Academic journal article Nursing and Health Care Perspectives

MILES to Go before We Sleep

Academic journal article Nursing and Health Care Perspectives

MILES to Go before We Sleep

Article excerpt

The discoveries of the Human Genome Project (HGP), established in 1990 at the National Institutes of Health and the United States Department of Energy, are bringing important new technologies for genetic diagnosis and treatment to nearly all areas of health care delivery. Nurses, who play an integral role in supporting health consumers as they respond to health and illness, require up-to-date genetic knowledge for conducting clinical practice, engaging in nursing research, and educating a new generation of nurses.

"Virtually every disease (except perhaps trauma) has a genetic component" (1, p. 19). Before the year 2005, the HGP will completely map the approximately 100,000 genes located within the cells of the human body. This accomplishment will result in the increased accuracy of diagnoses through genetic testing, and make new, gene-mediated therapies possible for many diseases (2).

Efforts for increasing genetics in nursing education have been undertaken in many sectors (3,4). However, the authors contend that specific content with regard to genetics must be endorsed by approval and accreditation bodies. One of the strongest influences on nursing curricula comes from State Boards of Nursing (SBNs), which govern the requirements in basic (prelicensure) nursing education programs.

SBN approval is required for the operation of schools of nursing and qualification of graduates for nurse licensure. What SBNs require with regard to genetic content in nursing education curricula was examined in this two-phase study. Phase 2 of the study examined whether, and to what degree, nursing textbooks in use today contain genetic content.

Background In a survey of SBN-required processes and content for nursing education, Packard, Polifroni, and Shah (5) found that content areas in basic nursing education differ widely from state to state, with inconsistencies among states regarding qualifications for faculties, requirements for clinical instruction, and faculty-student ratios. An examination of the Model Nursing Administrative Rules and the Model Nursing Practice Act for the present study revealed that genetic content is not listed as an educational requirement by the National Council of State Boards of Nursing (6,7). While broad areas of agreement exist for nursing education (critical care, community-based practice, care of clients across the lifespan), specific areas, such as genetics, are the subject of debate among nurse educators, governmental education regulatory agencies, and voluntary accreditation commissions.

Advances in genetic research and technology have heightened the need to develop an infrastructure of knowledgeable health professionals prepared to identify patients and refer them to appropriate specialists. Prows and Latta (8) showed that reinforcement of genetic education by genetic resource nurses increased the utilization of genetic knowledge by staff nurses as evidenced in nursing assessments and interventions. The outcomes of this demonstration project showed a correlation between improved quality of care and nurse sensitivity to the needs of clients with genetic concerns. Indeed, in a survey of 1,000 nurses regarding knowledge of genetics and experiences with genetics in practice, 39 percent of respondents reported that they had received requests for information about genetic testing and counseling from their clients (9).

Anderson (10) conducted a comprehensive summary of results from several studies since the 1960s pertaining to nursing education programs, roles of nurses in clinical practice, and attitudes of nurses toward genetics. Echoing the call for increasing the knowledge base of nurses as advances in genetic health care proliferate, she recommended a number of initiatives to strengthen genetics in nursing, including invitational conferences, graduate nursing programs in genetics, and increased funding opportunities to support nursing research in genetics. …

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