Discussion: Inclusion of Nurses in the Systems Development Life Cycle Essay
Inclusion of Nurses in the Systems Development Life Cycle
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Due to the increasing popularity of information technology in healthcare, Systems Development Life Cycle (SDLC) is a phrase that nurses and other healthcare workers should get familiar with. The SDLC is a multistep model that helps plan and implement technological changes within an institution (Singletary & Baker, 2019). Because changes in an institution affect everyone, multidisciplinary teams must be involved in the planning, analysis, designing, implementation, and post-implementation phases of the SDLC. Nurses should be involved in every step lest the project fails to meet its targeted use. I participated in implementing electronic health records in my organization and learned a few things I present hereafter.
During planning, nurses play a vital role in providing system requirements, including details on the flow of information, data, documentation form, and how the system will relate to the nursing process, as well as enabling information exchange between departments (Singletary & Baker, 2019). Furthermore, nurses guide in addressing the risks associated with the system. At the analysis stage, nurses inform the team about the available resources and their conditions as well as lay down the care process, system requirements, and actions (Teo et al., 2019). Failure to include nurses in planning or analysis increases the risk of losing information on risks and resources, which may further jeopardize the subsequent steps.
During the designing phase, nurses are required to evaluate and determine the appropriateness of the system in aligning with the nursing process and action. Failure to agree on the design leads to the scrambling of the whole system, thus limiting implementation (Zadvinskis et al., 2018). The implementation phase is an integral phase allowing nurses to determine the functionality and workflow of the system before its launching and integration into practice. Without nurses in this stage, the system’s feasibility to the working process can not be determined. In the final phase of post-implementation support, nurses use the system and identify areas that require improvement to enhance the system’s efficiency (Zadvinskis et al., 2018). The exclusion of nurses from either step jeopardizes the whole system and makes the implementation process unrealistic. Therefore, nurses should understand their roles and be involved in every step of SDLC to improve care delivery.
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References
Singletary, V., & Baker, E. L. (2019). Building informatics-savvy health departments: The systems development life cycle: The systems development life cycle. Journal of Public Health Management and Practice: JPHMP, 25(6), 610–611. https://doi.org/10.1097/PHH.0000000000001086
Teo, W., Khoo, H. S., Tang, Y. L., Ng, Y., Chew, N., & Jong, M. (2019). Administrative and managerial skills for tomorrow’s medical professionals: A needs assessment. Journal of Graduate Medical Education, 11(4 Suppl), 200–202. https://doi.org/10.4300/JGME-D-18-01007
Zadvinskis, I. M., Garvey Smith, J., & Yen, P.-Y. (2018). Nurses’ experience with health information technology: Longitudinal qualitative study. JMIR Medical Informatics, 6(2), e38. https://doi.org/10.2196/medinform.8734
Discussion: 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.
Learning Resources
Required Readings
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
- Chapter 9, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” (pp. 191–204)
- Chapter 12, “Electronic Security” (pp. 251–265)
- Chapter 13, “Achieving Excellence by Managing Workflow and Initiating Quality Projects”
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Required Media
Walden University, LLC. (Producer). (2018). Interoperability, Standards, and Security [Video file]. Baltimore, MD: Author.
Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript
Walden University, LLC. (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.
Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript
Health IT Evaluation Toolkit and Evaluation Measures Quick Reference Guides
Health IT Evaluation Toolkit
This toolkit, which was designed to help project teams develop an evaluation plan of their health IT project, consists of three sections:
- Section I outlines a step-by-step process for a team to determine what the goals of a given project are, what is important to their stakeholders, what needs to be measured to satisfy those stakeholders, what is truly feasible to measure, and how to measure those items.
- Section II includes a list of measures that are often employed in health IT projects. Each of the provided tables includes a list of possible measures, suggestions on data sources that can be leveraged for each measure, cost considerations, potential pitfalls, and general notes.
- Section III contains some examples of a variety of implementation projects.
Download Health IT Evaluation Toolkit (PDF, 384 KB) (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison)
Health IT Evaluation Measures – Quick Reference Guides
The guides expand individually on some of the measures included in the Health IT Evaluation Toolkit and provide details about individual measures that can be incorporated into a health IT evaluation plan. Each guide includes a brief description of the measure, summary of current literature on the measure, measurement methodology, and study design and analysis considerations. The guides provide a starting point for evaluators in the development of an evaluation plan for a given measure.
- Impact of Health IT on Nurses’ Time Spent on Direct Patient Care (PDF, 112 KB): Monitoring nurses’ time spent on activities related to patient care allows organizations to measure whether the introduction of health information technology (IT) decreases administrative tasks, thereby potentially impacting nurse time spent on direct patient care.
- Improved Accuracy of Coding (PDF, 100 KB): Monitoring the use of current procedural terminology (CPT) codes can help organizations determine whether health information technology (health IT) improves coding accuracy and completeness by providing decision support for documentation activities.
- Length of Stay (PDF, 104 KB): This measure allows organizations to systematically assess the impact of implementing health IT with the intent to decrease inpatient length of stay (LOS).
- Medication Turnaround Time in the Inpatient Setting (PDF, 111 KB): Medication turnaround time is defined as the interval from the time a medication order is written (manually or electronically) to the time the medication was administered. Monitoring medication turnaround time in inpatient settings allows organizations to measure the impact of their health IT application on the increased efficiency of patient care.
- Patient Use of Secure Messaging (PDF, 122 KB): Monitoring the use of secure messaging by patients over time is one way to measure the success of the implementation of secure messaging functionality, which may be made available through a patient portal or a personal health record (PHR).
- Percentage of Alerts or Reminders That Resulted in Desired Action (PDF, 115 KB): Determining the frequency in which a given alert or reminder is executed may help assess its effectiveness.
- Prescribing Patterns of Preferred or Formulary Medications (PDF, 102 KB): Evaluating the prescribing patterns of preferred or formulary medications can help organizations determine whether health IT, in particular, electronic prescribing (e-prescribing) and computerized provider order entry (CPOE) systems with included formularies, impact the use of preferred or formulary medications.
- Percentage of Orders Entered by Authorized Providers Using CPOE (PDF, 107 KB): Monitoring who uses computerized provider order entry (CPOE) allows organizations to measure CPOE use by providers versus their proxies over time and is one way to evaluate the success of their implementation.
- Prescribing Patterns of Cost-Effective Drugs (PDF, 94 KB): Evaluating the costs of prescription drug expenditures can help organizations determine whether health IT, in particular, electronic prescribing and computerized provider order entry (CPOE) with clinical decision support, impact the use of cost-effective medications.
- Percentage of Verbal Orders (PDF, 94 KB): Monitoring the percentage of verbal orders allows organizations to measure the use of verbal ordering over time and whether that use is trending downward with the implementation of health IT, most commonly, computerized provider order entry (CPOE).
- Reduction in Hospital-Acquired Complications and Infections (PDF, 135 KB): Monitoring the number of hospital acquired complications and infections can help organizations determine whether health IT has impacted patient safety in hospital settings
Workflow Assessment for Health IT Toolkit
A key to successful implementation of health information technology (health IT) is to recognize its impact on both clinical and administrative workflow. Once implemented, health IT can provide information to help you reorganize and improve your workflow. This toolkit is designed for people and organizations interested or involved in the planning, design, implementation, and use of health IT in ambulatory care.
RUBRIC
Rubric Detail
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Select Grid View or List View to change the rubric’s layout.
Name: NURS_5051_Module05_Week09_Discussion_Rubric
| Excellent | Good | Fair | Poor | |||
| Main Posting | 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. |
||
| Main Post: Timeliness | 10 (10%) – 10 (10%)
Posts main post by day 3. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not post by day 3. |
||
| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
||
| Second Response | 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
||
| Participation | 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
||
| Total Points: 100 | ||||||
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