Advancing Nursing Practice with Genomics: A Framework for EHR-Based Genetic Data Integration

The rapid development of genomic knowledge and precision medicine holds great promise to improve diagnosis, treatment, and risk assessment. However, nurses, the largest segment of the healthcare workforce worldwide, are not adequately prepared to apply genomic information in clinical practice. Genomic learning health systems that utilize structured genomic data in electronic health records (EHRs) in real time highlight the existing gap between genomic advances, informatics resources, and the nursing workforce. The findings of this narrative integrative review of nursing competency statements, genomic informatics resources, and clinical decision support (CDS) in the literature provided the Genomic Nursing Informatics – Electronic Health Record (GNI-EHR) Framework, whose components were introduced and described in detail. This multi-dimensional model of genomics into the workflow of nursing practice includes three layers: ۱) Genomic data capture and infrastructure for interoperable and computable genomic nursing data in the EHR; ۲) Intelligent and automated clinical decision support at the point of care as derived from genomics, including pharmacogenomics and oncology; and ۳) A workforce equipped through competency-based education and patient-centered practices. This model envisions a significant role for nurses in collecting structured family histories, responding to genomically informed CDS, tracking outcomes, and guiding informed decision-making with patients. By aligning informatics standards, CDS design, and nursing competency training, the GNI-EHR Framework offers a potentially scalable way to bridge the gap between genomic science and bedside nursing practice. It remains to be tested in multiple care environments.

کلیدواژه ها:

Genomics ، Nursing Informatics ، Electronic Health Records ، Clinical Decision Support Systems ، Professional Competence ، Pharmacogenetics