Introduction
About the Book
Precision Healthcare: Genomics-Informed Nursing was developed for Georgian College as course material for NURS 4001.
Genomics is changing the healthcare landscape and providing opportunities to personalize patient care. With the widespread integration of genomics, nurses will increasingly need to incorporate genomic knowledge into their practice to provide safe, equitable, timely, and accessible care. This book will provide nursing professionals with the foundational genomic knowledge to navigate this rapidly evolving field.
Readers will explore genomics integration in personalized healthcare and how it relates to nursing practice. Genomic literacy is vital to understanding how genetic variations and environmental and lifestyle factors contribute to disease susceptibility and progression. Nurses with a strong foundation in genomics will be better equipped to assess genetic risk factors, interpret genetic and genomic data, and communicate with patients about their genomic health.
The chapters in this book will allow readers to explore the many factors that influence gene expression and lead to disease development, such as obesity, cancer, diabetes, cardiovascular disease and mental health disorders. Nurses will gain insight into modifiable and non-modifiable risk factors to develop evidence-based interventions that promote health and improve patient outcomes. By applying genomics-informed practices, nurses can advocate for personalized healthcare strategies that meet the needs of individual patients and populations. Nurses will also consider their role as part of an interdisciplinary team delivering genomic services and future nursing practice initiatives.
Navigation
The content of this book is divided into thirteen units. Students are expected to work through the materials in a unit for each week of study. This course was designed for an asynchronous course. The 28-hours of course time is to be used reviewing materials. Additional time will be spent on reviewing and completing assignments in further depth. Units 7 and 11 provide time to apply learning. The intent of these two weeks is to give students time to work on discussion posts, case studies, and scholarly posters. Additional case studies and learning activities are provided for optional independent practice.
Each chapter begins with an overview of the content covered and learning outcomes for the unit. Canada has not developed genomic competencies for nurses. Therefore, the NHS competencies from the UK and the ANA competencies from the US will be used. It should be noted that the competencies are meant to be demonstrated in practice. Each chapter aims to provide foundational theoretical knowledge that nurses need to be able to demonstrate these competencies in practice. However, this course does not include a practical component, so the competencies should be interpreted with this in mind. The competency documents should be consulted for clinical performance indicators.
The National Institutes of Health (NIH), National Human Genome Research Institute (NHGRI) talking glossary, and other sources provide definitions of key terminology in the unit. For pronunciation of terminology and audiovisual resources to enhance understanding of the term, visit the NHGRI talking glossary website. Select terms are listed at the start of each chapter and are highlighted as they appear in the body of the text. The subsequent sections of each unit contain the course content, learning activities, external resources, additional required reading, and related media. Key takeaways and additional optional readings are in the final chapter of each unit.
Overview
Unit 1: Introduction to Personalized Healthcare and the Role of the Nurse
- Genetics and genomics introduction
- The contributions of nursing professionals in genomics healthcare
Unit 2: Molecular Genetics Review
- DNA structure and function
- The genome and the cell cycle
- Cancer and the cell cycle
- The cellular basis of inheritance
- Patterns of inheritance
Unit 3: The Exposome
- Nature vs nurture
- Epigenetics
- Developmental origins of health and disease
- The exposome
- Adverse early childhood experiences
- Epigenetics in practice
Unit 4: Genetic Disorders
- Gene variants
- Genetic disorders
- Single gene disorders
- Polygenic disorders
- Chromosomal disorders
- Mitochondrial disorders
Unit 5: Genomics Nursing Research
- Genomic research in nursing
- Human genetic research in Canada and Internationally
- Research priorities and funding
- Knowledge translation and mobilization
- Scholarly posters
Unit 6: Assessing Genetic Risk
- Family history
- Constructing a pedigree chart
- Pedigree analysis and modes of inheritance
- Calculating probabilities using pedigree charts
- Polygenic risk scores
Unit 7: Application of Theory in Practice Part 1
- There is no new reading material for this unit.
- Some case studies and exercises are presented for optional additional independent review and practice.
- Students are given time to complete the discussion post group assignment and begin work on the case study assignment.
Unit 8: Genetic Testing
- Genetic testing overview
- Types of Genetic tests
- Interpreting genetic test results
Unit 9: Pharmacogenomics
- Pharmacogenomics overview
- Genomic variation in drug response
- Personalized drug therapy
- Limitations of pharmacogenomic testing
Unit 10: Ethical, Legal, and Social Issues Arising from Genomics
- Genetic discrimination
- Eugenics and scientific racism
- Use of population descriptors in genomics
- Nursing implications
Unit 11: Application of Theory in Practice Part 2
- There is no new reading material for this unit.
- Some case studies and exercises are presented for optional additional independent review and practice.
- Students are given time to complete the discussion post group assignment and complete work on the case study assignment.
Unit 12: Special Topics in Genomics
- Genomics and global health
- Cancer genomics
- Genomics application by specialty
Unit 13: The Future of Genomics and Nursing
- Gene editing
- Other genomic technologies
- Health system readiness for the genomic era
Attribution
Except where otherwise noted, this page is written by Andrea Gretchev, CC BY-NC 4.0
