to your colleagues using one or more of the following approaches: Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions? This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process. An organization should never underestimate the importance of the involvement of all key stakeholders from beginning to the end of the system development life cycle (SDLC) (McGonigle & Mastrian, 2012). Nurses play a vital role in the success of an implementation of a new Health Information Technology (HIT) system, and efforts should be made to maintain their involvement throughout the process. The majority of nurses have positive attitudes towards HIT, and most negative attitudes come from poor system design or a slow or malfunctioning system (Huryk, 2010). Nurse leaders set the stage for a successful implementation by providing a positive and nurturing environment for the staff (Huryk, 2010). For successful adoption of a new HIT system the nurse must feel that the system has value and will be helpful in their daily workflow (Hsiao, Chang, & Chen, 2011). Countless aspects influence this perceived usefulness including management support, compatibility, and information quality (Hsiao et al., 2011). The role of nurses is critical as the providers of bedside care and managers of patient health information. Sustainment may fail without the initial buy-in, continued support, and involvement of nurses in the adoption process. Nursing feedback is essential to consider when conducting all stages of the SDLC process, to improve training, functionality, and adoption by all staff members. Although the process is trying, most nurses prefer the electronic system to paper after time and are willing to get involved with the process and promote usage. The first step of assessing the systems needs carries the obligation of identifying all the needs of the facility; no one knows this better than the nurse providing care for the patients. In this phase, an analysis of every area of the hospital, clinical and non-clinical, is completed to assess the services they provide and identify gaps that may exist in the current system as compared to the planned system. The nurses give invaluable information and can help avoid costly errors and potential
change requests in the future. This process also addresses step two, analyzing specifications for the system. If the facility has a need for a particular system, program or interface that exists or needs to be built, these should be identified at this point. Designing, developing, and testing the system is the next step in the SDLC process. Although some electronic health records (EHRs) have more flexibility than others, the nurse can help identify any issue that may exist in the present system to ensure prevention in the new system. A good example is in the system we are presently implementing. The ADT system does not allow for a transfer to another facility within our system and to move a patient to another campus, a discharge must occur. This process will create a new encounter number, requiring duplication of all documentation (i.e., admission history). If it was not for the workflow process review and the help of our nursing and ancillary staff this issue may not have been addressed. During the implementation process the nurses are invaluable. Nurses are our trainers for both physician and staff and our super users. Without the assistance of the nursing staff and their support, the implementation process would not be successful. This process also encompasses the next SDLC step which is support the system operations and users. The nurses work closely with the physicians, staff members, and the informatics department to support one another during and after the implementation process. One potential issue that could occur without the assistance of the nursing staff is the participation of computerized physician order entry (CPOE) by the physicians. The nursing staff support will assist the physicians in this process as they do today in many other areas. Evaluating the system is the last step and we do this process prior to and after the implementation. The subject matter experts, nurses from specialized areas, run test scripts after the interfaces are built to ensure they are working correctly. These nurses become experts on the system and excellent resources for their coworkers and the implementation team. These nurses continue the role of the super user and assist with maintaining the system with upgrades and changes in the future. Problems, issues, and questions arise at every point in an implementation process and the nurse is frequently our first resource for reliable information. References Hsiao, J., Chang, H., & Chen, R. (2011). A study of factors affecting acceptance of hospital information systems: A nursing perspective. , (2), 150-160. londonessays.com Huryk, L. A. (2010). Factors influencing nurses attitudes towards healthcare information technology. , (5), 606-612. londonessays.com McGonigle, D., & Mastrian, K. (2015). Systems development life cycle: Nursing informatics and organizational decision making. In D. McGonigle & K. Mastrian (Eds.), (3rd ed., pp. 173-185). Burlington, MA: Jones & Bartlett Learning.