Generally speaking, Nursing has the largest representation within an acute hospital setting. Nursing is involved in the care of every patient that comes into the hospital. That being said, how nursing document their interactions with patients is a large part of their day. Integrating a new health information technology system should require the input of nursing. Nursing’s input is essential in understanding how the system could require additional workflow changes or updates. Poorly implemented systems can lead to unintended consequences that may have a negative impact on clinical processes and patient outcomes. (Piscotty, 2011)
When integrating a new system, the System Development Life Cycle (SDLC) model is used. This cycle has five different stages: Planning, Analysis, Design, Implementation, and Maintenance. Each of these stages is essential as you integrate new systems. During the analysis phase, the requirements for the system are teased out from a detailed study of the business needs of the organization. As part of this analysis, workflows and business practices are examined. It may be necessary to consider options for changing the business process. (McGonigle, 2017)
Nursing is especially crucial when you enter into the implementation stage. The system also was tested by three nurses before implementation. To ensure that the nurses could operate the CDSS correctly, a training manual was developed and provided to the nurses 3 weeks before the implementation date. (Lyerla, 2008) Once you have planned, analyzed, and implemented any new system, occasionally maintenance is required. We need to constantly be evaluating our systems to make sure that we are using it effectively and to its max potential.
During my time at Homestead Hospital, the operating systems were changed. Nursing was not consulted at the hospital level. The decision to change these systems was made at the corporate level and rolled out to the different facilities in stages. Our hospital was the first and the rollout was rough. We had representatives from the OS company to help facilitate the roll-out 24/7 for 1 week. We needed to constantly refer to them whenever we needed to address a concern or be reminded of how to mitigate certain situations. I think that transition would have been a bit smoother if there were training sessions with the staff prior to roll out. Physicians and nursing could have been trained with time before “go live” and a few issues could have been avoided. Any time that changes are made within an existing system or a new one is implemented, there will be hang-ups. Involving those that would be the most significant users helps in finding any conflicts or adjusting workflows prior to them impacting patient care.
Lyerla F. (2008). Design and implementation of a nursing clinical decision support system to
promote guideline adherence. CIN: Computers, Informatics, Nursing, 26(4), 227–233.
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