Transcript Sharpening Your Tools for the Cutting Edge

Marketing the Gold Standard:
Educating Others About
WOCNCB Certification
Mikel Gray, PhD, CCCN, FAANP, FAAN
Objectives
Define (or redefine) specialty practice
certification in nursing
 Communicate the unique benefits of
WOCNCB certification*
 Identify key marketing points to
justify & support your position as a
certified nurse*
 Discuss methods for marketing your
value as a certified nurse*
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* Defined by WOCNCB
Certification: What is it?
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POP QUIZ: Which of the following reflects
an accurate application of Laplace's Law to
compression therapy for LEVD?
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A. Adding layers to a compression bandage
increases sub-bandage pressure
B. Increasing bandage width decreases subbandage pressures.
C. A larger leg circumference decreases subbandage pressure.
Increasing tension elevates sub-bandage
pressure.
Certification: What is it?
Certification: What is it?
Slide 1 is about the anxiety provoking
process of testing to earn the
credential
 Slide 2 is about the process of
documenting evidence of professional
growth and ongoing education to
maintain the credential
 Certification goes far beyond both of
these processes….
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Certification
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Online Dictionary: the state of being
certified, a certificate that attests the truth
of a statement or event1
Online Medical Dictionary: adherence to a
set of standards defined by nongovernmental society or association;
certification is achieved on a voluntary
basis, and it represents a professional
status when achieved
1. Online Dictionary: http://dictionary.reference.com/browse/certification
2. Online Medical Dictionary: http://cancerweb.ncl.ac.uk/cgi-bin/omd?query=certification
Certification
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Fulfills multiple purposes, but two are
considered primary and essential1
Protect the public by setting standards
for the individual’s knowledge/
experience/ skills against a benchmark of
accepted standards
 Meet needs of key stakeholders*:
certified nurses, nurse colleagues and
trans-disciplinary colleagues
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1. Woods DK. Journal of Nursing Administration 2002; 32(7/8): 379.
Certification: Additional Benefits
Recognition of specialty practice
within facility, regionally and
nationally1
 Criterion for promoting via clinical
ladder
 Financial benefits (some facilities)
 Fosters enlarged role of certified
nurse; especially in the area of clinical
leadership
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1. ANCC online: http://www.nursecredentialing.org/cert/certfaqs.html
Certification vs Licensure
Licensure provides legal basis for
practice and defines scope of practice
 Certification reflects achievement
beyond that required for licensure;
unique features:
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It is voluntary
It is regulated by professional societies (not
the government)
It is equated with a standard of practice
above ‘minimum’ required for licensure
Value of Certification:
Consumer Perspective
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Consumer perspective
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Patients and their families increasingly want to
know – are you qualified to perform care for me
or my family member?1
1999 ANCC survey: 33% more confident when
care for by certified nurse; 16% aware that
nurses could be certified in a specialty area2
2002 Harris Poll: 75% wanted to receive care
from certified nurse; 90% aware of specialty
certification for nurses3
1. Mason DJ. American Journal of Nursing 2001; 110(1):7.
2. URL: http://www.nursingworld.org/pressrel/1999/pr0507.htm.
3. Hams Interactive Inc. AACN Survey. November 2002
Value of Certification as Perceived by Certified
Nurses (n=19,423)
Recognized as expert by colleagues
39%
Credential recognized or publicized
32%
Recompense for associated costs
28%
Advancement potential (adds to
professional portfolio*)
21%
Cary A. American Journal of Nursing 2001; 101(1): 44.
Realized Benefits of Certification (n=18,385)
 Satisfaction as a professional nurse
67%
More effective resource to staff
39%
Serve as consultant within facility
22%
 Competence in specialty skills
65%
 Satisfaction/ Confidence in decisionmaking
 Perception as a credible specialty
provider
56%
56%
Value of Certification: Administrator’s Perspective
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AONE commissioned study found that
certification associated with job satisfaction &
retention1
ANCC commissioned study supports greater
skill competency and ↓ risk of iatrogenic error
and harm among certified nurses2
2 studies comparing certified and non-certified
nurses in skill-related knowledge3 and skill
performance4 favored certified nurses
1.
2.
3.
4.
Woods DK. Journal of Nursing Administration 2002; 32(7/8): 379.
Critical Care Nurse Focus Study Group. TNS Market Development, 2000.
Practice Guidelines for Pulmonary Artery Catheterization. 2003.
Redd ML, Alexander JW. Nursing Management 1997; 30: 45.
Strategies for Marketing Yourself as a WOCNCB
Certified Nurse
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Identify and communicate the unique value
of WOCNCB certification
Evaluate your competitors
Identify your market – who are your
Customers and who are your Clients?
Determine patient needs and measure
satisfaction with your services
Document your contributions to your facility
Liguori R. Journal of Pediatric Health Care 2005; 19: 407.
Marketing Yourself as WOCNCB Certified
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Communicate your credential and scope of
practice: CWOCN
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Wound Care Assessment
• Identify etiologic and contributing factors and their
effect on healing
• Apply TIME or DIME conceptual frameworks
• Evaluate and manage wound pain
• Assess impact of factors on wound healing (eg:
bacterial bioburden, systemic disorders, depression)
• Differential diagnosis
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Resource utilization: specialty dressings,
specialty beds, pressure redistribution devices,
negative pressure wound therapies
Marketing Yourself as WOCNCB Certified
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Communicate your credential and scope
of practice: CWOCN
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Wound Care: Prevention & Management of
the most difficult to heal & costly wounds
• Pressure ulcers (resource for CMS changes)
• Lower Extremity Ulcers
• Non-healing surgical wounds
• Catastrophic traumatic wounds
• Neoplastic wounds
• Atypical wounds
Marketing Yourself as WOCNCB Certified
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Communicate your credential and
scope of practice: CWOCN
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Ostomy Care
• Historic heart of WOC specialty practice
• Stoma site marking (WOCN-ASCRS position,
WOCN-AUA to follow)
• Pre- and postsurgical counseling, customized
to patient readiness and facility
• Discharge teaching and patient hand-off
• New and existing ostomy management
Marketing Yourself as
WOCNCB Certified
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Communicate your credential and
scope of practice: CWOCN
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Ostomy Management
• Urinary and fecal continent diversions
• Fecal and urinary orthotopic diversions (IPAA,
orthotopic neobladders)
• Management of abdominal fistulae; good
example of interrelationships among
principles of WOC nursing
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Resource utilization: ostomy supplies,
supplies for managing abdominal fistulae
Marketing Yourself as WOCNCB Certified
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Communicate your credential and
scope of practice: CWOCN
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Continence Management: 2 levels not yet
entirely articulated; strengths unevenly
recognized by CWOCN
• Comprehensive management involves UI, FI
and IAD (another interrelationship)
• UI, FI containment (pads, wrap-around briefs,
underpads for beds)
• Temporary urinary diversion via indwelling
catheter (resource for CMS policy changes and
balance between IDC and PU prevention)
Marketing Yourself as WOCNCB Certified
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Communicate your credential and
scope of practice: CWOCN
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Continence Management
• Temporary diversion of stool via bowel or
fecal management systems
• Counseling about options for long-term
management and identification of appropriate
referral sources
Marketing Yourself as WOCNCB Certified
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Communicate your credential and scope of
practice: CWCN
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Wound Care Assessment
Resource Utilization
Prevention & Management
Emphasize your particular expertise as well
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Conservative sharp wound debridement
Negative pressure wound therapy techniques
Draining wounds and fistulae
Non-healing or indolent wounds
Atypical and complex wounds
Marketing Yourself as WOCNCB Certified
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Communicate your credential and scope of
practice: COCN
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Stoma site marking, counseling, counseling
Continent urinary and fecal diversions
IPAA and other orthotopic bowel procedures,
orthotopic neobladders
Resource utilization
Emphasize in-depth knowledge, including role
in managing short- and long-term stomal and
peristoma complications, associated diseases
(colorectal cancer, bladder cancer, etc).
Marketing Yourself as WOCNCB Certified
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Communicate your credential and
scope of practice: CCCN
• Comprehensive management of UI, FI and
IAD
• Containment
• Temporary urinary diversion (IDC, B/F MS)
• Assessment of chronic/ established UI/ FI
• Behavioral and lifestyle interventions
• Toileting schedule manipulation including
habit training/ retraining
• Pelvic floor muscle training
Marketing Yourself as WOCNCB Certified
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Communicate your credential and
scope of practice: CFCN
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Holistic health assessment focusing in foot health
Physical examination including vascular,
temperature, sensations of foot
Evaluate risk profile and assess adequacy of
footwear
Skin and nail care
Education and referral
Excellent adjunctive certification for
CWCN, as well as CDE
Marketing Yourself as WOCNCB Certified
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WOC and Advanced Practice Nursing
AP credentials (NP, CNS) provide value
added benefits to W/O/C certification
 Consider adding AP portfolio to your
certification when AP nursing education
completed
 Emphasize potential for reimbursement
(esp NP), enhanced autonomy in
outpatient & inpatient consultations,
prescriptive authority, potential as source
of independent patient referrals
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Communicate the unique quality of your
WOCNCB Certification
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3 standard elements
Credential earned through combination of
didactic knowledge and focused skill
acquisition (preceptor supervised plus
independent experience)
 Maintain and update knowledge & skills
through formal re-certification process
 Credential legally defensible; testing
psychometrically sound, re-certification
process transparent and fair
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CWCN/ CWOCN vs Other ‘C’s’
WOCNCB
NAWC
 Accredited by
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NCCA, ABNS
No external
accreditation
Active in wound
care + 5 day
hrs,120 precepted
seminar
 240 didactic
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Reexamination
or PGP
Reexamination,
CE, Community
outreach, fee plus
course
URL: http://www.wocncb.org/ updated 4/21/2008
AAWM
(CWS)
 Accredited by
NCCA
 BS or higher, 3
yrs in wound care
Self-assessment
examination every
10 yrs
COCN/ CWOCN vs Other ‘C’s’
WOCNCB
 Accredited by NCCA,
ABNS
All Others
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240 didactic hrs,120
precepted
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Reexamination or PGP
URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm
CCCN/ CWOCN vs Other ‘C’s’
WOCNCB
 Accredited by NCCA,
ABNS
All Others
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240 didactic hrs,120
precepted
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Reexamination or PGP
URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm
Communicate the quality of your WOCNCB
Certification: WOCNCB Brochures
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Marketing Brochure for
Facility/ Administrators
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Brief description of WOCNCB
Why certification matters
2 studies supporting overall
value of certification
1 study suggesting ↓ risk of
malpractice filing
1 study providing evidence
that certified nurse achieve
better wound outcomes than
non-certified nurse
Communicate the quality of your WOCNCB
Certification: Use the WOCNCB Brochures
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Marketing Brochure for
Facility/ Administrators
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Certified nurses associated
with better retention than
non-certified nurses
WOCNCB certification is
psychometrically sound and
legally defensible (based on
criteria established by NCCA
and ABNS)
Communicate Key Research Findings
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“Rules” of the game
Focus is on identifying key points
 Look for bulleted points to bolster your
argument
 Use only verifiable, published data
 Less emphasis on weaknesses of
research methods than systematic or
highly academic reviews
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Communicate Key Research Findings
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WOCNCB Certified Nurses have better
clinical outcomes that non-certified
nurses
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Retrospective (“real world”) review of
519 patients admitted to 5 home health
agencies revealed that 78.5% of wounds
managed by WOCNCB certified nurses
healed as compared to 36.3% of noncertified nurses
Arnold M, Weir D. Journal of Wound, Ostomy and Continence Nursing 1994;
21(4): 126.
Communicate Key Research Findings
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WOCNCB Certified Nurses act as
resources for non-certified nurses to
improve patient outcomes
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WOCNCB Certified nurses achieved faster
wound healing and reduced home visits
by 50% using a telemedicine system
Kobza L, Scheurich A. Ostomy Wound Management 2000;45(10):48.
Communicate Key Research Findings
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Other key points
Nurse managers recognize that hiring
certified nurses seen as exerting positive
impact on patient care and safety1
 Hospitals who hire more board certified
nurses tend to have reduced malpractice
suits, resulting in rebates on insurance
rates2
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1. Stromborg MF et al. Nursing Management 2005; 36(5): 36.
2. Trossman S. American Journal of Nursing 2002; 102(5): 71.
Communicate Key Research Findings
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Canadian based certified WOC (ET) nurses
achieved faster and more cost effective
wound healing than non-certified nurses
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The greatest differences were seen when the ET
nurse was directly involved in delivering wound
care
Statistically significant and clinically relevant
differences were seen even when ET nurses
were indirectly involved in patient management
Harris C, Shannon R. Journal of Wound, Ostomy and Continence Nursing
2008; 35(2): 169.
Evaluate competitors
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Assess formal competitors within your
facility, within other facilities, and from
different settings
Identify informal competitors; those
offering WOC services without certifications
or formal credentials
Can competitors become allies? Partners in
delivering care? Supplements to your
practice or can you function to supplement
their practice?
Identify your Market
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Customers vs Clients
Your clients are your patients – those
who require and benefit from our direct
services
 Your customers are those who provide
you with clients, for the WOCNCB
certified nurse, they are often surgeons,
other physicians, AP and influential staff
nurses
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Evaluate and Meet Patient (client) Needs
Routinely measure patient/ client
satisfaction
 Encourage patients to communicate
with key decision makers whenever
possible
 Establish and nurture key client
relationships within bounds of
professionalism when indicated
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Provide Family & Patients with WOCNCB
Expert Care Brochure
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Defines what board
certification mens in
broad term
Traces origins of
WOCNCB to 1978
Lists possible
certification credentials
Speaks directly to
patient & family as
consumers
Provide Family & Patients with WOCNCB
Expert Care Brochure
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Nice description of WOCNCB
certified nurses as:
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Clinical experts
Treatment specialists
Health educators
Experienced and
knowledgeable care providers
Summarizes research bullet
points noted on general
marketing brochure
•  clinical expertise
• Better clinical outcomes
•  likelihood of medical errors
WOCNCN Evaluation Form
Please check which of the following services I provided to you:
 Wound Care  Ostomy Care  Continence Care  Foot Care
Please check which customer type best describes you:
 Physician  Nurse  Insurance Company  DMERC  Other
(specify)
URL: http://www.wocncb.org/pdf/satisfaction_profsurvey.pdf
WOCNCB Evaluation Form
On a scale of 1 to 5, with 1 being the lowest and 5 being the
highest, please evaluate my performance on the
following. Please circle the appropriate number.
Knowledgeable
Assess needs appropriately
Performs patient care appropriately
Maintains caring attitude toward patients
Innovative problem solver
Professional
Communicates well
Responds in a timely manner
Completes documents accurately
Overall performance rating
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Document Your Contributions to Facility
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Differentiate being busy from productive
Measure only highly select indicators of
productivity
Maintain productivity database (even if you
do not keep a clinical or research database)
Learn and use language that non-clinical
(business) administrators can relate
to…even if you are not allowed to bill
directly for these services
Conclusions
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Board certification is more than passing an
examination; it is a combination of education,
skill acquisition and ongoing vigilance
WOCNCB certification is a rigorous & legally
defensible board certification accurately
recognized as the gold standard for WOC
nursing
Every acute care facility, every long-term care
facility, every home-care facility, every major
university department needs one or more of
these key players