Expanding Scope of Practice: Evaluating the Integration of Genomic Competency in Nursing Practice

Sunday, 17 November 2013: 11:20 AM

Laurie A Badzek, LLM, JD, MS, RN, FAAN1
Kathleen A. Calzone, PhD, MSN, RN, APNG, FAAN2
Jean Jenkins, PhD, RN, FAAN3
Stacey Culp, PhD1
Sarah Caskey, MS1
(1)School of Nursing, West Virginia University, Morgantown, WV
(2)Center for Cancer Research, Genetics Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
(3)Office of the Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD

Learning Objective 1: will be able to identify the current level of integration of genomics into nursing practice.

Learning Objective 2: will be able to idenify perceived barriers to the integration of genomics into nursing practice.

Background/Significance: Genomics is redefining the healthcare continuum. Nurses are an integral part of the interdisciplinary care team, directly affecting public welfare and safety. Integration of genomic competencies into nursing practice is necessary for the provision of safe, responsible, and accountable care.

Purpose: Evaluate institutional nursing workforce attitudes, practices, receptivity, confidence and competency in genomics of common disease and utilization of family history.

Methods: Roger's Diffusion of Innovation theory guided this study consisting of a baseline online survey utilizing practicing nurses in one of 21 Magnet Hospitals participating in a year-long genomic education initiative.  The survey assessed knowledge, skills, attitudes and utilization related to collecting family history, and beliefs about the usefulness of genomics in nursing practice.  Results were analyzed using descriptive statistical techniques. 

Results: 7306 licensed RNs responded for an overall response rate of 33% (range 17-63%) from all participating institutions.  Respondent’s mean age was 45 (range 20-72), with an average of 17 years in practice and most prepared at the baccalaureate level (59%).  Ninety percent considered genetics very important to nursing practice; however, 65% rarely or never assessed family history.  Seventy-nine percent rated their understanding of the genetics of common diseases as poor or fair. Nurses felt most confident in their skills of protecting confidentiality but were least confident related to genetic testing.  A total knowledge score was calculated from 12 questions revealing a mean 8.09/12 however 72% did not know or incorrectly stated that diabetes and heart disease are caused by a single gene variant, illustrating knowledge gaps.  More than 70% indicated they intend to learn more and are willing to attend on their own time.

Implications: Most respondents felt genomics was important but felt inadequately prepared to incorporate genomics into their practice.  Most were receptive to learning more.  All nurses would benefit from a broad-scale education intervention.