The Inclusion Of Nurses In The Systems Development Life Cycle Essay

The Inclusion Of Nurses In The Systems Development Life Cycle Essay

The Inclusion Of Nurses In The Systems Development Life Cycle Essay

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.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

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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: Things to consider

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


300-350 WORD -APA FORMAT-In text citation-Reference last 5 years, peer reviewed

*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.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

*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 potential impacts of being included or not in the decision-making -process.

*Be specific and provide examples

NURS 6051
Week 6 Media: Systems Development Life Cycle
The future of the health care field lies in technology and the greater efficiency, quality, and costeffectiveness it can provide. However, successfully integrating technology can be a major challenge.
Many health care organizations experience difficulty in trying to incorporate informatics and innovations
into preexisting processes. The systems development life cycle (or SDLC) can help to address this by
providing a series of steps for integrating new systems to support current practices.
The SDLC is an overarching term that describes a cyclical process of steps that can be tailored to unique
needs and goals. There are many different SDLC models that can be applied to different situations and
different types of technology systems.The Inclusion Of Nurses In The Systems Development Life Cycle Essay
While no two SDLC models are exactly alike, most of them include similar steps for implementing new
technological systems. In general, SDLC models follow this basic pattern of steps:
1. Assess the needs that the system should address
2. Analyze specifications for the system
3. Design, develop, and test the system
4. Implement the system
5. Support the system operations and users
6. Evaluate the system
Some versions of the SDLC include testing as a separate step, or postpone testing until after
implementation. Many SDLC models also include a seventh step for maintaining and revising the system.
Some models even have an eighth step for properly destroying the system in the event of an upgrade or
revised need.
Let’s explore an example of a specific type of SDLC known as the waterfall model. The steps of the
waterfall model include: Feasibility, Analysis, Design, Implement, Test, and Maintain.
The waterfall model is most appropriate for small-scale projects that involve simple goals and systems.
Consider, for example, a health care organization that already uses electronic health records and wants
to incorporate a new patient check-in kiosk. The waterfall model would be an appropriate SDLC for this
For the first step of the waterfall model, the organization’s leaders would meet with representatives from
several work groups, including nurses, physicians, and medical assistants, to determine whether a checkin kiosk would be a feasible project.
Next, the organization’s leaders would analyze the goals and requirements for the check-in kiosk. These
goals could include user-friendliness, a graphical interface, and clear instructions for patients to follow at
the kiosk.The Inclusion Of Nurses In The Systems Development Life Cycle Essay
After the analysis step, the organization’s leaders would authorize the design of the system and hand the
project over to the design team. This team would consider the goals and requirements and design a plan
for the software and hardware of the kiosk. Then, the design team would proceed to the implementation
phase and create a working kiosk.

Once the kiosk is up and running, the design team would test the kiosk’s functionality to ensure that it is
ready to be used. Finally, the design team would maintain the kiosk by providing technical support for
users, and ensuring that necessary upgrades and revisions are made.
As this example has shown, using an SDLC model can help health care organizations to overcome the
difficult task of integrating new technologies into current processes. The waterfall model is just one of
many SDLC approaches and will not work for every project.
For example, the waterfall model would not be the best approach for an organization looking to
completely change from paper-based to electronic health records. Instead, a more complex, iterative
model would be more appropriate, such as the dynamic system development method. In order to select
the best SDLC model for the job, health care leaders should carefully consider several different models
and choose the one that is tailored to their organization’s needs and goals.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

The Systems Development Life Cycle (SDLC) consists of phases used in developing a piece of software. It is the plan of how to develop and maintain software, and when necessary, replace that software. In 2007 during my hospital’s transition to a new software system, I was fortunate enough to be included in the process. I did not get involved until the implementation phase, but from then on, until now, I remain very active in the process. I decided to highlight the Waterfall Model of SDLC. The Waterfall Model is a “sequential development process” with each phase continuing in a line (McGonigle and Mastrian, 2012, p. 205).
The first stage in the SDLC is feasibility. The upper echelon of leadership usually decides if they want or need to pursue this software. An initial budget is determined in this phase. Governmental obligations, legal issues, and cost benefit are discussed here. I believe that the Chief Nursing Officer (CNO) should be involved here to help understand the implications to the hospital. Hopefully the health care setting has Nursing Informatics (NI) in their institution and is aware of upcoming governmental mandates. Financial penalties or loss of income could be involved if the hospital is not in compliance with software.
Analysis consists of compiling data that consists of who is going to use the system, what data will be needed to be put into the system, what data will be needed out of the system, and what it needs to do for the institution. In my hospital at this step, our Information Technology (IT) department and some middle management were involved along with NI.

While we were doing our training sessions, certain parts of our system were still being assembled. It was beneficial to be able to tell nurses with concerns or ideas that we could still address and change the system before it was officially rolled out and we went “Live”. We still have updates and changes all the time. We are learning and improving with ideas coming from our nurses and firsthand experience. Having this ability seems to create satisfaction and ownership that I do not think we would have with it.

The systems development life cycle, in its variant forms, remains one of the oldest and yet still widely used methods of software development and acquisition methods in the information technology (IT) arena. While it has evolved over the years in response to ever-changing scenarios and paradigm shifts pertaining to the building or acquiring of software, its central tenants are as applicable today as they ever were. Life-cycle stages have gone through iterations of different names and number of steps, but at the core the SDLC is resilient in its tried-and-true deployment in business, industry, and government. In fact, the SDLC has been called one of the two dominant systems development methodologies today, along with prototyping (Piccoli, 2012). Thus, learning about the SDLC remains important to the students of today as well as tomorrow.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

This paper describes the use of the SDLC in a real-world heath care setting involving a principle component of a regional hospital care facility. The paper can be used as a pedagogical tool in a systems analysis and design course, or in an upper-division or graduate course as a case study of the implementation of the SDLC in practice. First, a review of the SDLC is provided, followed by a description of the case study environment. Next, the application of the methodology is described in detail. Following, inferences and observations from the project are presented, along with lessons learned. Finally, the paper concludes with implications for the three areas of research, practice, and pedagogy, as well as suggestions for future research.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

The SDLC has been a part of the IT community since the inception of the modern digital computer. A course in Systems Analysis and Design is requisite in most Management Information Systems programs (Topi, Valacich, Wright, Kaiser, Nunamaker, Sipior, and de Vreede, 2010). While such classes offer an overview of many different means of developing or acquiring software (e.g., prototyping, extreme programming, rapid application development (RAD), joint application development (JAD), etc.), at their heart such programs still devote a considerable amount of time to the SDLC, as they should. As this paper will show, following the steps and stages of the methodology is still a valid method of insuring the successful deployment of software. While the SDLC, and systems analysis and design in general, has evolved over the years, at its heart it remains a robust methodology for developing software and systems.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Early treatises of the SDLC promoted the rigorous delineation of necessary steps to follow for any kind of software project. The Waterfall Model (Boehm, 1976) is one of the most well-known forms. In this classic representation, the methodology involves seven sequential steps: 1) System Requirements and Validation; 2) Software Requirements and Validation; 3) Preliminary Design and Validation; 4) Detailed Design and Validation; 5) Code, Debug, Deployment, and Test; 6) Test, Preoperations, Validation Test; and 7) Operations, Maintenance, Revalidation. In the original description of the Boehm-Waterfall software engineering methodology, there is an interactive backstep between each stage. Thus the Boehm-Waterfall is a combination of a sequential methodology with an interactive backstep (Burback, 2004).The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Other early works were patterned after the Waterfall Model, with varying numbers of steps and not-markedly-different names for each stage. For example, Gore and Stubbe (1983) advocated a four-step approach consisting of the study phase, the design phase, the development phase, and the operation phase (p. 25). Martin and McClure (1988) described it as a multistep process consisting of five basic sequential phases: analysis, design, code, test, and maintain (p. 18). Another widely used text (Whitten, Bentley, and Ho, 1986) during the 1980s advocated an eight-step method. Beginning with 1) Survey the Situation, it was followed by 2) Study Current System; 3) Determine User Requirements; 4) Evaluate Alternative Solutions; 5) Design New System; 6) Select New Computer Equipment and Software; 7) Construct New System; and 8) Deliver New System.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Almost two decades later, a book by the same set of authors in general (Whitten, Bentley, and Dittman, 2004) also advocated an eight step series of phases, although the names of the stages changed somewhat (albeit not significantly). The methodology proceeded through the steps of Scope definition, Problem analysis, Requirements analysis, Logical design, Decision analysis, Physical design and integration, Construction and testing, and ending with Installation and delivery (p. 89). It is interesting to note that nearly 20 years later, the naming conventions used in the newer text are almost synonymous with those in the older work. The Whitten and Bentley (2008) text, in its present form, still breaks up the process into eight stages. While there is no consensus in the naming (or number) of stages (e.g., many systems analysis and design textbooks advocate their own nomenclature (c.f. Whitten, Bentley, and Barlow (1994), O’Brien (1993), Taggart and Silbey (1986)), McMurtrey (1997) reviewed the various forms of the life cycle in his dissertation work and came up with a generic SDLC involving the phases of Analysis, Design, Coding, Testing, Implementation, and Maintenance.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Even one of the most current and popular systems analysis and design textbooks (Kendall and Kendall, 2011) does not depart from tradition, emphasizing that the SDLC is still primarily comprised of seven phases. Although not immune to criticism, Hoffer, George, and Valacich (2011) believe that the view of systems analysis and design taking place in a cycle continues to be pervasive and true (p. 24). Thus, while the SDLC has evolved over the years under the guise of different combinations of naming conventions and numbers of steps or stages, it remains true to form as a well-tested methodology for software development and acquisition. We now turn our attention to how it was utilized in a present-day health care setting.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Case Study Setting
The present investigation regards the selection of a software package by a medium-size regional hospital for use in the Home Health segment of their organization. The hospital (to be referred to in this monograph by a fictitious name, General Hospital) is located in the central portion of a southern state in the USA, within 30 minutes of the state capital. Its constituents reside in the largest SMSA (standard metropolitan statistical area) in the state and consist of both rural, suburban, and city residents. The 149-bed facility is a state-of-the-art institution, as 91% of their 23 quality measures are better than the national average (“Where to Find Care”, 2010). Services offered include Emergency Department, Hospice, Intensive Care Unit (ICU), Obstetrics, Open Heart Surgery, and Pediatrics. Additional components of General Hospital consist of an Imaging Center, a Rehabilitation Hospital, Four Primary Care Clinics, a Health and Fitness Center (one of the largest in the nation with more than 70,000 square feet and 7,000 members), a Wound Healing Center, regional Therapy Centers, and Home Care (the focal point of this study).The Inclusion Of Nurses In The Systems Development Life Cycle Essay

There are more than 120 physicians on the active medical staff, over 1,400 employees and in excess of 100 volunteers (“General Hospital”, 2010). In short, it is representative of many similar patient care facilities around the nation and the world. As such, it provides a rich environment for the investigation of using the SDLC in a 21st century health care institution.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

Home Health and Study Overview
Home Health, or Home Care, is the portion of health care that is carried out at the patient’s home or residence. It is a participatory arrangement that eliminates the need for constant trips to the hospital for routine procedures. For example, patients take their own blood pressure (or heart rate, glucose level, etc.) using a device hooked up near their bed at home. The results are transmitted to the hospital (or in this case, the Home Health facility near General Hospital) electronically and are immediately processed, inspected, and monitored by attending staff.The Inclusion Of Nurses In The Systems Development Life Cycle Essay

In addition, there is a Lifeline feature available to elderly or other homebound individuals. The unit includes a button worn on a necklace or bracelet that the patient can push should they need assistance (“Home Health”, 2010). Periodically, clinicians (e.g., nurses, physical therapists, etc.) will visit the patient in their home to monitor their progress and perform routine inspections and maintenance on the technology.

The author was approached by his neighbor, a retired accounting faculty member who is a volunteer at General Hospital. He had been asked by hospital administration to investigate the acquisition, and eventual purchase, of software to facilitate and help coordinate the Home Health care portion of their business. After an initial meeting to offer help and familiarize ourselves with the task at hand, we met with staff (i.e., both management and the end-users) at the Home Health facility to begin our research.The Inclusion Of Nurses In The Systems Development Life Cycle Essay


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