Inclusion of Nurses in the Systems Development Life Cycle

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Inclusion of Nurses in the Systems Development Life Cycle

Description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples.
The SDLC describes a continuous life cycle of delivering an efficient and effective HIT system that uses a waterfall model to implement change in a healthcare organization. In this paper, the author discusses the role of nurses in every stage of the SDLC and the consequences of not involving nurses in each stage. Incorporating nurses in every stage of the SDLC ensures the development of an efficient system that meets all the needs of an organization. Inclusion of Nurses in the Systems Development Life Cycle.

Stages of the SDLC (Systems Development Life Cycle)

SDLC stages vary depending on the system being developed. Within healthcare organizations, the most important determining factor of a system’s content is nursing documentation. The SDLC has six stages namely: requirements definition and planning, analysis, design of the new system, implementation, and post-implementation support. According to McGonigle & Mastrian (2018), developers generally include nurses in each stage to ensure that all organizational and patient needs are met. However, to incorporate all the necessary inputs from stakeholders in an organization, most SDLC developers use a reverse system development approach.


Consequences of Not Involving Nurses in Each Stage of the SDLC

Planning and Requirements Definition

This is the initial phase in the SDLC of a new HIT and encompasses performing an economic, legal, operational, and schedule feasibility. Nurses play an integral role in determining and defining the scope of issues to be addressed, enlisting and discussing potential solutions, resource collection, determining the timeline of the project, and identifying the requirements to formulate outputs that the SDLC developers will use to build codes (Thomas, Seifert & Joyner, (2016). Inclusion of Nurses in the Systems Development Life Cycle. Including nurses in this stage of the SDLC is necessary since they have the right clinical knowledge of an organization’s processes and workflow. Failure to include nurses will result in developing a system that does not address specific patient care needs.


In this phase, the developers try to design workflow processes. As patient managers and advocates, nurses collaborate with other healthcare providers in managing patients. This implies that they are well knowledgeable on the workflows, roles, and responsibilities of each staff involved directly or indirectly in caring for patients. The nurse can help in identifying, explaining, and discussing HIT components such as tools for decision making that must be considered. As stated by Yen et al (2017), this is important in maintaining the performance of a system. Failure to include nurses in the analysis phase can lead to the development of a system with processes and workflow flaws.


The design phase includes data and interfaces design to determine the visualization of programs and the data that will be required. Nurses know the required non-essential and essential output and input data in nursing care processes at every point of care. Apart from helping with identifying the required input and output data, nurses can help with scrutinizing the flowcharts and work processes to ensure that they follow the right path to producing the expected output (Zytkowsi et al., 2015).Inclusion of Nurses in the Systems Development Life Cycle. Excluding nurses increases the risks of excluding important input or output data which can ultimately decrease the efficiency of a system.



In this phase, nurses check and troubleshoot the coded flowcharts to determine whether the developed system produces the required output. Nurses also collaborate with members of the SDLC team in customizing, testing, and installing the new system. Nurses can help in the collaboration role by organizing staff meetings, obtaining feedback, identifying implementation barriers and facilitators and areas that may need modifications (McGonigle & Mastrian, 2018). Failure to include nurses in the implementation phase can result in the development of a non-functional system that does not support clinical care. In comparison, including nurses increases their understanding of how the system ought to operate and promotes easy navigation.

Post-Implementation Support (maintenance and testing)

The post-implementation phase is important in ascertaining the functionality of each IT resource of a system. Zytkowsi et al (2015) note that, it also involves providing user support through planned and periodic changes of resources such as software. Failure to include nurses in this phase can lead to the development of a system that does not support other roles of patient care or a system with potential delays in clinical care. Inclusion of Nurses in the Systems Development Life Cycle.

Selection and Planning in My Healthcare Organization

During the development and implementation of the HIT system in my healthcare organization, the organization’s leadership incorporated all nurses in each stage of the SDLC. Inclusivity proved to be a worthy idea since the developers managed to capture communication and design flaws that could decrease the efficiency and performance of the system from nurses’ feedback. Based on the feedback obtained, the developers considered re-designing workflows in the ED department whose HIT system was incompatible with the HIT systems in other departments. Without timely and prompt identification of such inadequacies, it is inarguable that the organization could have incurred additional operational costs.


McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning

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.

Zytkowsi, M., Paschke, S., McGonigle, D., & Mastrian, K. (2015). Administrative information systems. In D. McGonigle & K. G. Mastrian (Eds.), Nursing informatics and the foundation of knowledge (3rd ed., pp. 187-200). Burlington, MA: Jones & Bartlett Learning. Inclusion of Nurses in the Systems Development Life Cycle.