Translating evidence into practice: Developing Canada’s first position statement on genomics-informed oncology nursing

Andrea Gretchev, Rebecca Puddester, Patrick Chiu, Lindsay Carlsson, Kathleen Leslie, Catriona Buick, April Pike, Jacqueline Limoges

Abstract


The integration of genomics in oncology care is accelerating in Canada, presenting new opportunities for nurses to improve cancer outcomes through enhanced screening, diagnosis, and targeted therapies. However, nurses have identified that they require policy guidance to clarify their roles and responsibilities as members of interprofessional teams delivering genomic services. In response, the Canadian Nursing and Genomics Initiative, in collaboration with the Canadian Association of Nursing in Oncology/Association Canadienne des Infirmières et Infirmiers en Oncologie, and an interdisciplinary working group developed the first pan-Canadian position statement to guide genomics-informed oncology nursing practice. To support further engagement and use of the position statement, we outline the rationale for developing the position statement and the role of position statements in supporting nursing practice and innovation in genomics-informed oncology nursing. We describe the governance structure and co-design methodology that facilitated its collaborative interdisciplinary development, and how this approach is critical for nursing advocacy, integrated knowledge translation, and ongoing engagement. Finally, we offer recommendations for oncology nurses to translate the position statement into practice changes. This position statement is a preliminary step toward advancing genomics integration in cancer care and ensuring nursing practice remains at the forefront of innovation.

Keywords: genomics, nursing, policy, genetics, genomic literacy, workforce development

DOI: 10.5737/2368807636166


Full Text:

PDF

References


American Nurses Association. (2023). Essentials of genomic nursing: Competencies and outcome indicators (3rd ed.). https://www.nursingworld.org/nurses-books/ana-books/ebook-essentials-of-genomic-nursing-competencies-/

Anderson, E. C., DiPalazzo, J., Lucas, F. L., Hall, M. J., Antov, A., Helbig, P., Bourne, J., Graham, L., Gaitor, L., Lu-Emerson, C., Bradford, L. S., Inhorn, R., Sinclair, S. J., Brooks, P. L., Thomas, C. A., Rasmussen, K., Han, P. K. J., Liu, E. T., & Rueter, J. (2024). Genome-matched treatments and patient outcomes in the Maine Cancer Genomics Initiative (MCGI). Npj Precision Oncology, 8(1), 1–12. https://doi.org/10.1038/s41698-024-00547-4

Australian College of Nursing. (2020). Nurses, genomics and clinical practice. https://www.acn.edu.au/wp-content/uploads/position-statement-nurse-genomics-clinical-practice.pdf

Bokkers, K., Vlaming, M., Engelhardt, E., Zweemer, R., van Oort, I., Kimeney, L., Bleiker, E., & Ausems, M. (2022). The feasibility of implementing mainstream germline genetic testing in routine cancer care—A systematic review. Cancers, 14(4), 1–15. https://doi.org/10.3390/cancers14041059

British Columbia College of Nurses and Midwives. (n.d.). About BCCNM. https://www.bccnm.ca/BCCNM/Pages/Default.aspx

Bryant-Lukosius, D., & Dicenso, A. (2004). A framework for the introduction and evaluation of advanced practice nursing roles. Journal of Advanced Nursing, 48(5), 530–540. https://doi.org/10.1111/j.1365-2648.2004.03235.x

Calzone, K. A., Stokes, L., Peterson, C., & Badzek, L. (2024). Update to the essential genomic nursing competencies and outcome indicators. Journal of Nursing Scholarship, 56(5), 729–741. https://doi.org/10.1111/jnu.12993

Canadian Association of Schools of Nursing. (2022, November). National nursing education framework. CASN/ACESI. https://www.casn.ca/competency-guidelines/national-nursing-education-framework/

Canadian Cancer Statistics Dashboard. (2025). A closer look at cancer incidence. http://cancerstats.ca/Login/Index

Canadian Institute for Health Information. (2024, December 17). Health workforce: Supply and direct care. https://www.cihi.ca/en/the-state-of-the-health-workforce-in-canada-2023/health-workforce-supply-and-direct-care#overall-supply-trends

Carlsson, L., & Limoges, J. (2022). Canadian nursing and genomics: An engagement initiative. Canadian Oncology Nursing Journal, 32(4), 559–564.

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics & Nursing Practice, 22(4), 271–291. https://doi.org/10.1177/15271544211050611

Chiu, P., Gretchev, A., Limoges, J., Puddester, R., Carlsson, L., Pike, A., Leslie, K., & Dordunoo, D. (2024a). Fostering Pan-Canadian collaboration to advance nursing workforce development: A case study from the genomics experience. Nursing Leadership, 37(2), 41–48. https://doi.org/10.12927/cjnl.2024.27470

Chiu, P., Gretchev, A., Limoges, J., Puddester, R., Carlsson, L., Pike, A., Leslie, K., & Dordunoo, D. (2024b). Preparing Canadian nurses for the genomic era: A toolkit for Canadian nurses. https://genomicstoolkit.my.canva.site/

Chiu, P., Limoges, J., Pike, A., Calzone, K., Tonkin, E., Puddester, R., Gretchev, A., Dewell, S., Newton, L., & Leslie, K. (2024). Integrating genomics into Canadian oncology nursing policy: Insights from a comparative policy analysis. Journal of Advanced Nursing, 80(11), 4488–4509. https://doi.org/10.1111/jan.16099

Chiu, P., Limoges, J., Puddester, R., Gretchev, A., Carlsson, L., Leslie, K., Flaming, D., Meyer, A., & Pike, A. (2024). Developing policy infrastructure to guide genomics-informed oncology nursing in Canada: An interpretive descriptive study. The Canadian Journal of Nursing Research, 56(4), 363–376. https://doi.org/10.1177/08445621241252615

Cicero, E. C. (2023). Anti-transgender legislation and gender-affirming care bans: Are position statements without subsequent nursing action the equivalent of thoughts and prayers? Nursing Outlook, 71(4), 102022. https://doi.org/10.1016/j.outlook.2023.102022

Fonseca-Montaño, M. A., Blancas, S., Herrera-Montalvo, L. A., & Hidalgo-Miranda, A. (2022). Cancer genomics. Archives of Medical Research, 53(8), 723–731. https://doi.org/10.1016/j.arcmed.2022.11.011

Gill, F. J., Lin, F., Massey, D., Wilson, L., Greenwood, M., Skylas, K., Woodard, M., Tembo, A., Mitchell, M., & Gullick, J. (2019). Development of a position statement for Australian critical care nurse education. Australian Critical Care, 32(4), 346–350. https://doi.org/10.1016/j.aucc.2018.08.001

Gretchev, A. (2025). Precision healthcare: Genomics-informed nursing. https://ecampusontario.pressbooks.pub/personalizedhealthnursing/

Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., & Cella, D. (2009). Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Quality of Life Research, 18(7), 873–880. https://doi.org/10.1007/s11136-009-9496-9

Hébert, J., Bergeron, A.-S., Veillette, A.-M., Bouchard, K., Nabi, H., & Dorval, M. (2022). Issues associated with a hereditary risk of cancer: Knowledge, attitudes and practices of nurses in oncology settings. Canadian Oncology Nursing Journal, 32(2), 272–285. https://doi.org/10.5737/23688076322272285

Husereau, D., Bombard, Y., Stockley, T., Carter, M., Davey, S., Lemaire, D., Nohr, E., Park, P., Spatz, A., Williams, C., Pollett, A., Lo, B., Yip, S., El Hallani, S., & Feilotter, H. (2023). Future role of health technology assessment for genomic medicine in oncology: A Canadian laboratory perspective. Current Oncology, 30(11), 9660–9669. https://doi.org/10.3390/curroncol30110700

Husereau, D., Steuten, L., Muthu, V., Thomas, D. M., Spinner, D. S., Ivany, C., Mengel, M., Sheffield, B., Yip, S., Jacobs, P., & Sullivan, T. (2022). Effective and efficient delivery of genome-based testing–What conditions are necessary for health system readiness? Healthcare, 10(10), 2086. https://doi.org/10.3390/healthcare10102086

International Council of Nurses. (n.d.). What we do: Position statements. https://www.icn.ch/what-we-do/position-statements

Jenkins, J. (2011). Essential genetic and genomic nursing competencies for the oncology nurse. Seminars in Oncology Nursing, 27(1), 64–71. https://doi.org/10.1016/j.soncn.2010.11.008

Kelly, U., Edwards, G., & Shapiro, S. E. (2021). Nursing policies and protocols: Do nurses really use them? Journal of Nursing Care Quality, 36(3), 217–222. https://doi.org/10.1097/NCQ.0000000000000532

Kinnersley, B., Sud, A., Everall, A., Cornish, A. J., Chubb, D., Culliford, R., Gruber, A. J., Lärkeryd, A., Mitsopoulos, C., Wedge, D., & Houlston, R. (2024). Analysis of 10,478 cancer genomes identifies candidate driver genes and opportunities for precision oncology. Nature Genetics, 56(9), 1868–1877. https://doi.org/10.1038/s41588-024-01785-9

Limoges, J., Chiu, P., Dordunoo, D., Puddester, R., Pike, A., Wonsiak, T., Zakher, B., Carlsson, L., & Mussell, J. K. (2024). Nursing strategies to address health disparities in genomics-informed care: A scoping review. JBI Evidence Synthesis, 22(11), 2267–2312. https://doi.org/10.11124/JBIES-24-00009

Limoges, J., Pike, A., Dewell, S., Meyer, A., Puddester, R., & Carlsson, L. (2022). Leading Canadian nurses into the genomic era of healthcare. Nursing Leadership, 35(2), 79–95. https://doi.org/10.12927/cjnl.2022.26869

Limoges, J., Puddester, R., Gretchev, A., Chiu, P., Calzone, K., Leslie, K., Pike, A., & Letourneau, N. (2025). Building a genomics-informed nursing workforce: Recommendations for oncology nursing practice and beyond. Current Oncology, 32(1), 1–13. https://doi.org/10.3390/curroncol32010014

Limoges, J., Puddester, R., Pike, A., Calzone, K., Carlsson, L., Letourneau, N., & Gretchev, A. (2024). Leadership strategies for genomics integration: A descriptive study using the Canadian adaptation of the Genetics and Genomics Nursing Practice Survey. Nursing Leadership, 37(2), 22–40. https://doi.org/10.12927/cjnl.2024.27467

Mackley, M. P., Richer, J., Guerin, A., Caluseriu, O., Armstrong, L., Blood, K. A., Bernier, F., Boswell-Patterson, C., Chard, M., Costain, G., Dyment, D., Eaton, A., Faghfoury, H., Frosk, P., Gillespie, M. K., Goh, E. S., Hayeems, R. Z., Hashemi, B., Innes, A. M., … Boycott, K. M. (2025). Mainstreaming of clinical genetic testing: A conceptual framework. Genetics in Medicine, 27(8), 101465. https://doi.org/10.1016/j.gim.2025.101465

Miller, C. E., & Vasan, R. S. (2021). The southern rural health and mortality penalty: A review of regional health inequities in the United States. Social Science & Medicine (1982), 268, 113443. https://doi.org/10.1016/j.socscimed.2020.113443

Mintrom, M., Goddard, P., Grocott, L., & Sumartojo, S. (2024). Co-design in policymaking: From an emerging to an embedded practice. Policy Sciences, 57(4), 745–760. https://doi.org/10.1007/s11077-024-09550-9

Morone, J. F., Tolentino, D. A., Aronowitz, S. V., & Siddiq, H. (2022). The COVID-19 pandemic and the push to promote and include nurses in public health policy. American Journal of Public Health, 112(S3), S231–S236. https://doi.org/10.2105/AJPH.2022.306837

Njoku, A., Sawadogo, W., & Frimpong, P. (2024). Racial and ethnic disparities in cancer occurrence and outcomes in rural united states: A scoping review. Cancer Control: Journal of the Moffitt Cancer Center, 31, 2–8. https://doi.org/10.1177/10732748241261558

Pierce, J. B., Ng, S. M., Stouffer, J. A., Williamson, C. A., & Stouffer, G. A. (2025). Rural/urban disparities in cardiovascular disease in the US–What can be done to improve outcomes for rural Americans? The American Journal of Cardiology, 248, 10–15. https://doi.org/10.1016/j.amjcard.2025.03.033

Pleasance, E., Bohm, A., Williamson, L. M., Nelson, J. M. T., Shen, Y., Bonakdar, M., Titmuss, E., Csizmok, V., Wee, K., Hosseinzadeh, S., Grisdale, C. J., Reisle, C., Taylor, G. A., Lewis, E., Jones, M. R., Bleile, D., Sadeghi, S., Zhang, W., Davies, A., … Laskin, J. (2022). Whole-genome and transcriptome analysis enhances precision cancer treatment options. Annals of Oncology, 33(9), 939–949. https://doi.org/10.1016/j.annonc.2022.05.522

Puddester, R., Limoges, J., Dewell, S., Maddigan, J., Carlsson, L., & Pike, A. (2023). The Canadian landscape of genetics and genomics in nursing: A policy document analysis. The Canadian Journal of Nursing Research, 55(4), 494–509. https://doi.org/10.1177/08445621231159164

Purtle, J., Moucheraud, C., Yang, L. H., & Shelley, D. (2023). Four very basic ways to think about policy in implementation science. Implementation Science Communications, 4(1), 111. https://doi.org/10.1186/s43058-023-00497-1

Seed, L. M. (2021). Horizon scanning in cancer genomics: How advances in genomic medicine will change cancer care over the next decade. Current Genetic Medicine Reports, 9(3), 37–46. https://doi.org/10.1007/s40142-021-00200-7

Society of Pediatric Nurses. (2024, January 22). Position Statements. https://www.pedsnurses.org/position-statements

Tsouvalis, J., Little, R., Fajardo-Escoffie, J., Hartley, S. E., Rose, D. C., Ambrose-Oji, B., de Boon, A., Maderson, S., & Urquhart, J. (2025). Co-design in policy development: Leveraging opportunities, addressing challenges, and proposing solutions for inclusive governance –Lessons from England. Land Use Policy, 150, 107440. https://doi.org/10.1016/j.landusepol.2024.107440

Unger, J. M., McAneny, B. L., & Osarogiagbon, R. U. (2025). Cancer in rural America: Improving access to clinical trials and quality of oncologic care. CA: A Cancer Journal for Clinicians, 75(4), 341–361. https://doi.org/10.3322/caac.70006

Walker, S. C., Baquero, B., Bekemeier, B., Parnes, M., & Arora, K. (2023). Strategies for enacting health policy codesign: A scoping review and direction for research. Implementation Science, 18(1), 44. https://doi.org/10.1186/s13012-023-01295-y

Wang, H., Hua, X., Yao, N., Zhang, N., Wang, J., Anderson, R., & Sun, X. (2022). The urban-rural disparities and associated factors of health care utilization among cancer patients in China. Frontiers in Public Health, 10, 842837. https://doi.org/10.3389/fpubh.2022.842837

Weymann, D., Pollard, S., Chan, B., Titmuss, E., Bohm, A., Laskin, J., Jones, S. J. M., Pleasance, E., Nelson, J., Fok, A., Lim, H., Karsan, A., Renouf, D. J., Schrader, K. A., Sun, S., Yip, S., Schaeffer, D. F., Marra, M. A., & Regier, D. A. (2021). Clinical and cost outcomes following genomics-informed treatment for advanced cancers. Cancer Medicine, 10(15), 5131–5140. https://doi.org/10.1002/cam4.4076


Refbacks

  • There are currently no refbacks.