Integrating Genomic Professional Skills Into Nursing Practice: Results From a Large Cohort of Israeli Nurses

Nurses' Performance on the Genomic Nursing Inventory: A Cross-Sectional Study in Crete, Greece

Background/Objectives: Genomics plays a crucial role in healthcare, enhancing diagnostics, risk assessments, and therapeutic interventions. However, many healthcare professionals, including nurses, face challenges when it comes to integrating genomics into their practice. This study aims to evaluate the genomic knowledge of nurse practitioners in Greece by translating and validating the Genomic Nursing Concept Inventory (GNCI). Methods: A cross-sectional study involving 324 nurses was conducted in Crete, Greece. The GNCI, a 31-item questionnaire, was translated and validated for the Greek context to assess nurses' genomics competence. Results: The Greek version of the GNCI demonstrated acceptable reliability (Cronbach's alpha = 0.622). The confirmatory factor analysis indicated a satisfactory fit for the one-factor model. However, the mean GNCI score revealed significant knowledge gaps, with nurses answering only 30.1% of questions correctly. Notably, nurses showed a better understanding of genomic basics and mutations compared to inheritance and genomic healthcare applications. Conclusions: The present study successfully translated and validated the GNCI in Greek and highlighted important genomic-related knowledge gaps among Greek nurses, emphasizing the urgent need for more targeted educational interventions. By enhancing genomic literacy through curriculum integration and professional development, nurses could be better prepared, leading to improved patient care and healthcare outcomes in Greece.

Empowering midwives with genetic knowledge: A systematic review of educational needs in genomics

AIM

This systematic review aims to assess the level of genetics and genomics knowledge that midwives currently have and identify educational opportunities for them.

BACKGROUND

With mainstreaming of genetics and genomics in medicine, it is necessary to upskill health care professionals to ensure the best medical care for patients. Midwives offer continuity of care to pregnant women, which now includes talking about genetic screening and testing in pregnancy.

DESIGN

A systematic review was conducted, guided by the Arksey and O'Malley framework for scoping reviews.

METHODS

A systematic searched of Embase, PubMed, CINAHL, Medline and Scopus databases was conducted in February 2024. Full text of included studies were analysed and synthesised, with themes relevant to the study identified via meta-ethnography and narrative synthesis.

RESULTS

Sixteen studies were included, with diverse research questions and study types represented. Four themes emerged; 1) the low level of genetics/genomics knowledge of midwives, 2) the lack of educational opportunities available to them, 3) their understanding that genetics/genomics are critical to the care they provide and 4) their positive predisposition to further learning about genetics/genomics.

CONCLUSION

Extensive and comprehensive education in genetics/genomics is required for midwives to offer complete antenatal care to women and families and this should be embedded in midwifery educational programs.

Factors affecting nurses' genetic nursing competency: A systematic review

AIM

This study systematically analyzes key factors influencing nurses' genetic nursing competency to inform future genetic nursing education, research and practical interventions.

BACKGROUND

The advancements in genomic technology, genetic nursing has emerged as a critical component of personalized and precision medicine. However, existing research suggests that many nurses lack adequate preparation to address genetic nursing competency effectively.

DESIGN

This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42024577323) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.

METHOD

This systematic review retrieved quantitative studies published between January 2009 and June 2024 from seven databases. The inclusion process involved initial screening, full-text assessment for inclusion criteria and methodological assessment. Two researchers independently conducted literature screening and quality assessment using Zotero software, with discrepancies resolved through discussion or consultation with a third researcher. Thirteen studies included, encompassing 6816 registered nurses from multiple countries. The Joanna Briggs Institute risk of bias criteria was used for quality assessment and traditional content analysis was used to summarize quantitative findings.

RESULTS

Thirteen factors influencing genetic nursing competency were identified across three levels: individual (education, gender, work experience, basic knowledge, professional attitude, clinical skills, self-confidence, genetic awareness), environmental (unit differences, cultural and ethical cognition) and organizational (professional roles, professional development, leadership support).

DISCUSSION AND CONCLUSION

This study highlights individual, environmental and organizational factors affecting nurses' genetic nursing competencies. It emphasizes the need for targeted training, leadership support, policy development and international collaboration to achieve these competencies globally.

Developing Policy Infrastructure to Guide Genomics-Informed Oncology Nursing in Canada: An Interpretive Descriptive Study

BACKGROUND

Genomic technologies such as genetic testing and precision treatments are rapidly becoming routine in oncology care, and nurses play an increasingly important role in supporting the growing demands for genomics-informed healthcare. Policy infrastructure such as competencies, standards, scope of practice statements, and education and curriculum frameworks are urgently needed to guide these practice and education changes.

PURPOSE

This study is part of a larger three-phase project to develop recommendations and catalyze action for genomics-informed oncology nursing education and practice for the Canadian Association of Nurses in Oncology and the Canadian Association of Schools of Nursing. This phase aimed to enhance understanding of policy needs and action drivers for genomics-informed oncology nursing education and practice through the perspectives of Canadian oncology nurses and patient partners.

METHODS

Interpretive description methodology guided the study. Twenty semi-structured virtual interviews were conducted; 17 with oncology nurses in various domains of practice, and three with patient partner representatives. Data collection and analysis occurred concurrently.

RESULTS

Our analysis identified three themes: 1) nurses and patients recognize that it is time for action, 2) nurses and patients see advantages to executing intentional, strategic, and collaborative policy development, and 3) leadership and advocacy are required to drive action.

CONCLUSION

Nursing policy infrastructure is required to increase genomic literacy, support nurses in providing safe patient care, and establish clear roles, responsibilities, and accountabilities within the interdisciplinary team. Strong leadership and advocacy at the practice, organizational, and systems levels are vital to accelerating action.

Analysis of Nursing Education Curricula in Spain: Integration of Genetic and Genomic Concepts

The integration of genetics and genomics into nursing practice is essential for addressing genetic pathologies and providing personalized patient care. This study aims to analyze the nursing education curricula across Spanish universities to understand how genetic and genomic concepts are incorporated. Using the "Qué estudiar y dónde en la Universidad" (QEDU) database, an official source provided by the Spanish Ministry of Universities, a systematic review of 4720 teaching guides from 118 university centers was conducted. Our findings reveal that 12 centers do not include any genetic or genomic content, while 43% of the remaining centers focus solely on basic genetics. In contrast, 57% cover advanced topics, such as genetic counseling and pharmacogenetics. Teaching methodologies predominantly involve lectures and seminars, with limited practical training. On average, three to six ECTS credits out of the total 240 required for the Nursing Degree are dedicated to genetics and genomics. This study highlights the need for curriculum updates and standardization to ensure comprehensive training in these crucial areas. Improved integration of genetic and genomic education will better prepare nursing professionals to meet the evolving demands of modern healthcare. This study was not registered.

Essentials of genomics in nursing undergraduate education: A discussion paper

AIM

To map the 2021 American Association of Colleges of Nursing Essentials to the American Nurses Association Essentials of Genomic Nursing for all nurses and provide resources for nursing faculty to support the seamless integration of genomics into existing undergraduate curricula.

BACKGROUND

Since the completion of the Human Genome Project in 2003, rapid advancements in genomic science leading to practical applications of genomics have revolutionized all areas of healthcare. Nursing is built on foundational life sciences, including genomics. As the largest segment of the healthcare workforce, who spend the most time with patients and families, nurses play a critical role in healthcare teams integrating genomic knowledge into patient care to improve health and well-being. Consequently, nurses must be equipped with foundational genomic knowledge and skills during their undergraduate education. However, there is wide variability in whether and how nursing programs have incorporated genomics into their curricula. Additionally, nursing faculty may have limited knowledge of foundational genomic concepts and lack confidence in teaching genomics.

DESIGN

Discussion paper METHODS: We aligned domains from the American Association of Colleges of Nursing Essentials and American Nurses Association Essentials of Genomic Nursing.

RESULTS

A map illustrating alignment in multiple areas, which provide examples of ways to integrate genomics into existing nursing curricula.

CONCLUSION

Although based on domains developed in the United States, the map, curricular resources, example learning outcomes, and clinical vignettes can be used by nursing faculty globally to prepare future nurses who are competent in providing genomics-informed nursing care on entry-to-practice.

Predictors and outcomes of genomic knowledge among nurses in a middle eastern country: A cross-sectional study

BACKGROUND

Genomics has received significant attention in recent years. Nurses can uniquely contribute to the field of genomics and improve genomic healthcare. However, they lack the necessary knowledge to accomplish this, impacting their confidence, willingness, and ability to implement genomics healthcare negatively. Given Oman's unique healthcare context, its prospective genomics application, and the global trend toward genomic competency, it is essential to gauge nurses' genomic knowledge as basis for equipping them.

AIM

This study assessed the genomic knowledge among nurses in the Sultanate of Oman. It also explored the predictors and outcomes of their genomic knowledge.

DESIGN

This study used a quantitative, descriptive, cross-sectional design.

SETTINGS

Nurses from four public hospitals in Muscat Governorate, Sultanate of Oman were recruited to participate in the study.

METHODS

A total of 661 out of 700 nurses responded to the pen and paper self-report questionnaire (94 % response rate). Univariate, bivariate, and regression analyses were used for data analysis.

RESULTS

Consistent with international studies, nurses in Oman had low to moderate genomic knowledge. Years of experience in genetics healthcare and working in either the surgical and maternity units were positively associated with higher genomic knowledge. Working in the bone marrow transplant unit and having a family history of consanguinity were associated with poorer genomic knowledge. Higher genomic knowledge was associated with an increased willingness to care for patients with genetic issues, higher confidence in providing genomic healthcare, and a lower intention to pursue continuing education on genomics.

CONCLUSION

Strategies targeting variables, particularly those that are amenable to interventions, should be developed and implemented to foster genomic knowledge in nurses.

Developing leadership competencies for genomics integration through globally networked learning and education

Aim

To describe the implementation and evaluation of an education strategy called the globally networked learning-genomics (GNL-G) used in Master's courses in Canada and Finland. The study focused on the feasibility and effectiveness of GNL-G in developing leadership competencies for integrating genomics into practice.

Methods

Interpretive description qualitative methodology was used to explore how GNL-G, global exchanges and assignments standardized with the Assessment of Strategies to Integrate Genomics in Nursing (ASIGN) tool influenced competency development. The Reporting Item Standards for Education and its Evaluation in Genomics (RISE2 Genomics) framework guided the design, implementation, evaluation, and reporting of GNL-G. Data included one-to-one interviews, written assignments, and reflections.

Results

Interviews and assignment data from three cohorts of students for a total of ten Canadian and 11 Finnish master's students participated in this study. The ASIGN Tool played a crucial role in facilitating students' analysis of their practice context and the development of leadership strategies. Participation in GNL-G enhanced students' confidence to lead efforts to integrate genomics, irrespective of their genomics expertise. Engagement with global peers emphasized the importance of incorporating equity, ethics, and social justice into leadership strategies for genomics integration.

Conclusion

The GNL-G strategy enhanced leadership competencies for genomics integration in graduate students from Canada and Finland. The ASIGN Tool and global peer collaboration highlight the importance of innovative educational methods in preparing leaders for the complexities of genomics in healthcare.

Genomic Literacy among Nurses in Jordan: A Population-based Study

The current study aimed to measure genomic literacy among Jordanian nurses by evaluating their understanding of key genomic concepts and how they view genomics in nursing practice. Descriptive, Cross-sectional, and Correlational designs were used in this study. A descriptive design was used using the Genomic Nursing Concept Inventory (GNCI©), a 31-item instrument. Data were collected from a total of 751 participants. A total of 406 participants were female, and 395 (52.6%) were single. The mean score of the genome basics was 2.33, ranging from 0 to 13. The mean score of the knowledge about mutation was 0.57, ranging from 0 to 3. At the same time, the mean score for inheritance and genomic healthcare was 1.74 and 1.53, respectively. Nurses working in the oncology center had the highest genomic knowledge score (mean = 7.05, SD = 4.24) compared with nurses in other healthcare sectors (p =  < .001). There is a low level of genomic literacy among Jordanian nurses. Nurses must have sufficient genomic literacy to provide the best nursing care to patients, their families, and the community. Jordanian nurse authorities must develop competencies representing a minimum standard of care to provide competent genomic and genetically focused care.

Current State of Genomics in Nursing: A Scoping Review of Healthcare Provider Oriented (Clinical and Educational) Outcomes (2012-2022)

In the 20 years since the initial sequencing of the human genome, genomics has become increasingly relevant to nursing. We sought to chart the current state of genomics in nursing by conducting a systematic scoping review of the literature in four databases (2012-2022). The included articles were categorized according to the Cochrane Collaboration outcome domains/sub-domains, and thematic analysis was employed to identify key topical areas to summarize the state of the science. Of 8532 retrieved articles, we identified 232 eligible articles. The articles primarily reported descriptive studies from the United States and other high-income countries (191/232, 82%). More than half (126/232, 54.3%) aligned with the "healthcare provider oriented outcomes" outcome domain. Three times as many articles related to the "knowledge and understanding" sub-domain compared to the "consultation process" subdomain (96 vs. 30). Five key areas of focus were identified, including "nursing practice" (50/126, 40%), "genetic counseling and screening" (29/126, 23%), "specialist nursing" (21/126, 17%), "nurse preparatory education" (17/126, 13%), and "pharmacogenomics" (9/126, 7%). Only 42/126 (33%) articles reported interventional studies. To further integrate genomics into nursing, study findings indicate there is a need to move beyond descriptive work on knowledge and understanding to focus on interventional studies and implementation of genomics into nursing practice.

Genetics and genomics knowledge and competency of Chinese nurses based on the theory of diffusion of innovation: A descriptive cross-sectional study

Background

Nurses are responsible for providing genetics and genomics health care services, including disease risk assessment, medical referrals, and advocating for communities and individuals who probably benefit from genomics and genetics services.

Objective

This study aimed to investigate Chinese nurses' understanding and previous training in genomics and genetics. Additionally, we aimed to understand the degree to which Chinese nurses use genomics and genetics knowledge in their daily practice and to assess the learning needs regarding genomics and genetics.

Method

This study utilized the design of a descriptive cross-sectional study. From January 18 to March 15, 2022, 406 registered nurses from the Shandong province of China working in clinical institutions and with good English proficiency were recruited as study subjects. Nurses' demographic data and data related to genetic knowledge and competency were collected using the Genetics and Genomics Nursing Practice Survey (GGNPS) questionnaire. Kruskal Wallis and Mann-Whitney-U tests were utilized to investigate the descriptive statistics and non-normally distributed data.

Results

There are 406 nurses from Shandong Province, China participated in the study. Among them, BSN degrees accounted for 83.7%. Female nurses accounted for 96.8%, and 40% are clinical nurses. Among such nurses, 65.5% reported that genetics was involved in their nursing courses, and 56.2% planned to study more knowledge associated with genetics. The mean knowledge score was 7.35 (out of 12). Nurses' gender, primary role, genomics education, and experience caring for patients with common diseases influenced nurses' scores on genetic and genomics knowledge.

Conclusion

The genomics knowledge and competency of Chinese nurses need to be further improved. Incorporating genomics into the standard nursing curriculum can effectively reduce the knowledge gap. Simultaneously, it is also necessary to improve the attention of senior nurses and nursing managers to genomics nursing and improve the clinical practice environment.

A Scoping Review: Do instruments measuring genomic competence in nursing incorporate ethics?

AIM

To explore the instruments used in measuring genomic competence in nursing. The objective was to understand how ethical issues are reflected in the instruments.

DESIGN

A scoping review.

METHODS

A systematically conducted scoping review was conducted by using CINAHL Complete and Medline databases covering the years from January 2010 to January 2022. Two authors inspected potentially eligible papers and assessed their quality independently using the critical appraisal tools of Joanna Briggs Institute. Twenty-five articles were eligible including 19 different instruments. Included articles answered the research question: "How ethical issues are reflected in instruments measuring genomic competence in nursing?" The inductive thematic analysis was used in this review.

RESULTS

Descriptions of ethical themes were unstructured in the scoped articles and instruments. Not all genomic competence instruments covered ethical aspects. Only three studies asked direct questions by using the word ethics or its derivates, including confidentiality in solving ethical problems, familiarity with the ethical aspects of genetic counselling and ability to identify ethical issues. Thirteen articles included ethics-related themes encompassing knowledge, skills, concerns, advantages and disadvantages.

Genetic/genomic literacy, attitudes and receptivity of nursing students and practising nurses: A cross-sectional online survey

BACKGROUND

The growing demand for personalised nursing care in the genomic era requires nursing students and practising nurses to be better prepared to apply the knowledge of genetics/genomics to nursing practice. Several studies have shown that, despite having positive attitudes/receptivity towards integrating genetics/genomics into nursing practice, nursing students and professionals report a low level of genetic/genomic literacy. However, little is known about the status in Hong Kong.

OBJECTIVES

We assessed and compared the genetic/genomic literacy and attitudes/receptivity towards integrating genetics/genomics into nursing practice among nursing students and practising nurses in Hong Kong. We also explored the relationships between the students' background characteristics, attitudes/receptivity towards integrating genetics/genomics into nursing practice and genetic/genomic literacy.

DESIGN

A cross-sectional online survey conducted between March 2020 and January 2022.

SETTINGS

A government-funded university in Hong Kong.

PARTICIPANTS

We recruited a convenience sample of 234 nursing students, 145 were final-year undergraduate students (median age = 22 years, 84.1 % female) and 89 were practising registered nurses (postgraduate students studying part-time programme, median age = 28 years, 77.5 % female).

METHODS

The survey collected the participants' background information, attitudes/receptivity towards integrating genetics/genomics into nursing practice and levels of genetic/genomic literacy.

RESULTS

Overall, the participants reported positive attitudes/receptivity towards practice integration but had low levels of genetic/genomic literacy. Practising nurses were more likely to have lower genetic/genomic literacy, but more positive attitudes/receptivity towards practice integration, than undergraduate students. Multiple regression analysis suggested that the level of study (postgraduate/undergraduate programme) and perceptions of the disadvantages of 'needing to re-tool professionally' were significant independent factors associated with the level of genetic/genomic literacy.

CONCLUSIONS

Findings from this study call for the strategic integration of genetics/genomics education into all levels of nursing education in Hong Kong and across the globe. In particular, sustained efforts should be made to ensure that practising nurses receive further education in genetics/genomics.

Genetic and genomic nursing competency among nurses in tertiary general hospitals and cancer hospitals in mainland China: a nationwide survey

OBJECTIVES

To explore genetic/genomic nursing competency and associated factors among nurses from tertiary general and specialist cancer hospitals in mainland China and compare the competencies of nurses from the two types of hospitals.

DESIGN AND SETTING

A cross-sectional survey was conducted from November 2019 to January 2020, wherein 2118 nurses were recruited from 8 tertiary general hospitals and 4 cancer hospitals in mainland China. We distributed electronic questionnaires to collect data on nurses' demographics, work-related variables and genomic nursing competency.

PARTICIPANTS

2118 nurses were recruited via a three-stage stratified cluster sampling method.

RESULTS

More than half (59.1%, 1252/2118) of the participants reported that their curriculum included genetics/genomics content. The mean nurses' genomic knowledge score was 8.30/12 (95% CI=8.21 to 8.39). Only 5.4% had always collected a complete family history in the past 3 months. Compared with general hospital nurses, slightly more cancer hospital nurses (75.6% vs 70.6%, p=0.010) recognised the importance of genomics, while there was no significant difference in the knowledge scores (8.38 vs 8.21, p>0.05). Gender (β=0.06, p=0.005), years of clinical nursing (β=-0.07, p=0.002), initial level of nursing education (β=0.10, p<0.001), membership of the Chinese Nursing Association (β=0.06, p=0.004), whether their curriculum included genetics/genomics content (β=0.08, p=0.001) and attitude towards becoming more educated in genetics/genomics (β=0.25, p<0.001) were significantly associated with the nurses' genomic knowledge score.

CONCLUSION

The levels of genomic knowledge among mainland Chinese nurses in tertiary hospitals were moderate. The overall genomic competency of cancer hospital nurses was comparable to that of general hospital nurses. Further genomic training is needed for nurses in China to increase their genomic competency and accelerate the integration of genomics into nursing practice.

The Relationship Between Sleep Disturbance and Apolipoprotein E ε4 in Adults With Mild Cognitive Impairment and Alzheimer's Disease Dementia: An Integrative Review

BACKGROUND

Apolipoprotein E ε4 (APOE ε4) was shown to be a risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. When coupled with sleep disturbance, APOE ε4 posed additional risks to cognitive impairment. But the literature on the association between sleep disturbance and the APOE ε4 status of persons who are cognitively impaired has not yet been systematically examined.

OBJECTIVES

To explore and synthesize the relationship between sleep disturbance and APOE ε4 status of adults with MCI and AD.

METHODS

An integrative review was guided by Whittemore and Knafl's methodology. Systematic searches identified studies with multiple sources published before May 20, 2021. A matrix and narrative synthesis was employed to organize and synthesize the findings. Joanna Briggs Institute (JBI) Critical Appraisal tools (2020) were used to evaluate the quality of the selected studies.

RESULTS

A total of 7 studies were included. APOE ε4 was associated with poor sleep quality in terms of the deterioration of nighttime total sleep time, 24-hour total sleep time, rapid eye movement, sleep efficiency, sleep latency, and wake after sleep onset in a population with MCI or AD. The interacted and adjusted relationship between sleep disturbance and APOE ε4 on the progression of cognitive decline was inconsistent.

CONCLUSIONS

There is evidence to support an association between sleep disturbance and APOE ε4 in individuals with cognitive impairment, but a further examination of the relationship between sleep parameters and APOE ε4 is warranted, especially as the causal or dose-response relationship remains unclear.