Question

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.

Answer 1

Nurse’s Role in the Systems Development Life Cycle

Nurses are experts in the nursing domain and know the dynamic flow of the delivery of care including the interactions necessary among medical providers in the provision of nursing care. It is essential for nurses to have an understanding of new technology. Including nurses who participate at the point of care in each stage of implementing a new health information technology (HIT) promotes a swift transition to adopting the new technology. The systems development life cycle (SDLC) is a methodology for delivering efficient as well as effective and efficient information system that fits with the strategic business plans in an organization (McGonigle&Mastrian, 2015). ern HIT system development to foster nursing processes should employ an innovative measure in stimulating end users to use the technological potentials (Alkhafaji, &Sriram, 2012).)

Stages of the Systems Development Life Cycle

In health care organizations, the technology system simplifies the workload, which gets manually done, thereby bringing positive end results. The stages of the system development life cycle(SDLC) are revealed below.

1. Strategic planning on the HIT systems feasibility and applicability for enabling information delivery processes and procedures.

2. Analysis of the HIT system regarding their efficiency as well as the capabilities of the end-users to utilize the systems.

3. Designing the system efficiency for promoting health care services.

4. Implementation of the HIT system, taking subsequent attainable output into consideration.5. Maintenance of the whole system (Alkhafaji, &Sriram, 2012).

In healthcare organizations, the purchasing and implementation of a new HIT system remain the mandate of the managing director and the finance department. At the analysis stage, an organization may choose to develop the HIT system or purchase the system from a third party. It is essential to consider and determining the features the new system must enclose. Minus a properly comprehended and recorded goal for end-users requirements, the probability of a successful development process is impossible. During the designing stage, determining if the HIT system to be purchased will convene desired health care needs. An inclusion at this design stage is the infrastructure and hardware supporting this new system. Upon completion of the designing process, the next stage is implementing the new HIT system. For a newly purchased system, the implementation involves configuring the software, training users, converting data, as well as executing other physical activities. The maintenance stage, which is the final phase of SDLC becomes the system’s functions. This last stage includes reviews of post-implementation, utilizes in the evaluation of projects. This stage is crucial given that the advantages and disadvantages of projects offer recommendations for future projects (Gelinas, Dull, & Wheeler, 2011).

                Nursing Involvement

Nurses could contribute ideas like areas where more attention should be given in the first stage of the process, assist in the analysis procedure, as well as implementing plus maintenance of projects in their own knowledge including experiences.

Without user involvement, the probability of failing rises significantly. Nurses will implement new technology if they have had the chance to offer input during the planning and implementation processes via conducting trials of various kinds of equipment in various clinical sites, as well as the evaluation process by which nurses can confirm if alterations designed to promote the job environment have been efficient (Weckman, & Janzen, 2009). Informatics nursing involvement in completing a Healthcare Failure Mode and Effect Analysis with the nursing team before implementing the BCMAin hospitals registered a highly efficient process preventing adverse patient outcomes in BCMA implementation and eventual enhancement (Weckman, & Janzen, 2009). The team equally formulated the BCMA Contingency Plan that gets taught to new staff and gets tested yearly on all units, during busiest medication administration hours to ascertain nurse familiarity with the process (Weckman, & Janzen, 2009).

Consequences of not involving nurses

The consequences of not involving nurses may include lack of appropriate ideas to get beginner analysis as well as implementation, inability to operate the new HIT system by end-users. The project could fail due to the fact that nurses as end-users could miss the basic requirement of operating the system. Failure to involve nurses could produce equipment design flaws leading to costly situations that illustrate the absence of early nurse involvement. Organizations could create nurses who serve as “super users” or “champions” on units to motivate other nurses who may be reluctant to implement the HIT system. An example is the bar code scanning system that alerts nurses for possible medication error. Involving nurses in the system improves patient safety. Similarly, offering nurses the chance to trial equipment before purchasing may promote interest and ability to appropriately use the equipment. End users could initially fail to understand the technology well enough to fully maximize the HIT system. Nurses involvement in equipment design supports the ease and safe usage of such equipment. If organizations involve nurses in the design process, some early equipment concerns with BCMA may be prevented. When nurses provide input into actual medication practices plus equipment, workarounds get less frequent. Engaging nurses at an early phase helps to avoid adverse incidents as well as stress-related to technology. Providing nurses the chance to practice utilizing the system prior to implementation could decrease the learning curve for several users.

A vital step in planning is developing training plans with clarification of vendor participation. Equipment delivery points and times should be negotiated with all training materials and user manuals for new systems displayed on the nursing web page for easy accessibility. Organizations should collaborate with nurse managers to schedule training periods and encourage full stall participation. When organizations fail to address patient care needs, the project may fail or consume an extended implementation phase. Nurses could arrange for extensive patient orders, names, and barcoded medication labels to use in educating other staff in the new process. Nurses could select realistic patients to be utilized during trainings.

In the implementation stage, nurses offer relevant feedback concerning medication administration changes both at trial moments and post the official implementation of new technology. Implementing the BCMA system can get complex including scanning the wristband. Scanning failures can stem from smearing, spacing, barcode location or direction, durability when wet, plus patient comfort. These concerns can cause several workarounds by nurses. Nurses systematically investigated the challenges between the information printed on the wristband and the bar code printed next to it. This could stop possible future errors. Thus, nurses could address issues of age-related wear of wristbands that interfere with scanning. During implementation, nurses often indicate frustration with a lack of integration of the system and express concerns on the many changes in the planned improvements. Careful listening to nurses is crucial. It is reasonable to address these issues because system change in practice has the ability to bring a multiplier effect in other areas of workflow causing unanticipated and unfavorable consequences.

Nursing involvement in project evaluation. Focus groups with direct care nurses are very necessary in determining if concerns are unit specific or involve the whole stem. Talking to nurses could identify that workaround of bypassing the BCMA PROCESS or typing into the patient identification number instead of scanning the wristband is a practice pattern from severe system failure. Brief surveys could help to determine the intensity of a problem as well as identify practice patterns on compliance. Nurses can identify unnecessary steps in the BCMA system. Too many steps could cause workarounds and compromising patient safety. Nurses have the ability to evaluate the merits and demerits of further steps being considered and to offer decisions as to which steps are relevant for quality care.