The Inclusion of Nurses in the Systems Development Life Cycle
Respond to the two of post below
POST 1 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.
E: Discussion - Week 9
Top of Form
Initial Discussion Post
As nurses are healthcare providers that spend the most time with patients, it only makes sense that they be involved in policy making and health information technology system development. In the Systems Development Life Cycle (SDLC), it is crucial that the healthcare team assess what the priorities are, develop a strategy to deal with the problem at hand, carry out the plan, and gauge the success of the plan (McGonigle, 2017, p. 175). Studies show that many hospitals are using SDLC to advance hospital healthcare technology and policy in order to increase effective and efficient care and strengthen patient satisfaction and safety (Yingiuan & Ball, 2017).
In my hospital, I was involved in the Fall Prevention Plan for Emergency Room patients. Our team was made up mostly of bedside nurses, as they are the ones with the patients the most and can therefore determine the patients at highest risk for falls. We decided that the patients at highest risk for falls are the elderly, patients who have had a previous fall within the past 3 months, patients who use a cane or walker to ambulate, patients who are not aware of their limitations, and patients who are on medications such as anti-hypertensives. The team then developed a plan to deal with the problem. In our case, we decided to implement use of the Morse Fall Scale (MFS) to rate the patient's risk of a fall. This scale gives a score to each risk factor. A total score of 45 or more means that the patient is at a high risk for a fall. With this score, fall measures are put into place in order to ensure the highest level of patient safety. These fall measures include placing bright yellow socks with grips on the bottom on the patient, placing a bright yellow "Falls Risk" bracelet around the patient's wrist, using a fall alarm that is set off if the patient tries to get out of bed by him/herself, and placing a yellow "At Risk for Falls" sign on the patient's room door (Aranda-Gallardo et al., 2013). After this plan had been implemented and put in our computer system (Cerner) and made part of the patient assessment, our nursing team evaluated the plan monthly and determined how many falls occurred. By doing this, we could determine if putting the Morse Fall Scale into place was effective in protecting patients and ensuring their safety.
I believe that it is crucial that nurses be involved in this planning process and am happy to say that my fellow nurses and I were taken very seriously by nursing leadership in this decision making. Nurses are on the frontline and work with the patients the most of any healthcare provider. Therefore, they have firsthand experience to determine the patients' needs in order to ensure quality and safe care. While nursing leaders, such as managers and administrators, are certainly crucial, they are usually not involved with patient care and therefore cannot determine what the needs of the patients are.
References:
Aranda-Gallardo, M., Morales-Asencio, J. M., Canca-Sanchez, J. C., Barrero-Sojo, S., Perez-Jimenez, C., Morales-Fernandez, A., de Luna-Rodriguez, M. E., Moya-Suarez, A. B., & Mora-Banderas, A. M. (2013). Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis. BMC health services research, 13, 122. https://doi.org/10.1186/1472-6963-13-122
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Yingjuan, Cao, & Ball, Marion. (2017). A Hospital Nursing Adverse Events Reporting System Project: An Approach Based on the Systems Development Life Cycle. Studies in Health Technology & Informatics, 245, 1351.
Bottom of Form
POST 2
The Inclusion of Nurses in the Systems Development Life Cycle
The System Development Life Cycle is a process or model used to develop an information system (McGonigle and Mastrian, 2017). This model can be applied to various fields that require the use of electronic systems, and it is essential to utilize effective communication throughout the process in every field type (Bernstein, 2017). It is imperative to include nurses in each stage of implementing a new health information technology system in healthcare. This nurse believes one of the significant consequences of not doing so is an overall ineffective workflow. Nurses are the primary users of these systems and can provide the most beneficial insight. Without the nurse's input throughout the process, the system would eventually require a redesign, which would not be cost-effective.
There are potential issues at each stage of SDCL that the inclusion of nurses can assist with addressing. For example, in the beginning stage of planning and analysis, there could be issues with defining an objective or pinpointing the clinicians' needs. Nurses can easily discuss from experience what is clinically required from the system. During the design phase, nurses can help provide information on the system's elements instead of implementing the system, and then learning a particular aspect is not useful. Ineffective communication and a lack of skills are potential issues during implementation. Nurses would help relay information effectively and be involved with hands-on training. In the final stages, nurses can provide the best feedback and ongoing daily support.
According to Pepito and Locsin (2019), "Nurses should oversee the introduction of automated technology and artificial intelligence ensuring their practice to be more about the universal aspects of human care continuing under a novel system" (para. 3). When nurses are omitted, problems quickly arise. From personal experience, this nurse has not had any input on selecting or planning a new technology system. Recently a new depression screening scale was implemented into the current EHR but has required several changes. The objective was to eliminate duplicate screenings among the different clinics in the organization. Nurses were not included in the decisions made surrounding this new system, and it was found to hinder workflow instead of improving it.
References
Bernstein, R. (2017). Five System Development Life Cycle Phases. Concordia University Texas.
https://online.concordia.edu/computer-science/system-development-life-cycle-phases/
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge
(4th ed.). Burlington, MA: Jones & Bartlett Learning.
Pepito, J. A., & Locsin, R. (2019). Can nurses remain relevant in a technologically advanced
future? International Journal of Nursing Sciences, 6(1), 106–110. https://doi.org/10.1016/j.ijnss.2018.09.013
Bottom of Form
Respon
d
to the two
o
f pos
t below
POST 1
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
.
E:
Discussion
-
Week
9
COLLAPSE
Initial
Discussion
Post
As
nurses
are
healthcare
providers
that
spend
the
most
time
with
patients,
it
only
makes
sense
that
they
be
involved
in
policy
making
and
health
information
technology
system
development.
In
the
Systems
Development
Life
Cycle
(SDLC),
it
is
crucial
that
th
e
healthcare
team
assess
what
the
priorities
are,
develop
a
strategy
to
deal
with
the
problem
at
hand,
carry
out
the
plan,
and
gauge
the
success
of
the
plan
(McGonigle,
2017,
p.
175).
Studies
show
that
many
hospitals
are
using
SDLC
to
advance
hospital
hea
lthcare
technology
and
policy
in
order
to
increase
effective
and
efficient
care
and
strengthen
patient
satisfaction
and
safety
(Yingiuan
&
Ball,
2017).
In
my
hospital,
I
was
involved
in
the
Fall
Prevention
Plan
for
Emergency
Room
patients.
Our
team
was
ma
de
up
mostly
of
bedside
nurses,
as
they
are
the
ones
with
the
patients
the
most
and
can
therefore
determine
the
patients
at
highest
risk
for
falls.
We
decided
that
the
patients
at
highest
risk
for
falls
are
the
elderly,
patients
who
have
had
a
previous
fa
ll
within
the
past
3
months,
patients
who
use
a
cane
or
walker
to
ambulate,
patients
who
are
not
aware
of
their
limitations,
and
patients
who
are
on
medications
such
as
anti
-
hypertensives.
The
team
then
developed
a
plan
to
deal
with
the
problem.
In
our
c
ase,
we
decided
to
implement
use
of
the
Morse
Fall
Scale
(MFS)
to
rate
the
patient's
risk
of
a
fall.
This
scale
gives
a
score
to
each
risk