Survey of Nursing Integration of Genomics Into Nursing Practice

Abstract

Purpose Translating clinically valid genomic discoveries into practice is hinged not only on technologic advances, but also on nurses—the largest global contingent of health providers—acquiring requisite competencies to apply these discoveries in clinical care. The study aim was to assess practicing nurse attitudes, practices, receptivity, confidence, and competency of integrating genomics into nursing practice. Design A convenience sample of practicing nurses was recruited to complete an online survey that assessed domains from Roger’s Diffusion of Innovations Theory and used family history utilization as the basis for competency assessment. Methods Results were tabulated and analyzed using descriptive statistical techniques. Findings Two-hundred-thirty-nine licensed registered nurses, 22 to 72 years of age, with a median of 20 years in practice, responded, for an overall response rate of 28%. Most were White (83%), female (92%), and held baccalaureate degrees (56%). Seventy-one percent considered genetics to be very important to nursing practice; however, 81% rated their understanding of the genetics of common diseases as poor or fair. Per-question response rates varied widely. Instrument assessment indicated that modifications were necessary to decrease respondent burden. Conclusions Respondents’ perceived genomic competency was inadequate, family history was not routinely utilized in care delivery, and the extent of family history varied widely. However, most nurses indicated interest in pursuing continuing genomic education. Clinical Relevance Findings from this study can lead to the development of targeted education that will facilitate optimal workforce preparation for the ongoing influx of genetics and genomics information, technologies, and targeted therapies into the healthcare arena. This pilot study provides a foundation on which to build the next step, which includes a national nursing workforce study.

Introducing a New Competency Into Nursing Practice

“…The operational definitions of the Attitudes and Receptivity domain included the perceived importance, advantages, and disadvantages of integrating genomics into practice; the complexity of integrating family history into practice; and the perception of the value of family history in patient care and personal practice (Calzone et al, 2012). …”

“…The operational definitions of the Social System domain included supervisory support for nurses using genomics and institutional support for genomic continuing education (Calzone et al, 2012). Only 25.3% (n = 1,342/5,314) reported they thought theif senior staff members see genetics as an important part of the respondents’ role.…”

“…The operational definitions of the Confidence domain included self-reported confidence in discussing genetics with patients; deciding which family history information is relevant to assessing genetic susceptibility; facilitating referral for genetic services; and knowing the availability, risks, benefits, and limitations of genetic testing (Calzone et al, 2012). …”

“…The theoretical framework chosen to guide this project was Rogers’ Diffusion of Innovations (DOI) (Rogers, 2003). Genomics, as a new complex competency, meets the definition of an innovation according to DOI because it represents an idea, practice, or object with the perception of newness (Calzone et al, 2012). Though genomics is not new, Rogers (2003) argues that newness is also a function of knowledge, persuasion, or adoption.…”

Genomics and Precision Medicine

“…3 In 2005, nearly two-thirds of nursing leaders reported having an inadequate understanding of genomic medicine, and that number presumably was higher for bedside nurses. 4 Although genomics since has been added to many nursing curriculums, a knowledge gap remains and grows with the rapid advancements in this exciting field. 3 This knowledge gap may be especially true for advanced practice acute care nurses and nurses in the intensive care unit because genomics and precision medicine are more recent additions to critical care practice.…”