NURS 6051 Portfolio Assignment The Role of the Nurse Informaticist in Systems Development and Implementation

NURS 6051 Portfolio Assignment The Role of the Nurse Informaticist in Systems Development and Implementation

NURS 6051 Portfolio Assignment The Role of the Nurse Informaticist in Systems Development and Implementation

Adopting healthcare technology requires the input of all involved stakeholders. Essential members of the team are nurses. Nurses have intimate knowledge of the shortcomings of paper records and numerous time spent on clinical documentation. The providers are involved in patient intake, information management efforts, and understand that well-designed IT systems make workflows efficient (Akhu‐Zaheya et al., 2019). The current organization intends to adopt a new nursing documentation system. To make the system usable and acceptable to nurses, a nurse leader has to be part of the implementation team. The purpose of this paper is to articulate the role of the nurse leader in line with the Systems Development Life Cycle (SDLC) stages.

System Development Life Cycle Stages

The system development life cycle is a model that outlines the various stages followed to bring a project from inception to completion. When adopting a nursing documentation system, it is crucial to follow the stages to optimize its effectiveness. The stages followed are planning and requirement definition, analysis, designing of the new system, implementation, and post-implementation support. The results from each stage guide the implementation of the next stage since requirements are converted into design while the design helps in coming up with the code (Lalband & Kavitha, 2019). The final stage then authenticates the results from the implementation stage. Akhu‐Zaheya et al. (2019) assert that it is essential to involve nurses to produce a clinical documentation system that enhances inter-professional communication, improves clinical outcomes, and supports patient care. The involvement requires a clear definition of nurse roles at each stage of the SDLC.

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Planning and Requirement Definition Stage

At the planning and requirement definition stage, the software requirements are established. A stakeholders’ meeting is held to define the software use, end-users, how to use it, as well as input required and output expected. A nurse leader is needed at this juncture to explain and coherently put the nursing documentation requirements. The explanation reduces redundancy (Verma & Gupta, 2017). The nurse also offers essential information that makes the system different and more relevant clinically. The leader also helps in determining the resources, time, costs, benefits, and other items needed to adopt the new documenting system.

Analysis

Once the problems have been identified, the analysis stage sets in. The analysis aids in determining if the requirements can be integrated into the emerging software. A ‘requirement specification’ document is developed to guide the next stage. The nurse leader’s role at this juncture is to analyze the end-user needs to ascertain that the system will meet their expectations (Verma & Gupta, 2017). The leader also defines the system processes and workflow by explaining the components from the previous system that were viable and those that require adjustments or elimination. 

Design

With the requirement specification document at hand, the cycle moves to the design stage. The design requires the development of the code to translate the requirement specification document into a programming language. The nurse leader is needed at this point to guide on various terminologies used in the nursing documentation system (Akhu‐Zaheya et al., 2019). The leader ensures that a standardized nursing language is used to allow accurate communication of patient care information to nurses and other healthcare providers (Verma & Gupta, 2017). The nurse works with the IT team to come up with clear language instructions. The nurse informaticist can learn to code and take up the role of a coder. The role can enhance collaboration and ensure effective integration of the documentation system into practice. In addition to coding, the testing of the system takes place at this juncture. Testing influences the acceptability of the system by the users. The nurse leader helps in establishing innovation strategies to make the system successful. He or she becomes the tester to check the credibility of the system. 

Implementation

Once the coding and testing are done, the implementation of the system begins. The actual installation of the newly-developed system starts. The step involves moving data and components from the old system to the new system (Lalband & Kavitha, 2019). The nurse at this point helps in the accurate transfer of patient data. The system goes live and it is adopted by many users.  The nurse should train end-users on the new system and set meetings with users to get feedback and establish potential facilitators and barriers (Verma & Gupta, 2017). Additionally, they are supposed to track and monitor compliance with the system and use positive reinforcement to encourage users to adhere to the program requirements.

Post-Implementation Support

After implementation, the last stage is post-implementation support. The stage allows end-users to fine-tune the system to boost performance, meet additional user requirements, or add new capabilities. The role of the nurse informaticist is to ensure that the system output aligns with the identified requirements (Verma & Gupta, 2017). The system should capture and store patient information as planned. The nurse is also expected to suggest practical and clinically relevant alternatives for any end-user issues observed.

Conclusion

Nurses should be incorporated in the adoption of health technology. The incorporation will leverage their skills, esteem, and frontline involvement with patients. As indicated above, when adopting a nursing documentation system, a nurse leader is key. The leader roles in each SDLC stage are well articulated and prove that nurse’s involvement enhances system acceptability and optimization.

References

Akhu‐Zaheya, L., Al‐Maaitah, R., & Bany Hani, S. (2018). Quality of nursing documentation: Paper‐based health records versus electronic‐based health records. Journal of clinical nursing, 27(3-4), e578-e589. https://doi.org/10.1111/jocn.14097

Lalband, N., & Kavitha, D. (2019). Software engineering for smart healthcare applications. International Journal of Innovative Technology and Exploring Engineering, 8, 325-331. https://doi.org/ 10.35940/ijitee.F1066.0486S419

Verma, M. P., & Gupta, S. (2017). Software development for nursing: Role of nursing informatics. International Journal of Nursing Education and Research, 5(2), 203-207. https://doi.org/10.5958/2454-2660.2017.00044.8

The systems development life cycle (SDLC) is a conceptual model employed in project management. It outlines the various steps needed to develop a project from conception to the operation stage and maintain it. SDLC also contains policies and procedures for developing or changing systems throughout their project’s phases (Kyeremeh, 2019). The purpose of this paper is to explain a graduate nurse’s role in the implementation team for a health information technology.  

Planning and Requirements Definition

The stage involves defining the problem and scope of the existing health IT systems and outlining the objectives for the proposed new IT system. The graduate nurse’s role in this stage will include taking a general look at the new health IT and helping the team determine its objectives (Kyeremeh, 2019). The nurse will assess the feasibility of the IT system and participate in developing the schedule for its implementation. In addition, the nurse will analyze the potential threats and limitations of the IT system and how it can be integrated into the overall organization system.

Analysis

The analysis phase entails obtaining information about the proposed system and analyzing and validating this information. It also includes identifying the requirements and archetypes for the new system. The graduate nurse will help the implementation team in evaluating the information needs of end-users of the system and optimizing the goal of the health IT system. Furthermore, the graduate nurse will be involved in examining alternatives to the proposed IT system and prioritizing the requirements for the new system. The nurse will take part in developing a Software Requirement Specification document specifying the hardware, software, network, and functional requirements of the health IT system (Kyeremeh, 2019). The nurse will ensure the document outlines the health system’s general nature and identifies the design model’s architecturally essential parts.

Design of the new system

The design of the proposed health IT system entails its general outline, databases, network, and system and user interfaces. The implementation team will transform the Software Requirement Specification document into a valid structure. The structure should have comprehensive and complete specifications that the team can put into action in a programming language (Kramer, 2018). The team will also create a system design document for subsequent phases. The nurse will create a training plan that will be used to train healthcare providers in the organization on how to use the new health IT system. The graduate-level nurse will also examine the proposed IT system design to ensure that it meets the requirements outlined in the Software Requirement Specification document.

Implementation

The implementation team will be tasked with incorporating the new health IT system into the organization’s workflow processes and putting it into action (Kramer, 2018). The graduate nurse will help the team prepare a test report for the system that includes system implementation tasks. Besides, the nurse will be involved in integrating the new health IT system into the hospital environment and installing it.

Post-implementation support

Maintenance and support are needed for a longer period for large health IT systems compared to smaller systems. The nurse in this stage will be tasked with reporting challenges in the system to the developer (Kyeremeh, 2019). Besides, the nurse will address minor hitches in the system after implementation.

Conclusion

The SDLC defines the steps needed to plan and implement a project from conception to maintenance. The graduate nurse will impact the implementation team by helping to assess the system’s feasibility and developing the implementation schedule. Besides, the nurse will play a key role in creating a system contingency, maintenance, operation, and training plan.,

References

Kramer, M. (2018). Best practices in systems development lifecycle: An analysis based on the waterfall model. Review of Business & Finance Studies, 9(1), 77-84.

Kyeremeh, K. (2019). Overview of System Development Life Cycle Models. Available at SSRN 3448536.http://dx.doi.org/10.2139/ssrn.344853

Hello!

I enjoyed reading your post and your experience with the SDLC process. You mentioned the use of the RAD method when implementing MARTTI. “As technology advances and faster development is expected, rapid prototyping, also know as rapid application development (RAD), provides a fast way to add functionality through prototyping and user testing” (McGonigle & Mastrian, 2022, p. 196, para. 6). This seems to have been the best method when implementing the HIT you discussed. The RAD method “is chosen because it builds systems quickly through user-driven prototyping and adherence to quick, strict delivery milestones” (McGonigle & Mastrian, 2022, p. 197, para. 3). How do you feel like the implementation process would have differed if a different method was used? 

 In your case, the process utilized the knowledge and experiences of nurses which provided patient-centered insight to help improve the success of the system. To further explain the importance of including nurses and clinicians, a case study by Mark McMurtrey should be mentioned. McMurtrey conducted a case study of implementing a system within a home health setting. McMurtrey concluded “while the principle investigators both had doctoral degrees in business administration, and one of them (the author) had taught the systems analysis and design course for over ten years at two different institutions, neither of us had any practical experience in the Home Health arena” (2013, para. 37). This study shows that even with qualified business professionals on the team, it is crucial to include professionals with clinical experience within the SDLC process because they provide additional invaluable insight.

 References

McGonigle, D., & Mastrian, K. G. (2022). Systems Development Life Cycle: Nursing Informatics and Organizational Decision-Making. In Nursing Informatics and the Foundation of Knowledge (5th ed.). (pp. 191–205). Jones & Bartlett Learning.

McMurtrey, M. (2013). A Case Study of the Application of the Systems Development Life Cycle (SDLC) in 21st Century Health Care: Something Old, Something New? Journal of the Southern Association for Information Systems, 1(1). https://doi.org/10.3998/jsais.11880084.0001.103

The System Development Life Cycle (SDLC) is a conceptual model that includes procedures and policies for developing and altering systems so that such systems will remain effective throughout their lifetime. Organizations often apply the model while adopting new technologies. SDLC involves the planning, design, implementation, maintenance, and evaluation stages which run in a cyclic manner throughout the lifespan of the system (McGonigle & Mastrian, 2022). To develop and implement healthy systems that meet the need for which they are created, input from the project stakeholders must be taken at every stage of SDLC (Dwivedi, 2022). This is because such input will guide the project team to create a system that will meet the needs of the stakeholders better. Therefore, nurses should be involved in all the stages of the development and adoption of new healthcare technologies in a facility. Failure to involve nurses in the different stages of SDLC can lead to inefficiencies in the system that will discourage adoption.

Consequences of Lack of Nurse Involvement in the Stages of SDLC

Planning Stage:

In this stage, the team defines the scope of the problem and decides on the objectives for the new system. Because nurses are the most active health workers in patient care, they have a broader view of existing challenges and the most important ones that should be addressed by the system. Therefore, not involving them in planning can lead to the nonidentification of key problems or setting the wrong objectives for the health information technology (HIT) system being planned. Furthermore, it can lead to the adoption of the wrong technology that does not address the main issues in the facility.

Design Stage

This stage is a key part of the process of system development because it involves using the requirements drawn out in the planning stage to design a system that should solve the problem. Nursing professionals are the highest users of HIT therefore their input on how the systems they are to use should look or what should be placed where will increase the ease of using such systems (Vest, 2019). Without nursing input, the system designers may fail to include important features or arrange them in such a way that manipulating the system becomes tedious for nurses. An example of this scenario is a certain time at my former place of work when the administration decided to upgrade the EHR to take advantage of more advanced features to improve care processes. The new EHR was brought in without nursing input. Unsurprisingly, from the first-day nurses found it difficult to navigate the system and often complained about the cluttered interface and how difficult it is to access features commonly used by nurses. Hence, instead of improving workflow, the new EHR disrupted it further.

 Implementation, Maintenance, and Evaluation

These stages involve putting the system to work, making necessary adjustments to fine-tune its performance, and measuring the efficiency of the system including how it is affecting the problem it was designed to solve. As established earlier, nurses are the biggest users of HIT. Therefore they have hands-on experience with healthcare systems. If they are involved, they will be able to enable the smooth adoption of the news system. They will also give detailed feedback on what needs to be improved for the system to efficiently solve the target problem.

While nurse are involved in the design and introduction of new HIT systems in my workplace, I have never been part of such a team. However, nursing representatives in the development team for HIT leverage their extensive experience with patient care and the use of HIT systems to make great recommendations that will enable the system to meet the needs of the patients. In addition, feedback from nurses will enable the developers to carry out upgrades and make adjustments that will improve the efficiency of the adopted system. Finally, nursing involvement will smoothen the adoption of the new system by nurses. Asides from great input that creates designs other nurses can resonate with, nurse informaticists and other involved nurses can champion the new project to the rest of the workforce. Thereby increasing the speed of adoption.