Hello Everyone and Welcome to my blog for this week. Week 10 (Future Direction)

My blog this week will explore how I can utilize my learning from my nursing informatics as well as my other courses to address the following questions:

◾What would be considered a ‘clinical best-practice guideline’ in this new personalized healthcare world?  Would they exist?

Clinical best practice guidelines (BPG) are comprehensive documents that provide recommendations, supporting evidence, and resources/tools for evidence-based practices for nurses (Registered Nurse Association [RNAO], 2019).  I have also included a list of BPG provided by RNAO.

• RNAO Best Practice Guidelines
• Other Related/Supporting RNAO Best Practice Guidelines
• College of Nurses of Ontario Practice Standards and Guidelines
• Applicable Legislation and Regulations
• Other Practice Standards and Guidelines
• Organizational Assessment, Implementation, and Evaluation
• Clinical Assessment and Care Planning
• Policies and Procedures
• Education and Teaching resources/tools
• Self-Learning/e-Learning
• Other Supporting resources/tools
• Related Websites/Organizations

(RNAO, 2019)

Within the new personalized healthcare world, there would still be clinical best practice guidelines as I believe nurses need guidelines and evidence-based practice to provide care to the patients, which will result in good quality care. Although everyone is different and has a different outcome, based on personalized best practice guidelines for different patients, the nurse will have an overview of how to provide care. A personalized health care world seems fantastic, but either way, in my opinion, BPG will still exist.

What research designs would be the best to study cause-effect relationships in healthcare?  Would randomized control trials still be the ‘gold-standard’ when clinicians are able to develop treatments and medications specific to an individual’s genomic markers?

I think above design is unique as it includes all the elements needed, such as the people (the patient), cause, policies and procedures, and effect. As mention before, regardless of personalized care, policies and guidelines need to be in place. Randomized studies are design to randomly assigns participants into an experimental group or a control group. As the study is conducted, the only expected difference between the control and experimental groups in a randomized controlled trial (RCT) is the outcome variable being studied (Himmelfarb Health Science Library, 2019).

◾How would the profession of nursing look in a world where there is a focus on the genetic composition of an individual in terms of their treatment and recovery?  What would nursing education/practice need to do to support this refocus on client care? What are the potential legal and ethical considerations that nurses will need to reflect upon?

It is mind-blowing to think of a world focus on the genetic composition of an individual for treatment and recovery. Genetic composition refers to the genes that determine what the individuals look like and what physical characteristics they have.

 GENOTYPE: the color of your eyes, your blood type, your hair texture, the structure of your digestive enzymes (This is personalized healthcare (n.d.).

Nursing education and practice would need to be changed to avoid bias and discrimination. Nurses would need to learn about different culture and individuals. Being aware of what is different for each individual in order to provide the best possible care. It is essential for nurses to understand the legal, ethical and social issues in the genomic information to provide patients, families with competent safe and effective health care (Badzek, Henaghan, Turner, & Monsen, 2013).

I read an interesting article which highlight principles developed by the Ethics committee for the human Genome. It is imperative to use human right law to frame the law; the community must be consulted, nurses knowledge must not be based on ignorance, mythology, religion but on good science, effective policies must have global mechanism (Badzek et al., 2013). The process will be a challenge but I believe if nurses have policy and guidance to follow, patients will continue to receive competent care.

◾Do you think ‘personalized medicine/healthcare’ will ever exist?

I think personalized medicine/healthcare is here already, but the majority of the population has not been exposed. As technological advancement continues within our society, in fact, the world eventually, everyone will be exposed to personalized medicine. The best is yet to come as more technology and procedure are being implemented.

Reference

Badzek, L., Henaghan, M., Turner, M., & Monsen, R. (2013). Ethical, legal, and social issues in the translation of genomics into health care. Journal of Nursing Scholarship, 45(1), 15-24. doi:10.1111/jnu.12000

Himmelfarb Health Science Library. (2019). Randomized controlled trial. Retrieved from https://himmelfarb.gwu.edu/tutorials/studydesign101/rcts.cfm

Registered Nurses’ Association of Ontario. (2019). Clinical best practice guidelines. Retrieved from http://ltctoolkit.rnao.ca/clinical-topics

This is personalized healthcare. (n.d.). Retrieved from https://www.roche.com/about/priorities/personalised_healthcare.htm b