Advanced nursing practice and research contributions to precision medicine

Abstract

Identified opportunities are within the areas of: bolstering genomic focused advanced practice registered nurse practice, research and education efforts; deriving new knowledge about disease biology, risk assessment, treatment efficacy, drug safety and self-management; improving resources and systems that combine genomic information with other healthcare data; and advocating for patient and family benefits and equitable access to genomic healthcare resources.

Comparison of perceived genetic-genomic knowledge of nurse educators and graduate degree nursing students

“…This "preparation extends far beyond the science and technology", addressing "the issues that promote patient adaptation to, as well as personal and clinical decisions" and their possible consequences, and the "interpretation and impact of information, risk perception, and available resources". [41] [27,42] While all DNP participants answered correctly to understanding amniocentesis and fetal phenotypic expression, only 38% NEs and 34.5% APRNs answered correctly. All participants responded poorly to the interpretation of the genetic inheritance pattern depicted in a patient's pedigree, with only 10 NEs answering correctly, 4 APRNs and 2 DNP participants.…”

“…[24] The complexity of this com- [25,26] However, APRNs who have limited educational training of G-G lack the knowledge competency to apply clinically significant findings. [27] APRNs who "lack the knowledge to understand the application. .…”

“…within the complex area of patient care risk missing opportunities to use genomic discoveries, optimize patients' health care, promote patient understanding, and facilitate patient/provider engagement". [27] Despite the growing use of G-G significance in clinical practice, health professional knowledge about genomic information and confidence in using it have not kept pace, as many health care providers do not have either the knowledge or the tools they need in order to apply genetic-genomic information in their day-to-day practices. [28] APRNs and DNPs maybe unprepared to fully integrate genetic-genomic concepts to maximize health outcomes for patients and families based on nurse educators preparedness to implement genetic-genomic competencies into nursing curricula.…”

A strategy for implementing genomics into nursing practice informed by three behaviour change theories

“…With regard to precision medicine, simply making genomic discoveries is not enough and effective translation into practice is vital. We need to assess how such discoveries contribute to health outcomes for individual patients and elucidate the issues around the integration of this knowledge across diverse population and healthcare settings, through the most effective nursing interventions. Whilst the efforts of nurse researchers are undoubtedly helping to realize this, the evidence base for such interventions remains scarce…”

“…It is time to move beyond justifying the relevance of genomics in nursing practice and to focus on building the evidence base for practice . This is being brought into even sharper focus as epigenomics research is revealing the implications of genome–environment interactions for long term health, and precision medicine aims to tailor treatment options based on our understanding of genomics and epigenomics . Calzone et al ., 2012, used the diffusion of innovations theory to evaluate genomic competencies among the current US nursing workforce and to inform the further diffusion of such knowledge.…”