When I think of the System Development Life Cycle (SDLC) and the significance of integrating nurses in every step of the process, I think of Meditech’s electronic health records, provider ordering system, and nurses charting system. Each phase will be thoroughly examined. Planning, design, implementation, and maintenance are all parts of the SDLC (McGonigle & Kathleen, 2018). My healthcare organization’s failure to include nurses and the implications of nurses’ lack of participation will be explained. The role of nurses in decision-making at each level will also be discussed, with potential concerns resolved as a result of nurses being included in the SDLC.
The nurses are responsible for evaluating the quality of care supplied to patients through technology, and their efficacy decides whether the care provided will provide the best possible results today. When the best restorative care is delivered, and the harmful care is avoided, maximum effectiveness is achieved, and this is accomplished once nurses are included in the system building process. It is hazardous to the patient’s health, safety, and well-being and the health organization as a whole to exclude them from decision-making on new systems.
Planning and Design
The planning phase begins with the organization recognizing an issue or business requirement, followed by developing a solution to the problem and methods for addressing it (McGonigle & Kathleen, 2018). Nurses would play an essential part at this stage because they are the ones who are closest to their institution’s deficiencies and the services that are offered. Nurses will emphasize what needs to be reinforced and give solutions and organizational goals. An interview with nursing personnel can be highly beneficial. In 2013, my organization realized they were technologically behind since we were still ordering and charting on paper; thus, the planning phase for the Meditech deployment began. All of the parties formed a team, and Meditech began talks to provide us with a software system to fulfill all of our requirements and needs.
We needed to catch up on technology and adopt an EHR, but only one nurse was on board. If more nurses had been involved in the planning and design phases of the Meditech software, there might not have been as many nurse charting concerns. A high-level design phase identifies what programs will be required and how they will interact with one another. A low-level design step allows stakeholders to assess each program’s capability tactilely. There is also interface and data design, which is the visualization’s layout and which data is required (McGonigle & Kathleen, 2018). Even though I have a lot of regard for the nurse involved and his many years of ER nursing experience still only one nurse’s input could not be enough.
A team of nurses would have been advantageous since it would have created a more substantial nurse presence with various experiences and more confidence as a team to advocate for the planning and design aspect of the nurses charting software. My business did not create a shared governance voice until after the installation phase when they uncovered the software’s many flaws through multiple complaints from doctors and nurses (Weekman & Janzen, 2009). The management was compelled to reevaluate and obtain input from nurses and alter the procedure due to the absence of nurses’ involvement. If everyone had been included from the outset, a lot of time and resources would have been saved.
Implementation
Implementation is when the planning and design come to life efficiently and effectively. The nursing staff is intimately involved in gathering and evaluating data, diagnosing problems, and making recommendations for system improvement. The study of the end user’s information needs and the elimination of any inconsistencies will aid the project’s goal, which is part of the nursing job indirectly because it has more agility in interacting with the patient and clearly describing their wants. My organization’s Meditech implementation, also known as the “Go Live” of our new EHR, was completed with a two-hour seminar led by a Meditech consultant and a group of “super users” from each department. The super users received far more in-depth Meditech training and were available in each department 24 hours a day, seven days a week for two weeks.
There will be opposition and resistance to every change, but the implementation went relatively well in my memory. Of course, there was a learning curve, which resulted in a significant increase in charting time. It would have been helpful to both patients and nurses if they had staffed up to temporarily lower the number of patients each nurse had so that we could have enough time to deliver patient care and chart on the new system (Weekman & Janzen, 2009). On the other hand, nurses were not involved in that decision, which resulted in poor patient care and repeated patient complaints. I eventually became involved in finding answers for the claimed concerns that later surfaced, and I suggested that the nursing staff provide examples and desired features for better management of the electronic instrument. I went on to say that if nurses are involved, they can assist in ensuring that the electronic equipment provided is functional and can serve the purpose well because nurses are the ones who are familiar with the data they input and the data they want in return.
Maintenance
User assistance is provided through updated software updates overtime during the maintenance phase. SDLC is a never-ending process, not a one-time event that requires ongoing maintenance. Maintenance may necessitate a complete shutdown of Meditech, referred to as “Downtime.” This is necessary because software is continually evolving and changing to meet customer needs. When maintenance is performed, it impacts how or what we (the nurses) chart is transmitted via the health stream, and we electronically acknowledge our comprehension of the new requirement. If nurses need more training, they should contact the nursing informatics team. When caught in downtime it is always confusing since there is no communication between departments on when is a good time to take a break. Being the last step maintenance phase is the determinant of the success of the care given to patients since occurrence of any mistake at this final stage affect the outcome of the entire SDLC process.
We had a period with no computer access, so registering patients, charting, and ordering labs and medications were all done on paper. The results are printed and distributed by hand then all drugs are faxed, and each patient is manually entered into the Pyxis, which is set to override to eliminate handwritten orders. An error has an exponential likelihood and so the nurse’s ER providers and, of course, the patients are all affected by the timing of this. The impact of excluding physicians and nurses was significant. Delays in patient care, long waits for vital information on critical results that necessitated STAT intervention, lengthy medication turnaround times, a six-hour wait from checking in to receiving a bed for treatment, and frustrated providers, nurses, and patients all contributed to an unsafe and toxic work environment. When arranging scheduled maintenance it is critical to communicate and cooperate with all departments because it might be dangerous and harmful to patients.
References
MGonigle, D. & Kathleen Mastrian (2018). Nursing informatics and the foundation of knowledge , 4(3). Jones & Bartlett Learning.
Weekman, H. & Janzen, S. (2009). The critical nature of early nurse involvement for introducing new technologies. The online journal of issues in nursing, 14 (2).