A Nurse’s Role in the Systems Development Life Cycle

While the process of developing and implementing a health information technology system may seem overwhelming at first, the systems development life cycle (SDLC) provides organizations with a framework to deliver efficient and effective information systems. Though the SDLC is a common overarching structure for implementing information systems, it is not a one-size-fits-all process. In fact, there are a multitude of approaches that can be used to guide the systems development life cycle. The SDLC approach that is most appropriate for a particular organization will be highly contextual and subject to organization-specific differences.

This week prompts you to analyze the process of selecting an appropriate health information technology and then evaluate techniques that positively impact the steps of the systems development life cycle in an EHR implementation. You also determine what barriers might occur at each stage and how these could be overcome.

Learning Objectives

Students will:

• Analyze how a nurse can contribute to each stage of the systems development life cycle

Photo Credit: Jose Luis Pelaez Inc]/[Brand X Pictures]/Getty ImagesCredit 

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

• • Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making”This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.

• Chapter 11, “Administrative Information Systems”This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.

Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change. Consulting Psychology Journal: Practice and Research, 63(2), 138–148.

Retrieved from the Walden Library databases.

 

The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.

Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective. Journal of Nursing Research, 19(2), 150–160.

Retrieved from the Walden Library databases.

 

The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated that self-efficacy, top management support, and the quality of information retrieved are the most important determinants of the willingness of nurses to adopt and use a new technology.

Kelley, T. F., Brandon, D. H., & Docherty, S. L. (2011). Electronic nursing documentation as a strategy to improve quality of patient care. Journal of Nursing Scholarship, 43(2), 154–162.

Retrieved from the Walden Library databases.

 

This article summarizes a literature review of the relationship between electronic health records (EHRs) and quality of patient care. The article identifies deficiencies in existing research regarding the daily interactions of nurses, patients, and electronic documentation, and it provides a comparison between electronic and paper-based documentation and its effect on quality of care.

Nurse leaders discuss the nurse’s role in driving technology decisions. (2010). Virginia Nurses Today, 18(1), 8–9.

Retrieved from the Walden Library databases.

 

This article summarizes a roundtable held with a number of nursing executives to discuss the role nurses should take in the selection and adoption of new technologies for health care. The executives concluded that the nurses’ goals should be to select technology that will further their ability to provide safe, quality care to their patients.

Page, D. (2011). Turning nurses into health IT superusers. Hospitals & Health Networks, 85(4), 27–28.

Retrieved from the Walden Library databases.

 

This article highlights the importance of involving nurses with all phases of the decision and implementation process surrounding new health information technology. The author stresses the importance of communication in the process as well as defining success.

Swab, J., & Ciotti, V. (2010). What to consider when purchasing an EHR system. hfm(Healthcare Financial Management), 64(5), 38–41.

Retrieved from the Walden Library databases.

 

In this article, recommendations are given for purchasing health information technology. These include selecting the appropriate vendor, carefully considering the cost of both new equipment and personnel, and involving clinicians in decisions.

 

Successful Implementation of Electronic Health Information Technology

Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions?

This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process.

To prepare:

• Review the steps of the systems development life cycle.
• Think about your own organization, or one with which you are familiar, and the steps the organization goes through when purchasing and implementing a new HIT system.
• Consider what a nurse could contribute to decisions made at each stage when planning for new health information technology. What might be the consequences of not involving nurses?
• Reflect on your own experiences with your organization selecting and implementing new technology. As an end user, do you feel you had any input in the selection or and planning of the new HIT system?

ASSIGNMENT: Post an analysis of the ramifications of an organization not involving nurses in each stage of the systems development life cycle when purchasing and implementing a new HIT system. Give specific examples of potential issues at each stage and how the inclusion of nurses could help avoid such issues.

• APA FORMAT
• 2 pages
• minimum 3 references

In each case, answer the questions at the end of the case and give to support your assertions; also, explain what would be the ethical course of action and the legal requirements for action in the case. 3 pages minimum with intellectual well thought out and masters level writing.

Case One

Mrs. Lewis was head nurse on a medical surgical floor in a community hospital with 250 beds. Over the course of 6 months, she noticed that all patients admitted from the Shady Rest Nursing Home had signs of severe injuries other than those connected with the admitting diagnosis. There appeared to be patient abuse in the nursing home. Mrs. Lewis investigated discreetly and found no explanation possible except abuse. In accord with the obligations of the law in her state, she reported the matter to the Department of Welfare Bureau of Inspection.

The Welfare Department investigated immediately, found proof of abuse, and threatened to close down Shady Rest if there were any more recurrences. Mrs. Lewis was overjoyed until her hospital administrator, bypassing the director of nursing, called her in and warned her that she would be fired if she reported any other instances of abuse. Shady Rest sent the hospital a lot of business, and good relations had to be maintained.

Mrs. Lewis was even more shocked when she discovered that the administrator was a golf partner of the owner of Shady Rest and was doing an old buddy a favor. Despite fears of retaliation, Mrs. Lewis consulted a lawyer, who threatened the hospital with exposure and with penalties that would follow if one of its employees failed to follow the reporting provisions of the law on abuse in nursing homes.

Did Mrs. Lewis act correctly? What should she have done if she could not have afforded to consult with a lawyer? In what ways can whistle-blowers protect themselves? Must the art of intimidation be part of the toolbox of healthcare professionals in order to protect their patients? Is power an appropriate consideration in healthcare ethics?

Case Two

On a July weekend, Mrs. Allesfertig, nursing supervisor of the whole hospital, discovered that the intensive care unit was seriously understaffed. She pulled two nurses with previous ICU experience off other floors to bring the unit up to strength in view of the extreme level of acute care needed. On the following Monday, Dr. Bestknabe, who has overall responsibility for the ICU unit, closed the unit for further admissions until the staffing had been worked out on a permanent basis.

Should the new staffing policy give the nurses authority to refuse to admit patients when the staff is not sufficient to handle them? (In some hospitals, nurses have this authority.) Can any policy take precedence over the professional judgment of trained ICU nurses?

ACTION: Select one of the historical figures and their associated public health topic

• Margaret Higgins Sanger/Reproductive health
• Rachel Carson/Environmental health
• Franklin D. Roosevelt/Health care administration
• John Snow/Communicable and infectious disease
• Luther T. Terry/Smoking
• W. E. B. DuBois/Social determinants of health
• Larry Kramer/Health activism
• An individual of your own choice: YOU MUST OBTAIN INSTRUCTOR APPROVAL IN ADVANCE

ACTION: Research the individual’s background

• GRADED ELEMENT: Describe your selected person’s biographical background (i.e. experience).
  • HELP: This can include resume elements such as birthdate, location, education, and brief statement of their contribution to public health. (Reminder: biographical information can be easily plagiarized. Please do not copy from your biographical websites. Paraphrase and/or quote and cite everything according to APA.)

ACTION: Research the barriers and issue of the time

• GRADED ELEMENT: Analyze the climate of the time period in terms of political, socioeconomic, environmental and technological context in which this person worked
  • HELP: Think about whether this person was up against resistance or was their work welcomed. [For example, if you were writing on Abraham Lincoln and the abolition of slavery, you would note that slavery was prevalent and accepted at the time and the change was welcomed by some and rejected by others]
• GRADED ELEMENT: Examine the personal beliefs of your person that prompted this work.
  • HELP: You are basically addressing the question: “Why did this person get involved with the issue at the time?” [In continuing the Lincoln example above, you would note that black people were considered property, not people; yet Lincoln believed everyone had equal rights regardless of skin color].

ACTION: Think about how this person overcame the barriers and issues

• GRADED ELEMENT: Examine how this individual overcame and/or confronted any adversities to succeed in his/her task
  • HELP: Questions to consider: What did the person specifically do? Did they have any allies? How did their actions succeed/fail?

ACTION: Think about the importance of the contribution to community/public health at the time

• GRADED ELEMENT: Describe the final outcome of this individual’s contribution to community and/or public health
  • HELP: Think about this question: What occurred as a result of this person’s action?
• GRADED ELEMENT: Explain what his/her contribution did for overall community and/or public health at the time
  • HELP: Think about this question: What was the purpose for the community and/or nation? [In the Lincoln example, the explanation would involve a national recognition of human rights of all people, regardless of skin color]
• GRADED ELEMENT: Explain why this contribution was so important at that particular point in history
  • HELP: Think about this question: What made this important for our nation? [In the Lincoln example, you would answer the question: Why was it so important that Lincoln freed the slaves?]

You have a choice of which format you wish to present your findings:
Format 1: Written Paper

• Must be at least 4 pages in length (not including title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.
• Must include a separate title page with the following:
  • Title of paper
  • Students name
  • Course name and number
  • Instructor’s name
  • Date submitted
• Must use five scholarly sources (one of those may be the course text).
• Must document all sources in APA style as outlined in the Ashford Writing Center.
• Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.