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Sharpening Your Tools for the Cutting Edge

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    Sharpening Your Tools for the Cutting Edge Sharpening Your Tools for the Cutting Edge Presentation Transcript

    • 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 event 1
      • 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 essential 1
        • 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 nationally 1
      • 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 area 2
        • 2002 Harris Poll: 75% wanted to receive care from certified nurse; 90% aware of specialty certification for nurses 3
      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) Cary A. American Journal of Nursing 2001; 101(1): 44. 21% Advancement potential (adds to professional portfolio*) 28% Recompense for associated costs 32% Credential recognized or publicized 39% Recognized as expert by colleagues
    • Realized Benefits of Certification (n=18,385) 56%  Perception as a credible specialty provider 56%  Satisfaction/ Confidence in decision-making 65%  Competence in specialty skills 22% Serve as consultant within facility 39% More effective resource to staff 67%  Satisfaction as a professional nurse
    • Value of Certification: Administrator’s Perspective
      • AONE commissioned study found that certification associated with job satisfaction & retention 1
      • ANCC commissioned study supports greater skill competency and ↓ risk of iatrogenic error and harm among certified nurses 2
      • 2 studies comparing certified and non-certified nurses in skill-related knowledge 3 and skill performance 4 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’ URL: http://www.wocncb.org/ updated 4/21/2008 Self-assessment examination every 10 yrs Reexamination, CE, Community outreach, fee plus course  Reexamination or PGP  BS or higher, 3 yrs in wound care Active in wound care + 5 day seminar  240 didactic hrs,120 precepted  Accredited by NCCA  No external accreditation  Accredited by NCCA, ABNS AAWM (CWS) NAWC WOCNCB
    • COCN/ CWOCN vs Other ‘C’s’ URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm   Reexamination or PGP  240 didactic hrs,120 precepted   Accredited by NCCA, ABNS All Others WOCNCB
    • CCCN/ CWOCN vs Other ‘C’s’ URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm   Reexamination or PGP  240 didactic hrs,120 precepted   Accredited by NCCA, ABNS All Others WOCNCB
    • 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 safety 1
        • Hospitals who hire more board certified nurses tend to have reduced malpractice suits, resulting in rebates on insurance rates 2
      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
    • 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 1 2 3 4 5 N/A Assess needs appropriately 1 2 3 4 5 N/A Performs patient care appropriately 1 2 3 4 5 N/A Maintains caring attitude toward patients 1 2 3 4 5 N/A Innovative problem solver 1 2 3 4 5 N/A Professional 1 2 3 4 5 N/A Communicates well 1 2 3 4 5 N/A Responds in a timely manner 1 2 3 4 5 N/A Completes documents accurately 1 2 3 4 5 N/A Overall 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