Discuss The Systems Development Life Cycles And Nursing Invo

Discuss The Systems Development Life Cycles and Nurse Involvement

McGonigle and Mastrian (2022) analyze the Systems Development Life Cycle (SDLC), a structured approach to developing healthcare information systems. They describe various methodologies, including the Waterfall model, which follows a sequential phase process where outputs from one stage serve as inputs for the next. Rapid Application Development (RAD) emphasizes quickly creating prototypes for user testing, facilitating rapid feedback. Object-Oriented Systems Development (OOSD) involves modeling real-world entities as software objects, focusing on relationships rather than procedural steps (Gogou et al., 2002). The Dynamic System Development Model (DSDM) is suited for rapid development that may need ongoing adjustments to meet emerging needs (McGonigle & Mastrian, 2022). Additionally, Agile methodology prioritizes iterative development and team collaboration, emphasizing adaptability and continuous stakeholder involvement. Despite differences in phases, Dr. Kevin Johnson (Walden, 2018) outlines four core SDLC phases: Planning, Design, Implementation, and Evaluation/Maintenance. Nurse involvement across these phases is critical for ensuring systems meet clinical needs and enhance patient care.

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The Systems Development Life Cycle (SDLC) is a foundational framework guiding the design, development, implementation, and ongoing evaluation of healthcare information systems. Its importance lies in ensuring systematic progress, stakeholder engagement, and continuous improvement, particularly in the complex and dynamic healthcare setting. Central to SDLC is the recognition that successful health IT systems hinge not just on technical specifications but also on the input and collaboration of end-users, especially nurses, who are primary providers of patient care.

In the planning phase, defining the system’s purpose and scope is essential. Dr. Kevin Johnson (Walden, 2018) emphasizes that this phase is iterative; planners must revisit initial assumptions as new insights emerge. Engaging nurses early during this stage is vital because they understand clinical workflows and can specify system requirements that align with real-world practices. McGonigle and Mastrian (2022) further advocate for stakeholder collaboration, questioning, “what a system should have, must have, could have, and would have,” to prioritize features critical for clinical efficacy. Their experience suggests that involving nurses in defining 'must-have' functionalities helps develop systems that streamline workflows rather than hinder them.

During the design phase, the focus shifts to translating requirements into technical specifications. Effective design must incorporate workflow analyses to ensure new systems enhance rather than disrupt clinical routines. McGonigle and Mastrian (2022) argue that nurses must participate here to prevent design flaws that compromise patient safety. For example, if a new EHR system is blindly implemented without considering clinical workflows, it could create inefficiencies or safety hazards. An illustrative case from a past experience highlighted that redesigns driven solely by IT staff resulted in superficial aesthetic changes rather than meaningful process improvements. Involving nurses ensures that system workflows support actual patient care processes, such as batch data entry or streamlined documentation, thus improving the quality and safety of care.

Implementation involves deploying the system into clinical practice, a phase often challenged by resistance to change. Johnson (Walden, 2018) underscores that acceptance of new technology depends on how effectively staff are involved and prepared. Resistance may be overt or covert; nurses may understand that adoption is necessary but still feel reluctant, especially if the change threatens their routines or competence (Cho et al., 2021). To mitigate resistance, nurse champions or super-users are pivotal. These are well-trained staff who demonstrate system benefits and motivate peers to adapt (Tyler, 2019). Nurse informaticists play a key role in these efforts—facilitating training, addressing concerns, and guiding staff through the change process. Engaging nurses physically and emotionally during implementation increases buy-in and reduces frustration, ultimately improving system adoption.

Training is another critical component. Nurse informaticists not only need to learn the system themselves but also to serve as trainers and change agents. Their understanding of clinical workflows lends credibility to training efforts and helps translate technical functions into practical applications. Developing a core group of super-users fosters peer learning and support, which is especially important when facing complex or new systems like Epic (Walden, 2018). Such advocates can help colleagues troubleshoot issues, provide moral support, and reinforce the value of the new system. Beyond initial training, ongoing support and feedback channels are essential to sustain engagement and address emerging challenges.

The final phase, evaluation and maintenance, recognizes that the SDLC is cyclical. Continuous feedback from nurses and other clinical staff informs ongoing system refinements. Untalan et al. (2022) exemplify this with their use of audit tools and nursing huddles to identify and resolve system issues effectively. Their approach illustrates the importance of frontline staff involvement in quality improvement efforts. If nurses find that a system impedes their ability to meet patient care goals, modifications are necessary to restore functionality and safety. Regular review metrics, such as Lean Six Sigma tools, can assess system performance and guide continuous improvements (McGonigle & Mastrian, 2022). Nurse input remains vital during this phase to ensure that adjustments align with clinical needs and workflows.

In conclusion, the SDLC provides a structured pathway to designing, implementing, and maintaining healthcare systems that truly support clinical workflows. Nurse involvement from planning through evaluation ensures system relevance, usability, and safety. Nurse informaticists, as intermediaries between clinical staff and IT developers, are central to this process. Their expertise in workflow analysis, change management, and training creates a bridge that transforms technical solutions into practical tools for enhancing patient care. Emphasizing nurse participation in all SDLC phases ultimately leads to more effective, user-friendly, and sustainable health IT systems that meet the complex demands of modern healthcare.

References

• Cho, Y., Kim, M., & Choi, M. (2021). Factors associated with nurses’ user resistance to change of electronic health record systems. BMC Medical Informatics & Decision Making, 21(1), 1–12.
• Gogou, G., Mavromatis, A., Maglaveras, N., Engelbrecht, R., & Pappas, C. (2002). DIABCARD CCMIS—A Portable and Scalable CPR for Diabetes Care. IEEE Transactions on Biomedical Engineering, 49(12), 1412.
• McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
• Tyler, D. D. (2019). A Day in the Life of a Nurse Informaticist: Super Users. Journal of Informatics Nursing, 4(1), 18–20.
• Untalan, E., Cardenas, P., & Jenkins, Z. (2022). From Old to New: Process of Integrating PACU Phase 1 Documentation and Workflow from Old Electronic Health Record (EHR) System to New Electronic Health Record (EHR) System. Journal of PeriAnesthesia Nursing, 37(4), e9.
• Walden University, LLC. (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.
• Walden University, LLC. (2018). Systems Implementation [Video file]. Baltimore, MD: Author.