As many of you are keenly aware, preparing the entire nursing workforce to deliver genetically and genomically competent healthcare is vitally important to the successful translation of genetic and genomic discoveries into practice. To address this issue, an initiative was launched in 2004 to define essential genetic and genomic competencies for all registered nurses, regardless of academic preparation, role, or clinical specialty. The competencies guide academic curriculum, continuing education (CE), and specialty certification. Forty-eight organizations, including the National Association of Clinical Nurse Specialists, endorsed the competencies. Two unsolicited endorsements were also received from schools of nursing. The goal of the competencies is to prepare the nursing workforce to deliver genetic/genomic competent healthcare. A copy of the competencies can be downloaded at: http://www.genome.gov/17517146.

Implementation of the competencies across the profession of nursing is now the next priority. An advisory group of federal, academic, and national nursing leaders, including representation from the National Association of Clinical Nurse Specialists, was established in 2006 to provide guidance on next steps. Those representatives identified, reviewed, analyzed, and compared successful change initiatives and offered guidance on a strategic plan format. An invitational meeting of key stakeholders held on October 22-24, 2006, included Jo Ellen Rust, MSN, RN, CNS, from the National Association of Clinical Nurse Specialists, who represented the organization. Meeting attendees drafted a 5-year strategic implementation plan, which is being finalized. The framework for the 5-year implementation plan focuses on practicing nurses, regulatory/quality control issues, and academics. Within these arenas, each strategy is prioritized, including outcome measures, funding needs, funding source, critical timeline, and recommended project lead. Of high priority to the strategic plan success is promoting the relevance of genetics and genomics to nursing practice.

Outcomes from this meeting also included consensus on establishing an infrastructure that provides the structure, direction, and focus for all efforts identified under the 3 critical goals within the strategic plan. This represents a multiple agency, organization, and academic collaboration, and the infrastructure will provide centralized coordination to stimulate activities and reduce duplication. In addition, the stakeholders recommended identifying a theoretical framework for implementing genetics and genomics into nursing practice. Recommendations were made to establish a centralized repository of genetic and genomic nursing resources to facilitate access and enhance the ability to identify resource gaps, which will facilitate filling those deficits. Lastly, the group recommended establishing a national nursing research outcomes agenda for genetics and genomics in nursing. A summary of the strategic implementation goals and a brief list of strategy targets are provided below.

GOAL: PRACTICING NURSES

All nurses in practice will have a foundation of knowledge in basic human genetics and genomics and current applications to nursing practice. Potential target areas to achieve this goal include the following:

1. CE programs (ie, basics)

a. Target endorsing organization annual meetings

b. Poster presentation about competencies

2. Requirements for including genetics and genomics in CE

3. Models for CE

a. Train the trainer

b. Family history as exemplar

c. Vignettes/case scenarios

d. Video

e. Tool kits

f. Slide set

g. Information technology

4. Hospital/Ambulatory/Community/Public health settings

a. Orientation

b. Clinical ladders, awards

c. Staff development

5. Publications

6. Certification

GOAL: ACADEMICS

All nurses will have a foundation of knowledge in basic human genetics and genomics and current applications to nursing practice. Potential target areas to achieve this goal include the following:

1. Faculty requirements (ie, essentials and standards)

2. Faculty development

3. Faculty champions

4. Curriculum

5. Classroom resources

6. Publications

GOAL: REGULATION/QUALITY CONTROL

Genetics and genomics is included in the practice content on assessments of quality healthcare outcomes. Potential target areas to achieve this goal include the following:

1. State boards of nursing (ie, National Council Licensure Examination, fact sheets, and position papers)

2. Magnet status

3. Joint Commission on Accreditation of Healthcare Organizations

4. International Council of Nurses

5. Regulations

a. Federal/Territorial entities

b. Accrediting

6. Policy (ie, discrimination and reimbursement)

In summary, the detailed 5-year strategic implementation plan for the integration of the competencies into nursing practice, nursing curricula, National Council Licensure Examination, specialty certification, CE, and accreditation is a daunting challenge. The realization of these goals will only be achieved with ongoing nursing organization, federal agency, and academic collaborations. Obtaining innovative funding is essential to beginning this crucial work. We can also learn a lot through collaboration with our international partners who have similar ongoing initiatives. In addition, harnessing the extraordinary genetic and genomic expertise of the National Association of Clinical Nurse Specialists membership will be the cornerstone to implementation success as content experts will be essential to achieving each strategy. On behalf of the Competency Advisory Group, we look forward to engaging you as a National Association of Clinical Nurse Specialists member to work with us on preparing the entire nursing workforce in genetics and genomics.