JOPHON NCPD (2024 Mar/Apr) - Genomes for Nurses: Understanding and Overcoming Barriers to Nurses Utilizing Genomics-ARTICLE: JOPHON NCPD (Mar/Apr 2024)

ARTICLE: JOPHON NCPD (Mar/Apr 2024) - Genomes for Nurses

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This quality-improvement project examined why pediatric oncology nurses struggle to use genomic information in practice and how they prefer to learn genomics. Conducted at a large U.S. academic pediatric cancer hospital, the study surveyed registered nurses, nurse practitioners, and physician assistants and supplemented findings with five focus groups.<br /><br />An anonymous electronic survey (9 sections, including 15 genetics-focused knowledge items) was sent to 670 eligible staff; 168 participated (25% response rate). Most respondents were RNs (79%), primarily in clinical care, with an average of 14.9 years in pediatric oncology. Nearly 90% reported no prior genetics/genomics coursework or continuing education. Although 40% said patients/families ask them genomics questions at least occasionally, 72% felt unprepared to answer.<br /><br />Baseline knowledge was mixed: 75% understood variant classification (benign/pathogenic/uncertain significance), but only 55% could distinguish germline from somatic variants. Most recognized genomics’ clinical utility (94%).<br /><br />The top perceived nursing role in genomics was educating patients and families (66% ranked it most important), along with taking family histories and initiating genetics referrals. More than half did not view explaining genetic test results as part of their role. The leading barrier to obtaining genomics education was lack of time (77%). The leading barrier to using genomics in daily practice was lack of personal understanding/confidence (69%); over half were also unsure of their scope of practice in genomics.<br /><br />Education preferences favored interactive approaches: in-person seminars/Q&A with experts and case-based computer modules were most preferred. For patient/family education tools, respondents favored short illustrated books and handouts.<br /><br />Focus groups reinforced survey findings and highlighted additional barriers, including limited structured institutional communication about genomics and a perception that genomics training is “for the doctors.” The authors conclude that targeted, institution-supported, interactive education with protected time and accessible materials is needed to build nurses’ genomics confidence and integrate genomics into pediatric oncology care.

Keywords

pediatric oncology nursing

genomics education

genetic literacy

variant classification

germline vs somatic variants

nursing scope of practice

patient and family education

barriers to genomics implementation

interactive learning preferences

quality improvement project