Genetics and Genomics in Oncology Nursing: What Does Every Nurse Need to Know?

In addition to the need for basic education about genetics/genomics, other approaches are suggested to include awareness campaigns, continuing education courses, policy review, and onsite clinical development. These alternative learning strategies encourage oncology nurses across the continuum of care, from the bedside/seatside to oncology nurse research, to integrate genomics into all levels of practice and research in the specialty of oncology nursing. All nurses are warriors in the fight against cancer. The goal of this article is to identify genomic information that oncology nurses, at all levels of care, need to know and use as tools in the war against cancer.

Adult Acute Lymphoblastic Leukemia: A Genetic Overview and Application to Clinical Practice.

BACKGROUND: Cytogenetic and molecular features of diseases, such as B-cell precursor acute lymphoblastic leukemia (BCP-ALL), are increasingly used for diagnostic, prognostic, and treatment decisions in health care. OBJECTIVES: This review provides information on the current recommendations for evaluating genetic aberrations in patients with BCP-ALL and details how the results are incorporated to determine risk stratification. It also offers a brief overview of developing research on newly found genetic features that may play a role in prognostic and treatment decisions. METHODS: Databases were reviewed using search terms relevant to BCP-ALL genetics, as well as to the prognostic significance of genetic changes commonly seen in BCP-ALL. Because of the scope of this review, studies identified as having outcomes with implications for clinical practice were included. FINDINGS: Cytogenetic and molecular aberrations in BCP-ALL are important not only for risk stratification but also for treatment decisions. To provide efficient and effective care for patients with BCP-ALL, clinical practitioners need to be aware of current recommendations and the state of prevailing research.

Misattributed paternity in hematopoietic stem cell transplantation: the role of the healthcare provider.

BACKGROUND: With emerging technologies and genetic advancements in the field of oncology, ethical controversies and questions on how to approach them will continue to grow. Advancements in the field of hematopoietic stem cell transplantation have led to increased testing of transplantation recipients' children and parents as potential donors related to an increase in the use of haploidentical transplantations. This testing opens the door for an increased incidence of misattributed paternity findings. OBJECTIVES: This article attempts to address the ethical conflicts and provide potential solutions to assist in the transition from individual-focused care to family-focused care. METHODS: The principlist approach was used. FINDINGS: Healthcare providers should be educated on methods of incidental finding disclosure and how to provide adequate support for those individuals.

Cytogenetics: oncology nurses in advanced practice decipher del(13q14) and t(14:16).

Advances in genetics related to the diagnosis and treatment of cancer have transformed the oncology specialty into one with more promising outcomes. Because of the Human Genome Project, the association between genetics and cancer is more clearly defined and healthcare professionals need to be prepared to integrate new genetics knowledge into clinical practice. This article reviews basic genetic information essential for oncology nurses in advanced practice. Application of genetic guidelines uses the model of multiple myeloma. Multiple myeloma is an example of a disease in which cytogenetics has become increasingly important for diagnosis, prognosis, and treatment. As the basis of knowledge in genetics continues to expand, oncology providers are transitioning to a paradigm in which cytogenetic elements carry more weight in diagnosis and treatment.

Strategies to prepare faculty to integrate genomics into nursing education programs.

PURPOSE: Faculty knowledge of genomics, learner competencies, and program requirements for nursing education are described to assist educators in introducing genomic information into nursing undergraduate, graduate, postgraduate, and continuing education programs regardless of geographic location. Selected programs in the United States and the United Kingdom are described to illustrate successful approaches used by nursing faculty to enhance their genomic knowledge in order to increase application of genetic and genomic content within nursing education curricula. ORGANIZING CONSTRUCT: Nursing education guidelines and nursing competencies provide benchmarks for educators in planning genetic and genomic curriculum content and expected learner outcomes. METHODS: Elements within competencies from the United States and the United Kingdom are reviewed to provide the framework for faculty knowledge. Strategies to address development of faculty knowledge and expertise are suggested. Continuing education faculty development programs and strategies to develop doctorally prepared nurse scientists who will educate future students in the profession are described. CONCLUSIONS: Multiple faculty who are prepared to implement education on genetic and genomic topics are needed at all levels of nursing education. Faculty networking and application of genomic principles to nursing are key elements for sustaining nursing education to produce a nursing workforce that can apply essential genomic knowledge. CLINICAL RELEVANCE: There is an urgent need to offer genomics in accessible and effective education for nursing practice to optimize health outcomes regardless of geographic location.

The biology of cancer: what do oncology nurses really need to know.

OBJECTIVES: To describe the impact of genetics and genomics on the biology of cancer and the implications for patient care. DATA SOURCES: Pubmed; CINAHL. CONCLUSIONS: Cancer research in genetics/genomics has identified new mechanisms influencing personalized risk assessment/management, early detection, cancer treatment, and long-term screening/surveillance. IMPLICATIONS FOR NURSING PRACTICE: Understanding the basics of genetics/genomics on the biology of cancer will facilitate patient education and care delivery, including the administration and monitoring of genetically targeted therapies whose toxicities may in part be mediated by the molecular pathways targeted by the specific agent.

Implementing and measuring the impact of patient navigation at a comprehensive community cancer center.

PURPOSE/OBJECTIVES: To determine whether patient navigation in a comprehensive community cancer center affects patient and staff perceptions of patient preparation for treatment, access to care, and overall satisfaction. DESIGN: Program evaluation with patient and staff surveys. SETTING: Comprehensive community cancer center accredited by the American College of Surgeons in the southeastern United States with 1,037 analytic cases of cancer in 2007; population of the main county served is about 177,963. SAMPLE: 48 patients (28 navigator and 20 non-navigator) and 26 employees, including physicians, nurses, and other support staff. METHODS: A 10-item survey with Likert scale format was sent to a stratified sample of 100 newly diagnosed patients with cancer. A five-item survey with the same format was sent to 40 staff working with the patients. MAIN RESEARCH VARIABLE: Patient navigation. FINDINGS: Patients who received navigation services responded more positively to survey statements. Statistical significance (p > 0.05) was identified in 7 of 10 statements when patient groups were compared. Provider responses indicated agreement with all five statements included in the survey. CONCLUSIONS: Patients with cancer and oncology staff reported that patient navigation is effective in increasing patient satisfaction and decreasing barriers to care. IMPLICATIONS FOR NURSING: Patient navigation is an emerging trend in cancer care. Patient navigators can play a significant role in assisting patients with coordinating services across the continuum of care. Continued research is essential in refining the role and eminence of patient navigators.

A history of neonatal group B streptococcus with its related morbidity and mortality rates in the United States.

The history of neonatal sepsis related to early onset group B streptococcus (GBS) emerged in the early 1970s. The neonatal mortality rate was 55% for those neonates with invasive GBS disease. The first adopted guidelines by the medical community to prevent early onset GBS were developed in the 1990s. One year after implementation of the guidelines, the mortality rate dropped to approximately 5%. Despite the great accomplishments in reducing the mortality rate, GBS remains the number one cause of infant morbidity and mortality in the United States.

Warfarin therapy in older adults: managing treatment in the primary care setting.

Oral anticoagulant therapy with war farin is commonly used to prevent thromboembolic events in patients at risk. The degree of anticoagulation is variable among individuals and is influenced by many factors; therefore, patients must be monitored frequently to assess for potential adverse effects related to treatment. Individuals older than age 65 are at particular risk for thromboembolic events as well as anticoag ulant-related complications. Because of these factors, elderly individuals pose a unique challenge in maintain ing anticoagulant control. The purpose of this article is to revisit the role of warfarin therapy for elderly individ uals in the primary care setting and to provide nurse practitioners with the information necessary to prescribe and monitor this medication appropriately. This article provides indications for warfarin therapy and also identifies potential barriers to effective management with specific implications for the older population.