Introduction
Advancement in technology and its integration in healthcare to improve safety and efficiency has influenced additional roles and responsibilities to nurses in the field of informatics. A perfect example is the role of a nurse Informaticist who assists system developers to analyze problems and propose solutions in SDLC. The SDLC (Systems Development Life Cycle) describes the steps followed by system developers in designing, troubleshooting and implementing a system.
The entire process requires a systematic problem-solving approach that will provide solutions to an existing problem. As highlighted by McGonigle & Mastrian, (2018), the primary issue addressed by most nurse informacists in healthcare organizations is developing a documentation system that addresses the challenges of nursing documentation. Nurses are the majority in the health workforce and spend most of their time with patients. Therefore, they should be actively involved in developing the information systems used in healthcare organizations for more successful outcomes.
Steps of the SDLC (Systems Development Life Cycle)
The steps of an SDLC vary based on a type of a system being developed. However, the development of a system that supports nursing documentation has five major steps namely: planning and requirements definition, analysis, design, implementation, testing and maintenance (post-implementation) (McGonigle & Mastrian, 2018). Every stage of the cycle must involve nurses to improve chances for success since they are well-informed on the required output. For instance, nurse leaders can guide system developers in each stage of development and ensure that plans developed to identify and address organizational needs. On the other hand, to determine the most appropriate inputs to start development with, a system developer may consider using a reverse system development approach. A nurse informacist can identify and communicate any workflow issues witnessed in the system.
Planning and Requirements Definition
Planning is the most essential tool that guarantees high chances of a successful outcome of any program or operation. In the system development cycle, the lead nurse is responsible for giving a healthcare plan to the system developers. The information provided is used to plan the best approaches for system development. In the requirements definition, a nurse identifies the requirements for formulating specific outputs, which are incorporated into the system (Schoville & Titler, 2015). The system developer will later make plans on how to code the inputs provided.
Analysis
In the analysis stage, the system’s processes and workflows are established. A determination to ascertain whether the requirements provided are met and an evaluation of the processes for potential changes is done. In this phase, nurses can be useful in explaining and discussing the components that were working in the previous system with the system developer (Yen et al., 2017). This will help to determine components that need to be done-away-with or added. Besides, a nurse informacist can discuss with a system developer how to meet these requirements.
Design of the New System
In the design stage, the general look of the system is established. The implementation team makes several decisions including the required type of data. The team generates reports, prototypes, mockups, and screenshots to determine potential hitches that are likely to occur (Thomas, Seifert & Joyner, 2016). In this phase, a nurse Informaticist can scrutinize the developed flowcharts to ensure that they follow the appropriate performance path and display the expected output.
Implementation
A student nurse who has basic knowledge in programming can apply the five-step approach by Everett Rogers to facilitate adoption and implementation of the system in the following phases: knowledge, persuasion, decision, implementation, and confirmation (Ronquillo, Currie & Rodney, 2016). Since implementation incorporates the use of a specific coding language to code designs, the nurse student can also check the coded flowcharts and assist to troubleshoot the system in case it provides an incorrect output. He/she can also: organize for meetings with staff, obtain feedback from nurses, identify potential facilitators and barriers of the system, make modifications on techniques to evaluate processes, use positive reinforcements to encourage other staff to adhere to the system requirements, track and monitor the rate at which staff comply with the new system and measure outcomes. Ronquillo, Currie & Rodney (2016) suggest that, in the implementation phase, a nurse manager can plan for appropriate training of staff to ensure a successful transition in the implementation of a new system.
Post-Implementation Support
The final phase incorporates testing and maintenance. The system should be tested before its delivery. Testing purposes to ensure that the system provides the appropriate output and solves all the issues it is required to solve. A nurse informaticist can help to ensure that the output given by the system aligns with the requirements of the health system. The system should be able to assist in nursing documentation in roles such as capturing and storing information. A nurse informacist should also organize training to educate other nurses about the system and its usage. As emphasized by McGonigle & Mastrian (2018), the nurse informaticist should oversee the process of integration into the organization. As a maintenance role, the nurse Informaticist will notify the system developer on required changes where needed.
Conclusion
In today’s highly diverse and well-developed health sector, information technology has an integral role. Ensuring adequacy in nursing processes such as documentation requires a well-developed system that guarantees efficiency. This system should be able to address issues related to the maintenance of nursing processes such as nursing documentation. Steps in SDLC have addressed the burdensome process where nurses were required to manage information manually. When developing a system for nursing documentation or other nursing processes, it is advisable to involve nurses since they are informed on the issues that should be addressed and the expected solutions.
References
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning
Ronquillo, C., Currie, L. M., & Rodney, P. (2016). The evolution of data-information-knowledge-wisdom in nursing informatics. Advances in nursing science, 39(1), E1-E18. DOI: 10.1097/ANS.0000000000000107
Schoville, R. R., & Titler, M. G. (2015). Guiding healthcare technology implementation: a new integrated technology implementation model. CIN: Computers, Informatics, Nursing, 33(3), 99-107. doi: 10.1097/CIN.0000000000000130
Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative changes. OJIN: The Online Journal of Issues in Nursing, 21(3). DOI: 10.3912/OJIN.Vol21No03Man03
Yen, P. Y., Phillips, A., Kennedy, M. K., & Collins, S. (2017). Nursing informatics competency assessment for the nurse leader: instrument refinement, validation, and psychometric analysis. JONA: The Journal of Nursing Administration, 47(5), 271-277. https://doi.org/10.1097/NNA.0000000000000478