-tracie-covid-19-and-telehealth-quick-sheet.pdf
Solari-Twadell, P., Flinter, M., Rambur, B., Renda, S., Witwer, S., Vanhook, P., & Poghosyan, L. (2022). The impact of the covid-19 pandemic on the future of telehealth in primary care. Nursing Outlook, 70(2). https://doi.org/10.1016/j.outlook.2021.09.004
7 months ago
Jorge Trujillo
RE: Discussion – Week 9
Nahvote,
Thank you for your informative post; it has some points that stand out to me. The part that I could relate to was when you discussed the implementation process and how that frustrates nurses to the point where they do not use the system effectively. At the facility I currently work at, which is also mental health, we have experienced this exact problem. There was a brief training on a system that was confusing to staff and was not very useful. Due to this, many of the staff are not using the system correctly, and the organization is frustrated since its initial goal for the system is not being met. If the facility had engaged more nurses and nursing informaticists, this problem could have been avoided, and the implementation would be smooth. This is not exclusive to the facility I work. There are difficulties in many places due to poor leadership and a lack of incorporation of nurses (Laukka et al., 2020). A study suggests that more nurses be brought into the SDLC process to help mitigate implementation problems (Wang et al., 2019). Thanks again for your post!
References:
Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in hit implementation: A scoping review of the quantitative and qualitative evidence. International Journal of Environmental Research and Public Health, 17(8), 2865. https://doi.org/10.3390/ijerph17082865
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
Janelle McEwen
RE: Discussion – Week 9
Nahvote, translation of knowledge into rational care is as essential and pressing as the development of new diagnostic or therapeutic devices, and is arguably even more important (Qin et al., 2017). I agree with you that failure to involve nurses in every stage of change process, from inception through to evaluation phase decreases trust among nurses in the technology (Dagne & Beshah, 2021). The lack of trust engenders restraining forces and low buy-in behaviors among the nurses. Besides, the lack of buy-in behaviors promotes workarounds, which, in turn, contribute to poor health outcomes.
References
Dagne, A. H., & Beshah, M. H. (2021). Implementation of evidence-based practice: The experience of nurses and midwives. PLoS ONE, 16(8 August), 1–12. https://doi.org/10.1371/journal.pone.0256600
Qin, Y., Zhou, R., Wu, Q., Huang, X., Chen, X., Wang, W., Wang, X., Xu, H., Zheng, J., Qian, S., Bai, C., & Yu, P. (2017). 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, 17(1), 165. https://doi.org/10.1186/s12911-017-0569-3
7 months ago
Victoria Cortes
RE: Discussion – Week 9
Dr. Mattis and Colleagues,
“Nurses spend more time with patients than any other health professional…” (Schroeder and Lorenz, 2018.) It is because of this fact that nurses must not be left out of the integral role of involvement in the Systems Development Life Cycle. The SDLO is a process of developing systems with a life cycle. There are four major steps to this cycle: Planning, implementation, evaluation, and maintenance. (McGonigle & Mastrian, 2022.)
I believe that consequences will follow when nurses are not made a part of the SDLC process, especially in the implementation part of the process. Humans are creatures of habit and not many like change. The last thing a nurse wants to do during their already busy day is deal with change. Nurses involved with the implementation aspect of this process is vital. If a nurse is not involved in the planning of a system, a consequence could be a more complicated than necessary system. We know how to separate the meat from the potatoes. Less is more. We are with the patients more than anyone else, so we know what is needed in these systems and we know how to introduce the change. Evaluation is key to understanding if the system is doing its job, but evaluating the staff on how they are fairing with the system is a whole other evaluation. “Listening carefully to the comment and feedback from nurses, because 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, 2008.) Without nurses, This cannot be done. Unfortunately, I have never been able to have the privilege to be a part of this process, nor have any of the nurse leaders that I know or have worked with. I would say that a staff bedside nurse wouldn’t have a say in SDLO but nurse leaders would.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Scroeder, K., & Lorenz, K. (2018). Nursing and the Future of Palliative Care. Asia Pac J Oncology Nursing 5 (1) p. 4-8.
The Critical Nature of Early Nursing Involvement for Introducing New Technologies. Ojin.nursingworld.org. (2022). Retrieved 29 April 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 Victoria,
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
Shontrice Davis
RE: Discussion – Week 9
Hello, Victoria. I enjoyed reading your discussion post this week. It was very informative regarding the stages of software development life cycle. I agree with your take on the issue of not including nurses in the process of implementation of software.Their parts in innovation and change in healthcare facilities has been an issue that is growing everyday, yet such a huge part in the success of the implemented software. If nurses are a part of each stage of software development, they will be more likely to put their best foot forward in the implementation process (Cherry, Jacob, 2016). Being a part of each stage will also help nurses become more familiar with the software. Which, it will reduce their likeliness to become irritable towards the system (Stanley, 2017). Nurses’ involvement in the implementation of anything in a healthcare facility is the key to it’s success.
References
Cherry, B. & Jacob, S. (2016). Contemporary nursing: issues, trends, & management. Amsterdam: Elsevier Health Sciences
Stanley, D. (ed) (2017). Clinical leadership in nursing and healthcare: values into action (2nd ed.). Hoboken NJ: John Wiley & Sons, Ltd. Discussion: The Inclusion of Nurses in the Systems Development Life Cycle
7 months ago
Jorge Trujillo
RE: Discussion – Week 9
Victoria,
Thank you for your post and insight, I strongly agree that nurses need to be involved in the SDLC. As you noted, when nurses are not involved, it creates problems that can be ongoing. These issues can cause tension between administration, nurse managers, and staff nurses. There is already evidence that staff nurses struggle with nurse managers and the impact that nurse managers have on the unit (Khomami & Rustomfram, 2019). New software and technology are supposed to make workflow more efficient and aid in the improvement of healthcare quality and increase the satisfaction of nurses and patients (Lee et al., 2017). When nurses have a voice during the SDLC, more can be accomplished, and the process can be more seamless. Thanks again for your post!
References:
Khomami, H. M., & Rustomfram, N. (2019). Nursing efficiency in patient care: A comparative study in perception of Staff Nurse and Hospital Management in a Trust Hospital. Journal of Family Medicine and Primary Care, 8(5), 1550. https://doi.org/10.4103/jfmpc.jfmpc_37_19
Lee, T.-Y., Sun, G.-T., Kou, L.-T., & Yeh, M.-L. (2017). The use of information technology to enhance patient safety and nursing efficiency. Technology and Health Care, 25(5), 917–928. https://doi.org/10.3233/thc-170848
7 months ago
Nicole Jane Marwa Nabua
RE: Discussion – Week 9
Hello Victoria,
Thank you for sharing your thoughts. Functionality and usability of new projects can be successfully achieved when nurses actively participate in every systems development life cycle (Rizvi et al., 2017). I agree that nurses’ role in designing and implementing projects is essential because of their knowledge and first-hand experience. And as primary users of the new information system, their feedback will ensure effectiveness in improving patient care. According to McGonigle and Mastrian (2017), the inclusion of nurses in SLDC is essential to the success of new project implementation.
References
McGonigle, D. & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Rizvi, R. F., Marquard, J.L., Hultman, G.M., Adam, T.J., Harder, K.A., & Melton G.B. (2017). Usability evaluation of electronic health record system around clinical notes usage: An ethnographic study. Applied Clinical Informatics, 8 (4), 1095-1105. https://doi.org/10.4338/ACI-2017-04-RA-0067 ]
7 months ago
Lashonda Dingle
RE: Discussion – Week 9
When most people hear the word nurse, they envision a bedside nurse providing hands-on assistance. However, nurses have many roles and can provide care in different fields and specialties. Nurses can contribute to care in roles such as educators, researchers, consultants, administrators, and information. A nurse’s knowledge and input are vital and should be integrated more into today’s healthcare system. SCDL (system development life cycle) is defined as stages when selecting an information system. This process of SCDL is ongoing, which is known as development with a life cycle (McGonigle & Mastrian, 2022). When nurses are not used in the stages of SCDL, it can lead to results that can hinder efficient, timely, and cost-effective care. Nurses are the best to assist in each stage due to having a firsthand experience that can give insight into what needs to be included or excluded in developing the program (Verma & Gupta, 2017). A nurse’s involvement can help from the first stages by knowing how other nurses feel and what is needed for the proper standard of care. This allows us to focus on the issue and find the best solution that would be essential to the healthcare system. During the designing and implanting stages, nurses can work with IT to ensure that proper terminology is used for the appropriate standard of care. Nurses are the essential person to assist with an evaluation due to the credibility of what is needed from a nurse’s point of view.
As a nurse consultant, nurses are not used directly with IT in my current organization. IT will send emails or surveys, allowing staff to input changes for our Phoenix system. However, having a nurse involved with the IT team could help with time management and navigation system and decrease unknown cases or contact with individuals that are not in need (Farokhzadian et al., 2020). For example, using the initials “NHP “for Nursing Home Placement has been an issue due to the numerous types of patients and assessments needed for NHP. For example, NHP initials are used for individuals that are in the home/community that are seeking a nursing home, patients in a hospital that need a nursing home placement, and nursing home residents that are already in a nursing home but went to the hospital and now need to get back in. Using the same initials is an issue for the nurse conducting assessments due to not having the proper tools for the type of assessment before making contact. Each NHP case requires different information and forms to be used. A solution that nurses have advised the IT team is to use the first letter of the type of patient needing placement. For example, NHP- C (Patients in the community – Theses require home visits) and NHP-H (Patients in the hospitals) require proper documentation that hospital SW must upload, and NHP- NH (Nursing home provides all completed assessment forms). This example shows how including a nurse in a technology system is vital to providing the best patient care.
References:
Farokhzadian, J., Khajouei, R., Hasman, A., & Ahmadian, L. (2020). Nurses’ experiences and viewpoints about the benefits of adopting information technology in health care: A qualitative study in Iran. BMC Medical Informatics and Decision Making, 20(1). https://doi.org/10.1186/s12911-020-01260-5
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the Foundations of Knowledge (5th ed.). Jones & Bartlett Learning.
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
