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Understanding the application of genomics knowledge in nursing and midwifery practice: A scoping study

  • Jessica E Schluter
    Correspondence
    Corresponding author at: Clinical Nurse Consultant, The Prince Charles Hospital, Building 22, 490 Hamilton Road, Chermside QLD 4032. Tel.: 0422124078.
    Affiliations
    Clinical Nurse Consultant, The Prince Charles Hospital, Queensland Health, Brisbane, Queensland, Australia
    Search for articles by this author
Published:October 03, 2022DOI:https://doi.org/10.1016/j.colegn.2022.09.011

      Abstract

      Background

      With the increased realisation of the benefits of genomic testing, nurses and midwives are being exposed to genomic care as a part of normal clinical practice.

      Aim

      To explore how Queensland nurses and midwives are applying genomics knowledge in clinical practice to understand how best to support the workforce to meet patient needs in response to increased genomic testing rates.

      Methods

      A scoping methodology was used whereby the research question was defined, relevant studies were identified for the purposes of a literature review, followed by interviews with 32 nurses and midwives to support the interpretation of the literature review and to understand the implications for practice.

      Findings

      Nurses and midwives are working in partnership with their patients and families to support genomic decision making. The emerging needs of patients to understand their diagnostic and treatment pathway is forcing nurses and midwives to self-educate to keep pace with current practice demands. This approach to upskilling is not adequate for those nurses and midwives currently who are regularly exposed to patients requiring genomic support.

      Discussion

      Despite national and local policy documents identifying genomics workforce capacity as a strategic priority action and clinicians reporting their involvement in genomics care, there is a lack of succession planning, organisational support and educational opportunities to support these advances in practice.

      Conclusion

      There is a need to address the emerging genomic workforce and education requirements to ensure nurses and midwives are capable of supporting patients undergoing genomic testing.

      Keywords

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      References

        • Aiello L.
        Genomics education: knowledge of nurse across the profession and integration into practice.
        Clinical Journal of Oncology Nursing. 2017; 21: 747-753https://doi.org/10.1188/17.CJON.747-753
      1. American Association of Colleges in Nursing. (2008). Essentials of Baccalaureate Education for Professional Nursing Practice. Washington: AACN. Retrieved from https://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf.

      2. Australian College of Nursing. (2020). Nurses, genomics and clinical practice. Canberra: ACN. Retrieved from: https://www.acn.edu.au/wp-content/uploads/position-statement-nurse-genomics-clinical-practice.pdf.

        • Badzek L.
        • Henaghan M.
        • Turner M.
        • Monsen R.
        Ethical, legal and social issues in the translation of genomics into health care.
        Journal of Nursing Scholarship. 2013; 45: 15-24https://doi.org/10.1111/jnu.12000
        • Barr J.
        • Tsai L
        • Welch A.
        • Faradz S.
        • Lane-Krebs K.
        • Howie V.
        • Hillman W.
        Current practice for genetic counselling by nurses: an integrative review.
        International Journal of Nursing Practice. 24. 2018https://doi.org/10.1111/ijn.12629 (Article e12629)
        • Calzone K.
        • Jenkins J.
        • Culp S.
        • Caskey S.
        • Badzek L.
        Introducing a new competency into nursing practice.
        Journal of Nursing Regulation. 2014; 5: 40-47https://doi.org/10.1016/s2155-8256(15)30098-3
        • Camak D.
        Increasing importance of genetics in nursing.
        Nurse Education Today. 2016; 44: 86-91https://doi.org/10.1016/j.nedt.2016.05.018
        • Cashion A.
        The importance of genetics education for undergraduate and graduate nursing programs.
        Journal of Nursing Education. 2009; 48: 2
        • Competencies Consensus Panel on Genetic/Genomic Nursing
        Essentials of genetic and genomic nursing: Competencies, curricula guidelines and outcome indicators.
        2nd ed. American Nurses Association, Silver Spring, MD2009
        • Cornel M.
        Evidence-based genetic education of non-genetic-expert physicians: experiences over three decades.
        Frontiers in Genetics. 2019; 10https://doi.org/10.3389/fgene.2019.00712
        • Davis K.
        • Drey N.
        • Gould D.
        What are scoping studies? A review of the nursing literature.
        International Journal of Nursing Studies. 2009; 46: 1386-1400https://doi.org/10.1016/j.ijnurstu.2009.20.010
      3. Department of Health. (2017). National Health Genomics Policy Framework (No. 978-1-76007-328-2). Canberra: Department of Health. Retrieved from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/FD973B58DE82BCFFCA2581CC007D4682/$File/National-Health-Genomics-Policy-Framework.pdf.

      4. Department of Health. (2019). Health Workforce Data. Canberra: Department of Health. Retrieved from: https://hwd.health.gov.au/resources/index.html?topic=nrmw.

      5. Department of Health. (2018). Implementation Plan: National Health Genomics Policy Framework (No. 978-1-76007-362-6). Canberra: Department of Health. Retrieved from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/FD973B58DE82BCFFCA2581CC007D4682/$File/Implementation-Plan-to-the-Framework.pdf.

        • Godino L.
        • Turchetti D.
        • Skirton H.
        Knowledge of genetics and the role of the nurse in genetic health care: a survey of Italian nurses.
        Journal of Advanced Nursing. 2013; 69: 1125-1135https://doi.org/10.1111/j.1365-2648.2012.06103.x
        • Hagens V.
        • Dobrow M.
        • Chafe R.
        Interviewee transcript review: assessing the impact on qualitative research.
        BMC Medical Research Methodology. 2009; 9: 1-8https://doi.org/10.1186/1471-2288-9-47
        • Levac D.
        • Colquhoun H.
        • O’Brien K
        Scoping studies: advancing the methodology.
        Implementation Science. 2010; 5: 1-9https://doi.org/10.1186/1748-5908-5-69
        • Lillie A.
        • Clifford C.
        • Metcalfe A.
        Caring for families with a history of cancer: why concerns about genetic predisposition are missing from the palliative agenda.
        Palliative Medicine. 2011; 25: 117-124https://doi.org/10.1177/0269216310383738
        • Lincoln Y.
        • Guba E.
        Naturalistic inquiry. Newbury Park.
        Sage, Newbury Park, CA1985
        • Lynch F.
        • Niselle A.
        • Gaff C.
        • McClaren B.
        Rapid acute care genomics: challenges and opportunities for genetic counsellors.
        Journal of Genetic Counseling. 2021; 30: 30-41https://doi.org/10.1002/jgc4.1362
        • McCabe M.
        • Ward L.
        • Ricciardi C.
        Web-based assessment of genomic knowledge among practising nurses: a validation study.
        The Journal of Continuing Education in Nursing. 2016; 47: 189-196https://doi.org/10.3928/00220124-20160322-09
        • McCormick K.
        • Calzone K.
        Genetic and genomic competencies for nursing informatics internationally.
        Studies in Health Technologies and Informatics. 2017; 232: 152-164
        • Niselle A.
        • Bishop M.
        • Charles T.
        • Morissy S.
        • King E.
        • Metcalfe S.
        • et al.
        Lessons learnt from implementing change in newborn bloodspot screening processes over more than a decade: midwives, genetics and education.
        Midwifery. 2019; 79https://doi.org/10.1016/j.midw.2019.102542
      6. New South Wales Ministry of Health. (2017). The changing landscape of the genetic counselling workforce: Final report. Sydney: Urbis. Retrieved from: https://www.health.nsw.gov.au/workforce/alliedhealth/Documents/gsw-final-report.pdf.

      7. Nursing and Midwifery Council. (2018). Future nurse: Standards for proficiency for registered nurses. United Kingdom: NMC. Retrieved from: https://www.nmc.org.uk/globalassets/sitedocuments/standards-of-proficiency/nurses/future-nurse-proficiencies.pdf.

        • O'Leary P.
        • Maxwell S.
        Newborn bloodspot screening policy framework for Australia.
        Australasian Medical Journal. 2015; 8: 292-298
        • Polit D.
        • Beck C.
        Nursing research: Generating and assessing evidence for nursing practice.
        Lippincott Williams & Wilkins, Philadelphia2007
        • Prow C.
        • Glass M.
        • Nicol M.J.
        • Skirton H.
        • Williams J.
        Genomics in nursing education.
        Journal of Nursing Scholarship. 2005; 37: 196-202
      8. Queensland Genomics. (2021). Accelerating change in healthcare: July 2016 - June 2021. Queensland Genomics. https://queenslandgenomics.org/qldgenomics-updated/wp-content/uploads/2021/06/End-of-program-report.pdf.

      9. Queensland Health. (2019). Succession Management and Mentoring Manual and Toolkit for Nurses and Midwives. Brisbane: Office of the Chief Nursing and Midwifery Officer.

        • Health Queensland
        Genomics and precision health.
        Brisbane: Queensland Government, 2021 (Unpublished report)
        • Rickard C.
        • Williams G.
        • Ray-Barruel G.
        • Armit L.
        • Perry C.
        • Luke H.
        • et al.
        Towards improved organisational support for nurses working in research roles in the clinical setting: a mixed method investigation.
        Collegian. 2011; 18 (Article): 165-176https://doi.org/10.1016/j.colegn.2011.07.002
        • Saleh M.
        • Kerr R.
        • Dunlop K.
        Scoping the scene: what do nurses, midwives, and allied health professionals need and want to know about genomics?.
        Frontiers in Genetics. 2019; 10: 1066https://doi.org/10.3389/fgene.2019.01066
        • Skirton H.
        • O'Connor A.
        • Humphreys A.
        Nurses’ competence in genetics: a mixed method systematic review.
        Journal of Advanced Nursing. 2012; 68: 2387-2398https://doi.org/10.1111/j.1365-2648.2012.06034.x
      10. Ward, L. (2011). Development of the Genomic Nursing Concept Inventory. [Doctoral dissertation, Washington State University]. https://www.proquest.com/openview/43ffbc7e9d350926d1861ab00fae5045/1?pq-origsite=gscholar&cbl=18750.

        • White S.
        • Jacobs C.
        • Phillips J.
        Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care.
        Genetics in Medicine. 2020; 22: 1149-1155https://doi.org/10.1038/s41436-020-0785-6
        • Wright H.
        Genomics in nursing practice in Australia.
        2018https://doi.org/10.25903/5ee03361734a0 ([Doctoral dissertation, James Cook University]. Research Online @ JCU)
        • Wright H.
        • Zhao L.
        • Birks M.
        • Mills J.
        Nurses’ competence in genetics: an integrative review.
        Nursing and Health Sciences. 2018; 20: 142-153https://doi.org/10.1111/nhs.12401
        • Wright H.
        • Zhao L.
        • Birks M.
        • Mills J.
        Genomic literacy of Registered Nurses and Midwives in Australia: a cross-sectional survey.
        Journal of Nursing Scholarship. 2019; 51: 40-49https://doi.org/10.1111/jnu.12440
        • Wright H.
        • Birks M.
        • Zhao L.
        • Mills J.
        Genomics in oncology nursing practice in Australia.
        Collegian. 2020; 27: 410-415