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*

* Defined by WOCNCB

Certification: What is it? POP QUIZ: Which of the following reflects

an accurate application of Laplace's Law to compression therapy for LEVD? A. Adding layers to a compression bandage

increases sub-bandage pressure B. Increasing bandage width decreases sub-

bandage pressures. C. A larger leg circumference decreases sub-

bandage 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….

Certification 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 non-governmental 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 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

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

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: 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

Consumer perspective 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 decision-making

56%

Perception as a credible specialty provider 56%

Value of Certification: Administrator’s Perspective 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. Woods DK. Journal of Nursing Administration 2002; 32(7/8): 379. 2. Critical Care Nurse Focus Study Group. TNS Market Development, 2000. 3. Practice Guidelines for Pulmonary Artery Catheterization. 2003. 4. Redd ML, Alexander JW. Nursing Management 1997; 30: 45.

Strategies for Marketing Yourself as a WOCNCB

Certified Nurse 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

Communicate your credential and scope of practice: CWOCN 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

Resource utilization: specialty dressings, specialty beds, pressure redistribution devices, negative pressure wound therapies

Marketing Yourself as WOCNCB Certified

Communicate your credential and scope of practice: CWOCN 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

Communicate your credential and scope of practice: CWOCN 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

Communicate your credential and scope of practice: CWOCN 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

Resource utilization: ostomy supplies, supplies for managing abdominal fistulae

Marketing Yourself as WOCNCB Certified

Communicate your credential and scope of practice: CWOCN 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

Communicate your credential and scope of practice: CWOCN 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

Communicate your credential and scope of practice: CWCN Wound Care Assessment Resource Utilization Prevention & Management Emphasize your particular expertise as well

• 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

Communicate your credential and scope of practice: COCN 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

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

Communicate your credential and scope of practice: CFCN 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

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

Communicate the unique quality of your WOCNCB Certification

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

CWCN/ CWOCN vs Other ‘C’s’

WOCNCB NAWC AAWM (CWS)

Accredited by NCCA, ABNS

No external accreditation

Accredited by

NCCA

240 didactic hrs,120 precepted

Active in wound care + 5 day seminar

BS or higher, 3 yrs in wound care

Reexamination or PGP

Reexamination, CE, Community outreach, fee plus course

Self-assessment examination every 10 yrs

URL: http://www.wocncb.org/ updated 4/21/2008

COCN/ CWOCN vs Other ‘C’s’

WOCNCB All Others

Accredited by NCCA, ABNS 240 didactic hrs,120 precepted Reexamination or PGP URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm

CCCN/ CWOCN vs Other ‘C’s’

WOCNCB All Others

Accredited by NCCA, ABNS 240 didactic hrs,120 precepted 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

Marketing Brochure for Facility/ Administrators 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

Marketing Brochure for Facility/ Administrators 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

“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

Communicate Key Research Findings WOCNCB Certified Nurses have better

clinical outcomes that non-certified nurses 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 non-certified nurses

Arnold M, Weir D. Journal of Wound, Ostomy and Continence Nursing 1994; 21(4): 126.

Communicate Key Research Findings

WOCNCB Certified Nurses act as resources for non-certified nurses to improve patient outcomes 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

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

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

Canadian based certified WOC (ET) nurses achieved faster and more cost effective wound healing than non-certified nurses 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 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 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

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

Provide Family & Patients with WOCNCB Expert Care Brochure

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

Nice description of WOCNCB certified nurses as: 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

Please check which of the following services I provided to you:

Wound Care Ostomy Care Continence Care Foot CarePlease check which customer type best describes you:

Physician Nurse Insurance Company DMERC Other(specify)

WOCNCN Evaluation Form

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 thefollowing. Please circle the appropriate number.

Knowledgeable 1 2 3 4 5 N/AAssess needs appropriately 1 2 3 4 5 N/APerforms patient care appropriately 1 2 3 4 5 N/AMaintains caring attitude toward patients 1 2 3 4 5 N/AInnovative problem solver 1 2 3 4 5 N/AProfessional 1 2 3 4 5 N/ACommunicates well 1 2 3 4 5 N/AResponds in a timely manner 1 2 3 4 5 N/ACompletes documents accurately 1 2 3 4 5 N/AOverall performance rating 1 2 3 4 5 N/A

Document Your Contributions to Facility

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 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