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 the 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, SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.

Discussion one that needs a response in APA 7 format and at least 2-3 references.(  Micheal )

The health care industry has met with numerous changes over the years; some of the changes lay emphasis on either the patient, the organization or its employees. Of the numerous changes any given health care institution experiences, the goal of patient safety and patient satisfaction preempts the motive for necessary changes to better serve our patient population while also bearing in mind the effectiveness of the interventions that the organization is implementing. For an institution saddled with the responsibility of rendering health care services to members of its community, it is often faced with the need for constant system development of their life cycle to enhance the efficiency of the services provided while also taking patient safety into consideration. “The first step in developing a system is to understand the problems or business needs. It is followed by understanding the solution or how to address those needs; developing a plan; implementing the plan; evaluating the implementation and finally maintenance” (McGonigle, 2017, p175)

     System development life cycle presents as the precursor to the innovations that trigger the much needed difference in terms of efficiency or safety, such changes sometimes suffer the brunt when nurses are excluded in the preliminary phases of planning leading up to its implementation. The consequence of not having nurses weigh in on the intended innovation includes but is not limited to having a poorly designed project since the design and planning was done without the end users input, the project may become obsolete months after its implementation for failing to meet the needs of the nurses with regards to efficiency in patient care and safety considerations. According to a Laureate video presentation by Stuart Speedie, “the goal of health care informatics and technology should be its interoperability.” (Laureate Education Producer, 2018)

     In a different light, if the nurses were included as prospective end users of this innovation, ideas generated from the conversation about the intended innovation will be viewed from many perspectives which will in turn make for a better design knowing what the end user desires for the innovation to be mutually beneficial to the institution and the patient population alike. At the institution that I work, the latest innovation was the inclusion of an automated Alaris infusion pump that synchronizes information across the electronic health record platform and the medication pyxis, the nurses did not have any input on the planning or design of this new innovation.

     The impact of not being included or consulted prior to designing and implementing this design were as follows; some medications were not compatible with the pump interface and will not accept manual entry this problem in its self constituted a missed medication for the patient hence delaying patient care, the network interface on the electronic health record platform was a bit confusing and needed more than just a day of orientation to say the least, over all the system launch was chaotic and stressful leading to loss of considerable man hours trying to figure things out on the go with little to no assistance especially for nurses working on the night shift. According to a Laureate video presentation by Kevin Johnson, “He highlights the need to acknowledge that the cycle is ongoing and never done even after its implementation.” (Laureate Education Producer, 2018)

                                                                                                             References

Laureate Education (Producer). (2018). Interoperability, Standards, and Security [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learn

Discussion one that needs a response in APA 7 format and at least 2-3 references.( Monica)

Discussion Week 9 Initial Post

Nursing is the largest healthcare profession in the world. According to the American Association of Colleges of Nursing (2020), there is an estimated 3.8 million registered nurses (RN) nationally and 84.5% of those nurses are employed in the healthcare setting. Nurses are so vital to healthcare organizations because they are hands on with rendering care to patients and oversee the overall care that the patient receives.  Nurses serve as patient advocates and are involved on every aspect of the patient’s care. They are the integral party with the responsibility to make sure that other healthcare professionals are doing their part to ensure that patients are receiving the safest and best quality of care. High in numbers and with such an intricate role in healthcare, nurses are the heartbeat of the hospitals, therefore it would behoove healthcare organizations to involve nurses in every aspect of care including the Systems Development Life Cycle (SDLC).SDLC is a process of addressing an identified need and putting a plan/system into operation. Phases of the SDLC include planning, analysis, design, implementation, and maintenance (Laureate, 2018). Nurses can contribute greatly to the process of selecting and implementing new health systems because they are hands on and see first-hand the needs of the patients and healthcare systems.

 If healthcare administrations fail to include nurses during the SDLC process of purchasing and implementing new information technology system, consequences could be failure to identify pertinent issues (Cleveland, 2019). The planning, analysis, design, implementation, and maintenance phases would not persist because nurses are the primary bodies that are hands-on and they are on the frontlines to witness how the whole process plays out. Nurses play a role that is essential to the success of the system.  During the planning process, nurses contribute by identifying needs. They collaborate with multidisciplinary teams to formulate a plan to prosecute. During the analysis and design phases, nursing informaticists play a huge role by assuring that the plan is suitable and of evidence based practices. After the best practices are identified, nurses then, implement by using the system. Over time, evaluation and maintenance is done by the nursing staff. This cycle of evaluation is ongoing with the goal of the system to become more efficient with each evaluation.

About 6 years ago, I was involved in the maintenance and evaluation phase of an information technology tool (Patient Touch) that was launched 2 years prior on the medical surgical floor. The Patient Touch, similar to an iPhone, allows healthcare workers to chart all care and nurses to scan and record medication administration,  It is a hand-held scanner that has many protective measures built in, and it allows workers of all entities to pull up useful information in a matter of seconds. It heavily supports evidence-based practice and has produced positive outcomes with patient care. To keep the momentum going, nursing informaticians made rounds monthly to see how using the Patient Touch was going and they asked for feedback on how to improve the tool. I mentioned to them an issue I had with it, while charting the nursing assessment using Patient Touch, there were a lot of assessment pieces that did not apply to medical surgical patients which prolonged time. There were a lot of assessments that ICU utilized, and I asked if there was anyway to eliminate the issue. A couple of months later, the informaticians implemented a division of the units and whatever unit selected, the nursing daily assessment was customized for each unit. This change eliminated a lot of unnecessary assessments that did not apply to medical surgical floor. It made a huge difference with charting and really improve our nurses time management. “Nurses play an active and vital role in electronic healthcare information system acquisition and upgrading project along- side their health informatics and IT colleagues (McLean, Frisch, &Roudsari, 2020). Nurses being involved with the SDLC process is necessary because they are the ones using the systems the most. Without the nurses’ input and expertise, healthcare administrations will miss the mark and the success rate of the tool would be minimized.

References

AACN. (2020). AACN fact sheet – Nursing. The American Association of Colleges of Nursing (AACN). https://www.aacnnursing.org/News-Information/fact-sheets/Nursing-Fact-Sheet

Cleveland, K. A., Motter, T., & Smith, Y. (2019, May 31). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No2-May-2019/Affordable-Care.html?css=print

Laureate Education (Producer). (2018). Systems implementation [Video file]. Baltimore, MD: Author.

Mclean, A., Frisch, N., & Roudsari, A. (2020, September 21). Nursing’s voice in healthcare IT acquisition decisions. Canadian Journal of Nursing Informatics. https://cjni.net/journal/?p=4248#:~:text=%20Nursing%E2%80%99s%20Voice%20in%20Healthcare%20IT%20Acquisition%20Decisions,senior%20nurse%20executives%20and%20leaders%20develop…%20More%20 

I –

After reading chapters 13, 14, 15, answer the next question. Remember you need to answer one peer in each DQ.

Discuss the characteristics and requirements that research tools should have on quantitative research to give validity to the study. Give some examples.

II –

Describe why you were to chose a specific method to select a sample over other methods. Defend the method you preferred.

Remember you need to answer to one peer in each DQ

 – MUST BE APA STYLE 7TH EDITION

– DO NO COPY AND PASTE ALL WORK MUST BE CITED

– USE THE ATTACHMENT BELOW TO ANSWER ALL THE QUESTIONS & Reference all sources you’ve cited within your content at the end of your narrative.  It is required that you use two current, scholarly resources in addition to your textbook. 

– ONE PAGE LONG OR TWO PARAGRAPHS AND IS FOR TODAY AT (10PM MIAMI TIME)

• Discuss how Therapeutic Use of Self and Culture impacts the nurse-patient relationship.
• Identify how Therapeutic Use of Self and your personal cultural heritage have impacted your role as a nurse. (I AM LATINO/HISPANIC)
• Provide an example of a situation, in your career; where patient interactions were enhanced or where barriers were evident;  in the nurse-patient relationship. (USE YOUR IMAGINATION BE CREATIVE I AM A NURSE THAT WORKS DOING SURGERIES)
• If there was a barrier, what was done or could have been done to remove the barrier?

From your readings, it is suggested that we as health providers, and, for the purposes of this class health promoters, must ask ourselves why we do what we do.  Philosophically, this question can be answered in terms of why we have a desire to help people live better lives.  Pragmatically, as per Dr. Martin, it has to do with why we choose the type of promotion programming that we do.  Consider in this assignment being able to articulate WHY you would want to take on a certain health promotion or disease prevention project.  Ideally, the key is to take on a project that is justifiable within your community versus taking on a project that you personally think is important regardless of what the community or targeted population perceives or really needs.  As outlined in the readings, it is easy to place energy into an activity that is somewhat successful but that ultimately misses a larger, more important goal. 

For example, a community program that teaches bicycle safety would seem like a worthy undertaking.  However, using information learned in the course, a needs assessment (evidence-based literature review) could show that bicycle injuries were very low in the target community while drowning rates were very high. Thus, efforts aimed at reducing bicycle injuries would be noble but would not be the best allocation of talent and resources. 

Therefore, the first assignment of this semester is for you to perform a PRELIMINARY NEEDS ASSESSMENT by performing evidence-based literature review. Once you identify a need, then you can start creating a solution.  This will specifically later on assist you in explaining and justifying what the needs are in your target population. Use the following process to PREPARE to do your needs assessment. 

· Review Healthy People 2020 documents and the objectives from 2020 Topics and Objectives (Objectives A–Z) Link: https://www.healthypeople.gov/2020/topics-objectives (Links to an external site.).  Also Table 1-4 (pg. 26) (Course required textbook).

·  Choose a numerical Healthy People 2020  objective with a HEALTH BEHAVIOR CHANGE  FOCUS for your anticipated health promotion/education program (examples include obesity, tobacco use, substance abuse, responsible sex behavior, mental health, injury, violence, immunization). 

·  Make sure that the Healthy People 2020 OBJECTIVE and associated HEALTH BEHAVIOR CHANGE  FOCUS is one that you can envision being able to develop into a ready to implement community health promotion intervention with a strong health education component as well as a strong health promotion and empowerment focus. 

·  Approvals are not required. However, you if you are considering a health behavior focus for your assignment that is not included in Healthy People’s Objectives, you the professor and obtain approval prior to assignment due date.

REQUIRED COMPONENTS for Assignment #1: THE PRELIMINARY NEEDS ASSESSMENT (PLEASE READ CAREFULLY)

The assignment should be typed out on a word document in APA format. Each paragraph should consist 5-6 complete sentences. The assignment should consist of 1,500- to 3,000-words (excluding title and reference pages). This assignment must be completed and submitted on a Microsoft word document.  

 APA format is required. 12 font size should be used, font names that should be used are Times New Roman or Cambria (not both), normal margins (no more than 1 inch), double spaced, indentation, etc. Please include title page that consist of your name (First and Last), Panther ID number and title of the article (APA format).In addition, include a references page that consist of three (3) references from creditable resources.

Requirements:

·  Document your targeted Objective and your Health Behavior Change Focus. State your chosen health behavior focus and targeted objective from HP 2020 and the Leading Health Indicator it relates to that you intend to address in your health education and program.

2- Document the need for a program related to your targeted objective.   Discuss the rationale or need for your choice to design a program to meet the targeted HP 2020 objective by reporting on the following:  a) Report on the documented health risk(s) associated with not meeting this objective.  b) State ALL of the HEALTH RISKS AND HEALTH CONDITIONS and DISEASES that are associated with the objective’s corresponding maladaptive health behavior. This is to be done by doing an evidence-based literature review using appropriate sources of secondary data.

Examples of appropriate sources include official statistical databases like National Center for Health Statistics, technical reports, scholarly journal articles and literature review articles. A practical example of this would be to perform a literature review that provides documentation of all pertinent health risks and conditions and diseases that are associated with one of the Healthy People Objective’s that deal with tobacco use, and that describes each of these health risks and diseases (lung cancer, chronic obstructive pulmonary disease). 

3- Report on the incidence and prevalence rates of the health risks and the health conditions and diseases that are associated with your chosen Healthy People 2020/2010 Health Behavior.  Report on any pertinent morbidity rates or mortality rates that are directly linked to your chosen Healthy People 2020 health behavior.  Report any temporal trends of incidence and prevalence rates of the health risks and health conditions and health diseases that are directly linked to your chosen Healthy People 2020 health behavior.  Locate research data and statistics from scholarly literature, trustworthy websites and statistical evidence.  You must provide incidence and prevalence rates on a national level.  Examples of appropriate sources of data include official statistical databases like NCHS and census database at www.census.gov (Links to an external site.), technical reports, scholarly journals and literature review articles). An example of this would be to expound upon the prevalence AND incidence rates AND TRENDS of INCIDENCE AND PREVALENCE RATES of lung cancer and chronic obstructive pulmonary disease for one of the Healthy People 2020/2010 Tobacco Use Objectives at the national level morbidity and mortality rates associated with lung cancer and chronic obstructive pulmonary disease.  

4- Report what the research and literature suggests to minimize the risk that is associated with not performing your chosen health behavior change and thus, to meet the Healthy People 2020 objective. This is also to be done by doing an evidence-based literature review using appropriate sources.  Examples of appropriate data sources include evidence base search engines, journals and resources such as Cochrane, Medline, Trip Database, and any other evidence driven journals or resources.  An example would be to search the literature for “evidence-based” methods and programs that have been most effective to accomplish the desired behavior change (like increase physical activity).

 There will be many instances where an ethical decision needs to be made during your career.  Because this topic poses so may different arguments, it is important you search your own personal values first as this provides the foundation of how you make or come to an ethical decision.  Your challenge this week is to write a 2-3 page paper of an ethical situation you were involved in, one you have seen in the news, or one you have found in your research.  In this paper I want you to state both sides of the decision being decided upon.  What side would you be on and why?  Use 2 professional references to support your ethical decision making.  Include one paragraph within your paper on your personal values that help you make an ethical decision. Please include a title sheet and a reference page.