Pestka, Elizabeth L.

Genotyping for CYP2D6 and CYP2C19 variations is emerging as a potentially useful clinical tool to help mental health professionals prescribe psychiatric medications for their patients. Cytochrome P450 testing uses a blood sample to determine an individual's required dosage of identified drugs that are metabolized by the two enzymes. To provide care for patients and families, nurses should be able to demonstrate identified essential nursing competencies related to genetics and genomics, which include an understanding of cytochrome P450 testing. As patient advocates, nurses are expected to understand how to identify patients most likely to benefit from CYP2D6 and CYP2C19 testing, how to ensure informed consent for such testing, and how to educate patients about testing and test results.

This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5–10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health‐care cost savings.

The nursing profession has a long history of helping to advance health care. This column describes contributions of the first nurses associated with a major medical center in the Midwest and their vision to build and staff a hospital to support the medical practice of a local physician and his two sons. The story comes to life as a readers' theater featured in department-wide orientation to the Department of Nursing. J Contin Educ Nurs 2009;40(3):105–106.

A national consensus panel representing 48 nursing organizations, including the American Psychiatric Nurses Association, identified and endorsed essential genetic and genomic competencies for all registered nurses regardless of academic preparation, role, or clinical specialty. The competencies were designed to guide academic curricula, continuing education, and specialty certification. A 5-year implementation plan for these competencies includes components applicable to practicing psychiatric nurses, regulatory and quality control issues, and academics. This article will describe the implementation strategies identified, some examples of genetics and genomics nursing activities in the psychiatric specialty, and recommendations that support the national implementation plan. J Am Psychiatr Nurses Assoc, 2008; 14(1), 63-68. DOI: 10.1177/1078390307311974

The sequenced map of the DNA base pairs in the human genome is making it easier to understand the biological pathways involved in mental illnesses and to develop better methods of diagnosis, treatment, and ultimately prevention. This article describes the genetic counseling process for psychiatric disorders, including the use of a family pedigree and predicting genetic inheritance risks based on family history. It also addresses client education issues and the health professionals involved in genetics counseling services. Ethical, legal, and social implications of psychiatric genomics are discussed.

Research in genomics is producing new testing and treatments that are altering the way that mental health care is provided. To respond to questions and requests for information from patients and to provide comprehensive care, psychiatric nurses are seeking education on genomics. The planning process, content, and general outcomes of a regional psychiatric conference with the purpose of increasing participants’ knowledge related to genomics are described. Outcomes of learning from the participant’s assessment of knowledge gained and from correct responses to conference content were assessed. Data indicated positive learning occurred following participation in the conference.