The top fifteen leading causes of mortality in the United States all have a genetic and/or genomic component with heart diseases, cancers, and cerebrovascular diseases representing the top three causes of mortality (Heron, 2009
). Improved understanding of the contribution of genetics and genomics to the cause and treatment of these chronic illnesses is resulting in: improved identification of at risk individuals; targeted risk reducing interventions; enhanced screening; improved prognostic and therapeutic decision-making; novel, individualized therapy; and medication dosing and selection based on the genetic variation of drug response. For example, family history ascertainment and analysis is already viewed as one of the easiest genetic assessment tools. Using family history in practice as part of the multi-disciplinary health care team approach can improve recognition of potentially problematic genetic/genomic diseases, inform the differential diagnosis, and aid in risk stratification to inform risk management decision-making (Berg, 2009
Clearly, the impact of these advances is not limited to the practice of genetics specialists. Rather, health care professionals in all areas will increasingly use genetics/genomics technology and information to improve the health of those they serve. Further, consumers empowered by the proliferation of information technology are seeking, accessing and purchasing genetics tests without the guidance of healthcare professionals (Hunter 2008
). These consumers are often unprepared for the psychosocial impact of the results they receive. Confused and uncertain about what to do, they take the results to their health care professional to seek clarification and guidance. Yet, health care professionals' lack of knowledge about genetics/ genomics limits their ability to interpret those results, provide appropriate counseling or refer to professionals who can provide the necessary services (Scheuner, 2008
Preparing the entire nursing workforce to deliver genetically and genomically competent health care is vitally important to the successful translation of genetic and genomic discoveries into practice and quality health care outcomes. Nurses represent the largest group of health care professionals, generally have greater interaction time with patients, and as a consequence are uniquely poised to incorporate genetics/genomics information and services into practice as it becomes clinically appropriate (Calzone, 2010
). Preparing the current and future nursing workforce to merge these scientific advances into practice implies that nursing curricula, educational texts, resources and practice experiences are available to faculty as well as those in nursing staff development.
To address these challenges, in 2004 the National Human Genome Research Institute and the National Cancer Institute of the National Institutes of Health joined together to establish the Genetic/Genomic Nursing Competency Initiative (GGNCI). Leaders of the GGNCI then partnered with the American Nurses Association to begin planning for a broad US based nursing workforce genetic/genomic education initiative that focused on both the academic and practicing nursing communities. The work began with establishing by consensus The Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics (Consensus Panel on Genetic/Genomic Nursing Competencies, 2006
), a guide for academic education, continuing education, and specialty certification. The Genetic/Genomic Nursing Competency Initiative steering committee approached the task with the focus of identifying the essential knowledge and performance competencies necessary for all nurses. The competencies build on existing scope and standards of nursing practice and help guide individual continuing education, academic curriculum, professional organization continuing education and specialty certification (Jenkins, 2007
). The Essential Genetic/Genomic Nursing Competencies
do not represent the opinion or position of an individual, single nursing organization or government body. Instead, the competencies represent a consensus of the nursing community, endorsed by forty-nine nursing organizations and establish the minimum genetic and genomic competency required of every nurse regardless of academic preparation, role, practice environment or clinical specialty.
Implementation of the competencies has since been the priority for the Genetic/Genomic Nursing Competency Initiative. An additional Advisory Group of federal, academic, and national nursing leaders was established which identified, reviewed, analyzed, and compared successful change initiatives. A 5 year strategic implementation plan was drafted during an invitational meeting held October 22-24, 2006 with key stakeholders from the 49 endorsing organizations. The framework for the 5 year implementation plan focused on practicing nurses, regulatory/quality control issues, academics, and infrastructure. Outcomes from this meeting included complete consensus on a recommendation to further expand the Essential Competencies to include learning outcomes and clinical practice indicators for each specific competency. Additionally, faculty advisors requested increased guidance as to what knowledge, skills, and attitudes would be reflective of competency and indicative of needed course content. In response, a project focused on creating outcome indicators was initiated with the intent that they would include specific areas of knowledge needed for each competency and suggested clinical practice indicators that demonstrate proficiency of the competency.