Respond by offering additional thoughts regarding the examples shared, Systems Development Life Cycle SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.
Initial Post
Consequences of a Healthcare Organization not Involving Nurses
Nurses are the backbone of healthcare and when they are not involved in the design and decision-making processes of the Systems Development Life Cycle the results can be catastrophic. According to the authors Powell-Cope & Nelson (2008), nurses are the frontline and chief users of electronic health record (EHR) systems, it only makes sense they’d have a major say in EHR design and upgrades. Unfortunately, however, in many facilities, EHR design is left primarily to IT and only minor input is taken into consideration from the nursing staff. When subject matter experts, such as nurses, don’t have autonomy and responsibility within the design process, implementing and utilizing an EHR can take longer because providers are distanced from the outcomes (Powell-Cope & Nelson, 2008).
Inclusion of Nurses in EHR Design
When nurses are included in technology design, it enables and enhances safety (Hamer & Cipriano, 2013). A study was done in 2009 on early nursing involvement during the implementation of a Bar Code Medication Administration (BCMA) system. The authors of this study describe how nurses participated in the early design, planning, implementation, and evaluation phases of the BCMA. The study found that the benefits of early nursing involvement in each phase of BCMA technology greatly outweigh the problems that can arise from early nursing involvement (Weckman & Jansen, 2009). This study found that in order to find success when implementing new technologies, it is essential that nurses be involved throughout all phases of the process. Comments and feedback from nurses provide the necessary clues that are needed to resolve underlying systemic issues and can offer possible resolutions.
My Personal Input
My current healthcare facility is changing its EHR system to Epic. They have selected a specific team of nurses and nurse informaticists that are currently part of their healthcare team, to design and adapt the Epic program to meet the institution’s requirements. My facility has named their adaptation of the Epic EHR to Elle. The entire healthcare team has been invited to monthly townhouse meetings which involve disclosing the most recent updates made to Elle and team members are also encouraged to provide input on any modifications they would like to add to Elle. As critical nurses, we are excited that we will finally have a charting system that downloads our vital signs electronically. Before Elle, we had to write our vital signs every 15 minutes on each of our two patients. It might not seem like a big deal, but writing vital signs for two patients can take up a considerable amount of time, especially when a patient is unstable and on multiple drips. If nurses were not involved in the EHR design, downloading vital signs might be something that was overlooked again.
References
Hamer, S., & Cipriano, P. (2013). Involving nurses in developing new technology. Nursing Times, 109(47). Powell-Cope, G., Nelson, A. L., & Patterson, E. S. (2008). Patient Care Technology and Safety. Retrieved April 22, 2019, from https://www.ncbi.nlm.nih.gov/books/NBK2686/ Weckman, H. N., & Jansen, S. K. (2009). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. The Online Journal of Nursing Issues, 14(2).
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