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Biomedical subjects

Dale Halsey Lea

Publications and source records attributed to Dale Halsey Lea.

13 recordsLinked to original sources
PubMed2005

Telegenetics in Maine: Successful clinical and educational service delivery model developed from a 3-year pilot project.

PURPOSE: The goal of this 3-year pilot project was to increase accessibility to genetics educational and clinical services in Maine. METHODS: Southern Maine Genetics Services, Foundation for Blood Research in collaboration with Maine Telemedicine Services established telemedicine capacity to link with rural health care centers located in Northern, Central, and Southern Maine and public health nursing statewide for the provision of genetics clinical and educational services. Core partners included a rural family practice residency program, a rural pediatric practice in northern Maine, and public health nurses statewide. The telegenetics model created was based on development and implementation of a preventive and medical management technology solution, conducting a pilot study to collect data, and approaching insurance companies for reimbursement. Evaluation included surveys on the quality, acceptability, and usefulness of genetics services delivered via telemedicine, telephone interviews, and decision-making confidence evaluations. RESULTS: During the project period, 24 rural clinical sites participated. In total, 93 presentations were given, and 125 patients were evaluated. Sixty-four percent of patients evaluated were pediatric. Despite site coordinator efforts to complete satisfaction surveys, the provider and patient response level was low (18% and 25%, respectively). Of those evaluations received, provider and patient response to telegenetics was positive. Decision-making confidence for genetics and neurology consultants was high. Our experience contributes to the development of telegenetics models that can be used in other rural states.

Genetic Counseling↗
PubMed2003

How genetics changes daily practice.

Develop a firmer understanding of the role genetics plays in health and disease, and incorporate genetic questions into patient assessment.

Confidentiality↗
PubMedDate not supplied

Ethical issues in genetic testing.

Genetic factors contribute to risk for disease. Information clarifying risk in an individual and his/her family members can be identified through clinical screening and genetic testing. In some circumstances, this information can be used in clinical decisions about surveillance and prevention or treatment of disease. However, use of this information is not always a straightforward process. Application of knowledge about risk of genetic disease in provision of primary health care for women requires understanding of new genetic discoveries as well as the ability to participate in resolution of ethical dilemmas that may result when genetic screening and testing are considered. These dilemmas arise not only from the current state of knowledge about genetic risk factors and utility of genetic tests but also result from conflicts that can arise when the needs of the client are not in unison with needs of others within the family or society. Ethical theories and principles provide a framework for resolving ethical dilemmas in maternal screening for genetic conditions during a pregnancy, carrier testing prior to or during a pregnancy, clinical genetic testing, and newborn metabolic screening.

Attitude to Health↗
PubMedDate not supplied

Genetic discoveries and nursing implications for complex disease prevention and management.

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Ecology↗
PubMedDate not supplied

Genomic-based health care in nursing: a bidirectional approach to bringing genetics into nursing's body of knowledge.

Nurses can expect to become partners with patients and their families as genomic-based health care brings decisions involving gene-based diagnostics and therapeutics into commonplace practice. All health professionals need genetic literacy to continue competence in clinical practice in the future. This article explores the efforts nursing has undertaken during the past decade to integrate human and clinical genetics into practice and scholarship. Genetics nursing education literature in the second half of the 20th century was analyzed. A focused survey of 15 genetics nurses and nursing leaders regarding key national initiatives, genetics research training programs, and genetics education models was conducted. Nursing has taken a bidirectional approach (through grass roots and top-down initiatives) to implementing change and advancing genetics in nursing practice, research, and education. For optimal leadership in genetics education for nursing and other disciplines, bidirectional efforts must continue and concentrate on bringing genetics into clinical practice and scholarship as genomic-based health care spreads worldwide. Evidence of nursing's interdisciplinary leadership is recognized. Recommendations and strategies for continued nursing leadership and programs that build on previous work are presented.

Curriculum↗
PubMedDate not supplied

What nurses need to know about genetics.

New genetic discoveries are revolutionizing medical approaches to diagnosis, management, and treatment of disease. Because of these changes, nurses need to know basic genetic principles and apply them to clinical nursing practice. This article describes basic genetics and how nurses can incorporate a genetic focus into clinical practice, specifically family history assessment. Ethical principles of genetic healthcare also are discussed.

Chromosome Aberrations↗
PubMedDate not supplied

An ethical assessment framework for addressing global genetic issues in clinical practice.

PURPOSE/OBJECTIVES: To describe the perceptions of nurses regarding the importance of each action skill listed in the Ethical Assessment Framework (EAF) to their ethical decision-making process and how prepared they were to undertake each action when confronted by moral dilemmas in clinical practice, and to identify general genetic ethical issues of concern and frequency encountered. DESIGN: Descriptive, exploratory. SAMPLE AND SETTINGS: Members of the Oncology Nursing Society's Cancer Genetics Special Interest Group (n = 34) and the International Society of Nurses in Genetics (n = 101). METHODS: Participants completed the Ethical Assessment Skills Survey and Genetic Ethical Issues Survey. MAIN RESEARCH VARIABLES: Perceptions of level of importance and preparation for each action skill in the EAF and level of concern and frequency encountered regarding ethical issues in clinical practice. FINDINGS: Each ethical action skill listed in the EAF was rated as important to the ethical decision-making process, although minimal skill level was reported in 60% of the steps. Nurses reported major concerns about the frequently encountered issues of confidentiality, managed care, and informed consent. CONCLUSIONS: The EAF proposes action skills that can assist nurses in developing expertise in ethical decision making and offers a model for addressing genetic ethical issues in clinical practice. Protection of patient confidentiality was the number one ethical concern of nurses surveyed. IMPLICATIONS FOR NURSING: Nurses are challenged to have comprehensive and current genetic knowledge, which is necessary to advocate for, educate, counsel, and support patients and families confronting difficult genetic healthcare decisions. Nurses will be able to effectively translate genetic information to patients by developing and using ethical decision-making and counseling skills. Effective measures to protect confidentiality of patient data are important to ensure that genetic information is safeguarded.

Adult↗
PubMedDate not supplied

Preparing nurses for a 21st century role in genomics-based health care.

Advances in genomic research are changing the nature and focus of health care. All health professionals must be prepared with new knowledge and skill competencies to meet the social and scientific demands of clinical practice. Nurses can expect to take on new practice roles that involve family history assessments, screening, and case coordination for clients receiving genetic testing and gene-based therapies. The authors report on successful initiatives since 1995 resulting from efforts of national organizations to advance the diffusion of genetic knowledge and genomics in nursing education and practice. Recommendations to strengthen these developments, along with strategies for nursing leadership in carving a new role, that of Genomics Nurse Case Coordinator, are presented.

Case Management↗