NURS 6051 Software Development Life Cycle (SDLC)

RE: Discussion – Week 9

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According to McGonigle and Mastrian (2017), the Software Development Life Cycle (SDLC) is a method for delivering efficient and effective information systems (IS) that align with an organization’s strategic business plan. The consequences of failing to include nurses during the SDLC stages can be disastrous. Non-clinical programmers have no idea what is required for patient care or whether it works in an emergency. Because nurses will be the primary users of its functionality, nurses must be included in design and purchasing decisions. The main result is technology that does not work properly or flows well.

Nurses are required for potential issues at all stages of the SDLC. According to Singletary and Baker (2019), the SDLC has eight stages. The first phase is the initiation and concept phase, and one potential issue is not locating the appropriate information system (IS) for the organization. Nurses could help by being able to collaborate with the IS to ensure proper functionality. The second phase is planning, and one potential issue is not having an appropriate milestone date. A nurse could assist by reviewing census data and determining the best time to implement IS. The third stage is requirements, and omitting an important aspect of documenting patient care could be a problem. A nurse could assist in ensuring that all existing processes are carried over to the new IS. The fourth stage is design and development, and many problems can arise here, such as missing necessary charting systems and poor flow. A nurse would undoubtedly ensure that all required charting is entered into the new system and that documentation flows smoothly. The fifth stage is testing, and the main problem is that it is not functional. Nurses would address this by rigorously testing the new IS for form and functionality. The sixth stage is training and implementation, and problems with employee training may arise. Nurses must be super users and be able to learn the system as a result. The seventh stage is operations and maintenance, and one issue would be not updating software or fixing errors. Nurses should be able to address the problem by informing system designers of any problems. The disposition stage is the final stage, and one issue is not properly moving data from the old to the new system. Nurses would address this issue by having superusers ensure that legacy data is properly transitioned. A study conducted by McLean et al. (2015) confirmed that a large number of nurses contributed to healthcare IT acquisition decisions.

My organization did not give me any input during the transition into the new EPIC EHR. I was used as a superuser during the training and implementation stage. One impact of not being used is working in the emergency department for nearly a decade would give some clarity into what custom entry methods would need to go in the EHR as opposed to the new hire that took the job. The emergency department managers were the only ones who had any input into the process which none of them had any recent bedside experience. This can lead to missing vital charting portions of the EPIC-specific emergency charting system.

Resources

McGonigle, D., & Mastrian, K. (2017). Nursing Informatics and the Foundation of Knowledge. In Nursing Informatics and the Foundation of Knowledge (4th ed., p. 176). Jones & Bartlett Learning.

McLean, A., Frisch, N., & Roudsari, A. (2015). Nursing’s Voice in Healthcare IT Acquisition Decisions. Canadian Journal of Nursing Informatics, 10(3), 1. http://cjni.net/journal/?p=4248

Singletary, V., & Baker, E. L. (2019). Building Informatics-Savvy Health Departments: The Systems Development Life Cycle. Journal of Public Health Management and Practice, 25(6), 610–611. https://doi.org/10.1097/phh.0000000000001086

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

A healthcare organization’s lack of participation in the SDLC while procuring and implementing a new health information technology system might have serious ramifications. Explain how the participation of nurses in the SDLC might assist solve possible concerns at each level and provide specific examples. Then, talk about whether or not you had a say in the selection and planning of new health information technology systems in your nursing practice or healthcare organization, and discuss the possible consequences of your involvement or lack thereof. The more descriptive you are, the better.

The Inclusion of Nurses in the Systems Development Life Cycle

The Systems Development Life Cycle (SDLC) includes planning, analysis, design, execution, assessment, and maintenance stages of information technology design and development. The planning or feasibility stage is where the developers will define the problem and the current system’s scope and identify the new system’s objectives and goals. Nurses’ main role here is to help the team in foreseeing and incorporating patient’s needs in the new system implementation since they are charged with ensuring implementation of safe care procedures (McLeod et al., 2017).

One of the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health system is resistance to the application of the software in healthcare practice. This mainly occurs due to issues such as communication challenges. When nurses are not involved in the SDLC coding stage, a software developer may not get the necessary guidance on the use of medical terminology or patient care data hence failing to use a standardized patient care system that is able to accurately communicate patient care information among healthcare providers and nurses (McGonigle & Mastrian, 2017). Another consequence is medical errors which may occur because the terminology used by healthcare providers and nurses may be different in terms of the expected outcome and patient care hence creating uncertainty in healthcare instructions.

One of the potential issues at the first stage of the SDLC, which is understanding the problem, is ignoring the users’ needs, hence limiting the applicability of the software. The inclusion of nurses can address this issue by explaining and putting the requirements of the software coherently to reduce the redundancy of the final product. The potential issue in the codding planned solution stage is using the wrong program language (Verma & Gupta, 2017). Nurses can address this issue by guiding the software developer on the right medical terminology to use hence enhancing appropriate communication of patient care information. A potential issue that may arise in the third stage, which includes testing the actual program, is failing to identify challenges that may hinder the functioning of the software. Nurses can address this issue by accessing the credibility of software (Verma & Gupta, 2017). In the deployment and maintenance of the product stage, the main potential issue is adopting software that does not produce the desired results. Nurses can address this issue by identifying issues that may hinder the effective use of the software and proposing practical solutions to address the issues.

I had my first encounter participating in selecting and planning a new healthcare information technology system in my nursing practice after the onset of Covid-19. Our healthcare organization began developing software that would schedule patient visits and remotely monitor patients’ healthcare progress to reduce patient visits to reduce the risk of spreading the Covid-19 virus. The main impact of being included in the decision-making process was suggesting some important features to include in the software to make it user-friendly. For instance, I suggested the medical terminology that all nurses could understand, including interns who may not have medical experience, to understand some complex language in the nursing practice.

References

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Publishers.

Verma, M. P., & Gupta, S. (2017). Software development for nursing: Role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203. https://doi.org/10.5958/2454-2660.2017.00044.8

McLeod, A., Hewitt, B., Gibbs, D., & Kristof, C. (2017). Evaluating motivation for the use of an electronic health record simulation game. Perspectives in health information management, 14(spring). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430132/

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.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 9

To participate in this Discussion:

Week 9 Discussion

Module 5: The Nurse Leader and the System Development Life Cycle (Weeks 9-10)

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

Learning Objectives

Students will:

Analyze how inclusion of the nurse in the purchasing of health information technology systems impacts healthcare organizations
Analyze the impact of nurse inclusion on each step of the systems development life cycle

Due By	Assignment
Week 9, Days 1–2	Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post.
Week 9, Day 3	Post your initial Discussion post. Begin to compose your Assignment.
Week 9, Days 4-5	Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment.
Week 9, Day 6	Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 9, Day 7	Wrap up Discussion.
Week 10, Days 1-6	Continue to compose your Assignment.
Week 10, Day 7	Deadline to submit your Assignment.

Learning Resources

Required Readings

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

Chapter 9, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” (pp. 175–187)
Chapter 12, “Electronic Security” (pp. 229–242)
Chapter 13, “Workflow and Beyond Meaningful Use” (pp. 245–261)

Agency for Healthcare Research and Quality. (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide. Retrieved September 27, 2018, from

https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/health-it-evaluation-toolkit-and-evaluation-measures-quick-reference

Agency for Healthcare Research and Quality. (n.d.b). Workflow assessment for health IT toolkit. Retrieved September 27, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit

RE: Discussion – Week 9 – initial post

Integrating Nurses into the Systems Development Life Cycle

SDLC includes the phases of analysis, design, implementation, evaluation, and maintenance. The importance of nurses as end-users necessitates their participation in each phase of the SDLC (McGonigle & Mastrian, 2017). The failure to involve nurses in the analytical phase hinders the understanding of the new HITS, hence reducing the efficiency of the adopted information technology. During the design phase, HIT specialists enhance an existing system, suggesting a specific operational mechanism to be implemented into the new system (Ozkaynak et al., 2021). A nurse’s primary responsibility throughout the design phase is to refine and test the system. Therefore, the failure to incorporate a nurse results in the inability of new technology to meet output and input criteria.

Involving nurses in the implementation also hinders the successful operation of the new technology in terms of protocols, coordination, and workflow. If a nurse is not involved in the evaluation process, invalid results may be produced (McGonigle & Mastrian, 2017). Involving nurses in the maintenance phase may result in a failure to recognize and report the system’s nurse shortage executive bug. Due to the new system’s narrow focus, the failure to include nurses in SDLC may be impacted by the possibility of failure (Alijedaani &Babar, 2021). In my nursing profession, I have participated in the selection and design of new health information technologies. After the implementation of the new system, the participation resulted in trouble balancing alternatives. For instance, has lost confidence in the transformation process, resulting in frustration and fatigue are experienced. When implementing the System Develop Life Cycle, it is possible that some nurses will not attend the training, hence reducing their potential to perform quality job.

References

Aljedaani, B., & Babar, M. A. (2021). The Difficulties of Developing Secure Mobile Health Applications: A Systematic Analysis The 9(6) issue of JMIR mHealth and uHealth contains the article e15654.
https://mhealth.jmir.org/2021/6/e15654/

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

Ozkaynak, M., Sircar, C. M., Frye, O., & Valdez, R. S. (2021, June). A Systematic Analysis of Health Information Technology Design Workshops In Informatics, volume 8, issue 2, page 34. Institute for Multidisciplinary Digital Publishing.
https://doi.org/10.3390/informatics8020034

Replies

Regarding the failure to adhere to the SDLC in the introduction of EHRs, I concur with you.
When applying the SDLC, the failure to include nurses in the decision-making process, for instance, is problematic. Inadequate understanding of the software development process problem also creates the necessary dangers (Alqrainy et al.,2014). Environmental, managerial, and technical risk factors can generate uncertain situations that affect SDLC execution. There is also a problem with insufficient resources, which requires scope-appropriate management.

References

Alqrainy, S., Muaidi, H., & Khdour, T (2014). RISK FACTORS IN SOFTWARE DEVELOPMENT PHASES. https://www.researchgate.net/profile/Thair-\sKhdour/publication/266144501 Risk Factors in Software Development Phases/links/5428066\s10cf2e4ce940c36cc/Risk-Factors-in-Software-Development-Phases.pdf

I enjoyed reading your thoughts and list of EHR implementation issues.
However, I wonder if the paucity of nurse participation in the early stages of EHR conversions was due to the uncharted realm of computerized charting. When shifting to computer-only systems, nurses who were accustomed to using paper charts were unaware of what to expect. In my past career, I am aware that I would not have been an ideal resource for offering advice regarding the model workspace and ancillary component integration. In this situation, when there is no precursor technology, nurses may be most helpful during the SDLC’s revision and maintenance phase. During the infancy of the EHR movement, we were able to identify what was functional, efficient, and relevant to our practice, as well as which portions of the program did not function or did not ergonomically fit our workflow.
Now that EHRs are commonplace, I agree that nurses should be included in the design of developing technologies, as we have a comprehensive grasp of the process based on earlier trial and error. The knowledge gathered during the EHR journey has opened the path for nursing informatics and the design and implementation of related projects (McGonigle & Mastrian, 2018).

Reference

McGonigle, D., & Mastrian, K. (2018). Nursing informatics and the knowledge foundation (4th ed.). The company Jones & Bartlett NURS 6051 Software Development Life Cycle (SDLC) Learning.

Required Media

Louis, I. (2011, August 17). Systems development life cycle (SDLC) [Video file]. Retrieved from https://www.youtube.com/watch?v=xtpyjPrpyX8

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.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6051 Software Development Life Cycle (SDLC)

System Development Life Cycle (SDLC), according to McGonigle and Mastrian (2018), is a way to deliver an effective, efficient information system. That can fit an organization’s business plan. The cycle is a continuous revolving process that spans the software’s life. For example, planning software production to update, renew, or a new system is developed (McGonigle & Mastrian, 2019). The SDLC process has five stages, namely, Planning, Design, Implementation, Maintenance, and Evaluation (Laureate, 2018).

Burns (2012) purports that nurses are not always included in decision-making as it relates to technology implementation. He continued, “if an organization considers what is best for the patient, they will see that nurse plays a decisive role in Information Technology (IT) system implementation, and should be involved at all stages in the process.

The planning stage incorporates the needs of a particular system and technical requirement and should answer the question” what is best for the patient (Laureate Education, 2018). Nurses represent the largest professional group, and they spend the most time interacting with patients through direct patient care. Thus, they would be the majority end users of information systems in an organization and would know what is best to meet the patients’ needs (McGonigle &Mastrian, 2018).

During analysis, the requirement for the system is identified from the organization’s data. The needs and current practices are examined to determine possible changes (McGonigle &Mastrian (2019). According to Burns (2012), organizations should ensure their data is correct, and this can be done by utilizing nurses. Because nurses are responsible for recording a large amount of data. Notably, Burns (2012) states, “nurses believe they need to play a more active role when their organization is implementing new technology.”

Analysis and design are essential in the cycle. The design focuses on what programs are needed and established how they are connected. It involves deciding on a specific function of the hardware, software, and networking possibilities. Analysis and design are crucial in the cycle; nurses can analyze the design to determine shortcomings, thus preventing costly revision dow the road (McGonigle & Mastrian, 2019).

Implementation/ Evaluation in the phase where to software is put to work, in other words, “Go Live.” Burns (2012) states implementation is an important stage where workflows occur. Nurse leaders, Nurse informaticists, and Chief Nursing Officers can ensure a smooth transition of the software for the end-users.

I was not a part of the planning of the IT systems in my organization; however, I believe I have an impact on decision-making. I have a role to play in learning about the system, and it helps me as an individual and impacts the decision made. It is my responsibility to learn the system. I would be able to identify the software’s strengths and weaknesses and seek to become involved in the evaluation process. According to Burns (2012), if more nurses are involved in technology implementation, that could help hospitals embrace new models of care.

In conclusion, nurses are essential to quality healthcare delivery and should be involved in the life of the cycle of System Development. Nurses touch every aspect of care. This means they need to manage change and lead, particularly when it comes to IT (Burns, 2012).

References

Burns, E., (2012). Nurses have an important role to play during technology implementation

https://searchhealthit.techtarget.com/news/2240166948/Nurses-have-an-important-role-to-play-during-technology-implementation

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of

knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Laureate Education (2018). Interoperability, Standards, and Security [Video file]. Retrieved

from. https://class.waldenu.edu/bbcswebdav/institution/USW1/202070_27/MS_NURS/NURS_5051_WC/USW1_NURS_5051_module05.html?course_uid=USW1.26538.202070&service_url=https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/wslinks&b2Uri=https%3A%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN

Name: NURS_5051_Module05_Week09_Discussion_Rubric

	Excellent	Good	Fair	Poor
Main Posting	Points Range: 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	Points Range: 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	Points Range: 10 (10%) – 10 (10%) Posts main post by day 3.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not post by day 3.
First Response	Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_5051_Module05_Week09_Discussion_Rubric

Hello Dr. Wagner and Classmates

To effectively apply any healthcare process and technology system, developers must follow the Systems Development Life Cycle (SDLC); planning, analysis, design, implementation, and maintenance (Laureate Education, 2019). To develop a new health information system focused on patient care and outcomes, it is crucial to involve nurses to provide substantial inputs (Weckman et al., 2009). Therefore, the lack of nurse contributions in the implementation phase can bring terrible consequences (Laureate Education, 2019). Six months ago, the administration team of my organization (Hospice) decided to switch our electronic documentation system from Citrix to WellSky without involving the field nurses in the SDLC process. Instead of selecting an outside Electronic Medical Record (EMR), if the administration had decided to work with the company team (IT, informatics nurses, and the field nurses) to design an EMR that will meet all the staff needs, they would have saved many complications.

As a result, the administration team had to make many changes to the new system due to staff resistance and negative feedback with the new system. This forced the administration to re-evaluate and gather input from nurses to adjust the new system. If the administration team had involved the nurses in the selection of the new EMR at the beginning, the company would have saved a lot of time and stress. To be successful, the administration should have approached the implementation of the system by working as a team and involving nurses at each stage of the SDLC, from planning to maintenance (feedback). For instance, if nurses are involved in the planning phase, they can share project goals and contributions for significant efficacy. In the analysis, involving nurses in the design phase would have allowed the nurse to develop or select a successful EMR that will fit the patient and healthcare staff’s needs when documenting the head-to-toe assessment and general notes. Nurses should not have been left in the implementation phase since nurses give direct patient care and are active members of the nursing process.

Implementation is the most crucial phase in involving nurse thoughts and feedback. Implementing healthcare systems is essential, but the most important segment involves all stakeholders for successful implementation (Agency for Healthcare Research and Quality [AHRQ], 2014). In the healthcare setting, nurses are fundamental stakeholders for system implementation, and for this reason, they need to be involved for successful system implementation. If nurses were initially involved in the scenario mentioned above, the company could have saved time and budget.

References

Agency for Healthcare Research and Quality. (2014). Designing and Implementing Medicaid Disease and Care Management Programs: Section 2: Engaging Stakeholders in a Care Management Program. https://www.ahrq.gov/patient-safety/settings/long-termcare/resource/hcbs/medicaidmgmt/mm2.html

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

Burlington, MA: 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). doi: 10.3912/OJIN.Vol1402Man02.

NURS 6051 Software Development Life Cycle (SDLC)