A Nurse’s Role in the Systems Development Life Cycle
The system development life cycle (SDLC) is a comprehensive plan which details the modus-operandi of establishing or improving information systems. According to McGonigle and Mastrian (2018), the SDLC is a way to deliver efficient and effective information systems that fit with strategic business plans of an organization (p.175). The business plan of any healthcare delivery organization will facilitate administrative functions, clinician practice, improve patient care and advance the science of nursing (McGonigle and Mastrian, 2018). To that end a multidisciplinary team approach is necessary and nursing involvement critical.
Nurses are the majority of care-providers within healthcare delivery organizations, and thus the majority of the information systems end-users. End-user collaboration in all phases of the SDLC is vital to implementation success. The purpose of this discussion is to shed light on the ramifications a healthcare organization may face if nurses are not involved in each phase of the SDLC when purchasing and implementing a new health information technology (HIT) system.
The six phases of the SDLC are feasibility, analysis, design, implementation, test, and maintenance (McGonigle and Mastrian, 2018).
The objective of the feasibility study is to determine whether a project should be instituted and supported (McGonigle and Mastrian, 2018). The ramifications of not including nurses during this initial phase can result in developing a new HIT that will not be effective in achieving appropriate outcomes. Nurses are knowledge-workers and end-users which place them in a unique position for knowing what works. When nurses are excluded from this vital phase, organizations may adopt a new HIT system which may not improve patient care.
During the analysis phase, the requirements for the system are teased out from a detailed study of the business of the organization (McGonigle and Mastrian, 2018). Nurses are ultimately the coordinators and managers of patient care. The nurse interacts with all other members of the multidisciplinary team and has insight into the dynamics of work-flow. The ramifications of excluding the nurse in the analysis phase may result in missing the work-flow dynamics necessary to augment seamless care delivery. According to the Semantic Scholar, the task of the analysis phase which is prioritizing requirements by information technology experts should not be a replacement for the clinical judgment of nursing influence (Semantic Scholar, n.d.).
The design phase has a high and low-level design and interface. The multidisciplinary team decides what design is essential (McGonigle and Mastrian, 2018). The importance of nursing involvement in this phase is quite obvious. The new technology will be used primarily by nurses. Nursing involvement in equipment design makes the equipment simpler and safer for nurses to use (Weckman and Janzen, 2009). Ramifications of not involving nursing input in the design phase include adverse incidents, and technology-related stress (Weckman and Janzen, 2009).
During the implementation phase, the designs are brought to life through programming code (McGonigle and Mastrian, 2018, p. 179). Nursing contribution in the process of implementing HIT systems is essential. Not only do nurses support one another but have great influence on physicians as well. According to Page (2011), while improved care delivery and patient safety are primary drivers for nurse engagement, there often is an ancillary benefit of physicians learning the new HIT from trusted nurses and getting on-board (Page, 2011, p. 27). The ramification of excluding nurses in the implementation phase include dissatisfied, negative attitudes of the nurses influencing other end-users and ultimately adversely affecting the success of the new technology.
The testing phase is inclusive of five layers. (1) The individual programming modules, (2) integration, (3) volume, (4) the system as a whole, and (5) beta testing (McGonigle and Mastrian, 2018). This phase ensures functionality and working order of the HIT. The nurse end-user is best suited to make this determination. The ramification of not including the nurse in the testing phase is potentially putting forth HIT systems which lack efficacy in improving patient care and safety concerns. Nurses have the clinical knowledge and expertise to know what will work and provide feedback on needed adjustments.
It is necessary and expected that HIT systems would require maintenance. This phase includes user support through software changes that may occur over time (McGonigle and Mastrian, 2018). The future of healthcare delivery is an evolving inquisition for knowledge and technology to improve patient outcomes. HIT systems will never be static, but ever-changing to transform new information into best practice. The ramifications of not involving nursing into the maintenance phase include front-line users who are not cognizant with updates, available resources, and support, or software changes and direct caregivers who are lagging and may view HIT as a burden or mandated intrusion.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett Learning.
Page, D. (2011). Turning nurses into health IT superusers. Hospitals & Health Networks, 85(4), 27-28. Retrieved from the Walden Library databases.
Semantic Scholar (n.d.). Using SDLC methodology to implement HIT. Retrieved from https://pdfs.semanticscholar.org
Weckman, H., & Janzen, S., (2009). The critical nature of early nursing involvement in introducing new technologies. The Online Journal of Issues in Nursing, 14,2(2) doi:10.3912/OJIN.Vol14No02man02