Methods of Genomic Competency Integration in Practice

Key wordsChampions, competency, education, genomics, nursingAbstractPurpose: Genomics is increasingly relevant to health care, necessitating support for nurses to incorporate genomic competencies into practice. The primary aim of this project was to develop, implement, and evaluate a year-long genomic education intervention that trained, supported, and supervised institutional administrator and educator champion dyads to increase nursing capacity to integrate genomics through assessments of program satisfaction and institutional achieved outcomes.Design: Longitudinal study of 23 Magnet Recognition Program^R Hospitals (21 intervention, 2 controls) participating in a 1-year new competency integration effort aimed at increasing genomic nursing competency and overcoming barriers to genomics integration in practice.Methods: Champion dyads underwent genomic training consisting of one in-person kick-off training meeting followed by monthly education webinars. Champion dyads designed institution-specific action plans detailing objectives, methods or strategies used to engage and educate nursing staff, timeline for implementation, and outcomes achieved. Action plans focused on a minimum of seven genomic priority areas: champion dyad personal development; practice assessment; policy content assessment; staff knowledge needs assessment; staff development; plans for integration; and anticipated obstacles and challenges. Action plans were updated quarterly, outlining progress made as well as inclusion of new methods or strategies. Progress was validated through virtual site visits with the champion dyads and chief nursing officers. Descriptive data were collected on all strategies or methods utilized, and timeline for achievement. Descriptive data were analyzed using content analysis.Findings: The complexity of the competency content and the uniqueness of social systems and infrastructure resulted in a significant variation of champion dyad interventions.Conclusions: Nursing champions can facilitate change in genomic nursing capacity through varied strategies but require substantial training in order to design and implement interventions.Clinical Relevance: Genomics is critical to the practice of all nurses. There is a great opportunity and interest to address genomic knowledge deficits in the practicing nurse workforce as a strategy to improve patient outcomes. Exemplars of champion dyad interventions designed to increase nursing capacity focus on improving education, policy, and healthcare services.Nurses, as reflected in the Institute of Medicine's (IOM's) Report on the Future of Nursing (IOM, 2011), are an integral part of the interprofessional care team directly affecting public welfare and safety. Nursing leaders can enhance safe personalized health care as designers of delivery systems that include a prepared workforce and policies that deliver responsible, effective, and accountable care that includes new competencies. One example of a new competency with the potential to redefine the nature of healthcare is genomics (Calzone, Jenkins, Culp, Caskey, Badzek, 2014). Genomics is increasingly relevant to health care, necessitating support for nurses to incorporate genomic competencies into practice (Consensus Panel on Genetic/Genomic Nursing Competencies, 2009; Greco, Tinley, & Seibert, 2012). Genomics, which is inclusive of genetics, is the study of how genetic variation influences health. Genomics applications encompass risk identification, disease screening, prevention, diagnosis, prognostics, and therapeutic decision making (Green, Guyer, & National Human Genome Research Institute, 2011).BackgroundImplications of Genomics to Nursing PracticeThe current context of a rapidly changing healthcare environment spurred by technology and new scientific discoveries has produced expansion in healthcare information that impacts public welfare, patient safety, and cost containment. …