Genetics and Genomics in Nursing and Health Care

Genetics and Genomics in Nursing and Health Care Chapter 18 Health Professionals and Genomic Care Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Genomic Care § Ensuring that the influence of a person’s genetic history on health and disease is considered as part of general assessment information for all patients and families § Health-care professionals must not overlook genetic issues Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Genetic Professionals § Extensive education and, often, special credentialing in some aspect of genetics § All health-care professionals are expected to have a basic understanding of patterns of inheritance and genetic terminology Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Genetic Counseling “The process of helping people understand adapt to the medical, psychological and familial implications of genetic contribution to disease occurrence or recurrence” (National Society of Genetic Counselors, 2006) Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Nondirective Counseling Presents all facts and options in a way that neither promotes nor excludes any decision or action (within legal boundaries) Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Certified Genetic Counselor § A genetics professional who: • Has a master’s degree in genetic counseling from a graduate program accredited by the American Board of Genetic Counselors • Has passed a certification exam Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Genetic Counselor § Scope of practice • Providing expertise in genetics • Communicating/counseling patients and families at genetic risk • Ensuring that counseling services are delivered in a manner that is consistent with professional ethics and values Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Clinical Geneticist § Physician who: • Graduated from an accredited school/college of medicine • Successfully completed a medical board examination • Is eligible for licensure and can become a clinical geneticist • Completed clinical specialty residency • Completed a clinical genetics fellowship Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Clinical Geneticist § Sees patients with a wide variety of genetic disorders • Diagnosis • Clinically management • Counseling § May be certified in cytogenetics, molecular genetics, or biochemical genetics Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Clinical Laboratory Geneticist § MD, DO, or Ph. D-prepared scientist § 24 -month fellowship in a program approved by the American Board of Medical Genetics § Certification exam: three subspecialties • Cytogenetics • Molecular genetics • Biochemical genetics Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Clinical Laboratory Geneticist § Oversees and works in laboratories that perform genetic tests § Develops and implements new tests § Provides quality assurance of routine tests § Interprets test results § Communicates results to health-care and other genetic professionals Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Medical Geneticist § Not a physician § Has a doctorate (Ph. D), most commonly in population genetics or epidemiology § Works with genetic counselors to provide accurate recurrence-risk information § Often teaches in academic institutions Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Research Geneticist § Has a doctorate (Ph. D) in genetics or relevant biological science and completed postdoctoral laboratory training in genetics § May work with a clinical geneticist or a certified genetic counselor to provide the scientific details associated with a specific disorder Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Advanced-Practice Nurse in Genetics (APNG) § Master’s degree in nursing from an accredited program that includes 50 hours of genetic content § 300 hours of supervised genetic practicum experience, with > 50% practice component § Evidence of effective teaching § Certification through a professional portfolio (certification currently not available) Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care Genetics Clinical Nurse (GNC) § Certification through a professional portfolio (certification currently not available) § Licensed RN with BSN from an accredited program § Logs of 50 cases and 4 case studies reflecting the standards of clinical genetics nursing § 45 contact hours of genetic content from academic coursework or continuing education Copyright © 2018 F. A. Davis Company

Genetics and Genomics in Nursing and Health Care The Role of the Generalist Nurse in Genomic Care § Verify information to bring a genetic problem to light § Look for cues that signal genetic problems § Provide accurate information § Ensure appropriate referral to genetic professional § Serve as a patient advocate § Maintain confidentiality Copyright © 2018 F. A. Davis Company