Why is Genomic Literacy Important for Nursing?
Depending on education and area of practice, a nurse can:
(1) Incorporate genomic knowledge into their clinical assessments and identify potential genetic risks;
(2) Utilize assessment findings to make appropriate referrals to clinical genetic services and related specialities;
(3) Support equitable access to genetic testing and assist patient decision-making regarding participation in research that involves genetic testing;
(4) Engage in advocacy and educational efforts that incorporate genomics with an understanding of the social determinants of health; and
(5) Collaborate in interprofessional and cross-sector collaboration that involves innovation in genomics and precision health.
Genomics & Nursing
Genomics involves the study of genes, and the interaction between genes and with one’s environment. Genomics is transforming every sector of healthcare, including disease screening and prevention, diagnostics, and treatment decision-making. For example, genomics is transforming cancer screening with the clinical adoption of more comprehensive forms of genetic screening (e.g. multi-gene panel testing), and tumour testing for important biomarkers, such as PD-L1 and tumour mutational burden, to guide treatment with immunotherapy. Advances in genomics and our understanding of genetic risk have contributed to the emergence of precision health, where clinical recommendations and management are tailored to the individual patient. This facilitates a personalised approach to diagnostics and enables improved patient outcomes.
Precision health represents a new approach to clinical care and requires nurses to have foundational knowledge in genomics (genomic literacy) to implement new care pathways and healthcare strategies (Fawaz, 2021; Seed et al., 2021; Calzone et al., 2018). Nurses with genomic literacy can enhance the clinical utility of genomics, support patients, and address important ethical issues – all of which will improve the overall experience for patients.
With nurses working in all healthcare sectors, they are well positioned to facilitate the adoption of genomics while supporting equity and diversity in health system transformation to incorporate genomic discoveries.
Many Canadians are living with different health conditions and diseases known to have a genetic basis.
Within Canada, 1 in 12 Canadians are impacted by a rare disease,
and the majority have a genetic basis (CADTH, 2013).
Cystic fibrosis is a fatal genetic disease affecting one in
every 3,600 Canadians (Cystic Fibrosis Canada, 2021).
It is estimated that 27,700 Canadian women will be diagnosed
with breast cancer in 2021, of which 5-10% of cases will be attributed
to a genetic mutation in one or more cancer susceptibility genes (Canadian Cancer Society, 2021).
Inflammatory bowel disease (IBD) is anticipated to impact 1 in 100 Canadians by 2030.
Currently, there are approximately 200 genetic mutations linked to IBD,
as well as other autoimmune conditions, such as rheumatoid arthritis (Crohn’s and Colitis Canada, 2019).
Nurses are responsible for caring for individuals affected by these different conditions. Ensuring nurses have the foundational knowledge and skills to participate in genomics informed care will improve patient care and health outcomes, and patient experience and provider satisfaction.