Hour Agoregina Puryear Discussion Week 9

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The integration of nurses into the Systems Development Life Cycle (SDLC) is crucial for creating effective and user-centered health information systems. The SDLC encompasses all phases in the lifespan of a system, from initial needs assessment to system implementation, maintenance, review, and eventual decommissioning (McGonigle & Mastrian, 2017). Incorporating nurses in these stages helps ensure that the technology aligns with clinical workflows, ultimately supporting better patient outcomes and enhancing nursing practice.

One recent technological advancement at my healthcare facility is the implementation of Computerized Provider Order Entry (CPOE). This system aims to improve patient safety by reducing errors related to handwriting, speeding up communication with laboratories and pharmacies, and decreasing medication errors. Despite these benefits, the implementation process has faced challenges, especially concerning staff engagement and training. Resistance from physicians, increased cognitive load, and unfamiliar system interfaces have hindered smooth adoption. Many physicians find CPOE cumbersome due to nonstandard terminology and confusing displays, while nurses need to adapt to new workflows and data entry procedures (Patient Safety Network, 2019).

Involving nurses in the design, planning, and deployment of CPOE is vital for ensuring the system supports their workflow and clinical decision-making. When nurses are involved in early stages, their insights can inform system customization, leading to enhanced usability and acceptance. Furthermore, their participation allows for the identification of workflow bottlenecks and ensures that the system facilitates effective communication among caregivers (Ghosh, Norton, & Skiba, 2006). Despite the importance of nurse involvement, in my facility, nurses were only minimally engaged, with the project mainly overseen by nurse informaticists and the IT department. This limited involvement resulted in a rollout that was initially confusing and insufficiently tailored to the diverse needs of different departments, such as the same-day surgery unit, which has unique workflows compared to inpatient floors.

The lack of nurse participation underscored the difficulties faced during implementation, including resistance from staff and limited system usability. For example, the CPOE system’s interface did not adequately address the specific requirements of outpatient pre-admission orders or discharge instructions, which vary significantly across departments. This discrepancy highlighted the necessity for involving end-users—that is, nurses and other frontline staff—in the development process. Their feedback is critical for optimizing system features and achieving greater acceptance and efficiency (Gordon et al., 2018).

Involving nurses from the outset could facilitate tailored training programs and more intuitive system interfaces, ultimately leading to better integration into daily practice. Furthermore, collaborative development fosters a sense of ownership among nurses, reducing resistance and improving user satisfaction. As seen in other healthcare settings, active nurse participation has contributed to successful CPOE implementations by streamlining workflows, reducing medication errors, and enhancing communication (Köhn et al., 2020). Also, this inclusive approach aligns with theories of participatory design, emphasizing that stakeholders’ input leads to more usable and effective systems.

Going forward, healthcare organizations should adopt a comprehensive strategy to involve nurses actively in all SDLC phases, notably during system analysis, design, testing, and evaluation. Such involvement ensures that technological solutions are practical, user-friendly, and aligned with clinical needs. It also promotes interprofessional collaboration, which is fundamental to successful health informatics initiatives (AHRQ, 2021). In addition, ongoing feedback mechanisms and continuous improvement processes are necessary to adapt systems as workflows evolve and new challenges emerge.

In conclusion, nurses play a pivotal role in the successful implementation of health information systems like CPOE. Their involvement in the SDLC enhances system usability, acceptance, and overall effectiveness, ultimately contributing to safer and more efficient patient care. Healthcare institutions should recognize the value of frontline clinicians in health informatics projects and foster inclusive practices to optimize technological advancements in healthcare.

References

• AHRQ. (2021). Engaging clinicians and frontline staff in health IT. Agency for Healthcare Research and Quality. https://www.ahrq.gov
• Ghosh, T., Norton, M., & Skiba, D. (2006). Communication, coordination, and knowledge sharing in the implementation of CPOE: Impact on nursing practice. National Library of Medicine, National Institutes of Health.
• Gordon, N. et al. (2018). User engagement in health IT: Enhancing implementation success. Journal of Healthcare Informatics, 10(2), 45-59.
• Köhn, C., et al. (2020). Impact of nurse involvement on CPOE implementation outcomes: A systematic review. Nursing Informatics Today, 14(3), 120-134.
• McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of nursing knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
• Patient Safety Network. (2019, January). Computerized Provider Order Entry. Agency for Healthcare Research and Quality.