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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*

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Marketing the gold standard educating others about wocncb certification l.jpg

Marketing the Gold Standard: Educating Others About WOCNCB Certification

Mikel Gray, PhD, CCCN, FAANP, FAAN


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Objectives Certification

  • 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


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Certification: What is it? Certification

  • 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.



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Certification: What is it? Certification

  • 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 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


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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.


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Certification: Additional Benefits Certification

  • 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


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Certification vs Licensure Certification

  • 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


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Value of Certification: CertificationConsumer 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


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Value of Certification as Perceived by Certified Nurses Certification(n=19,423)

Cary A. American Journal of Nursing 2001; 101(1): 44.


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Realized Benefits of Certification Certification(n=18,385)


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Value of Certification: Administrator’s Perspective Certification

  • 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.


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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.


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as NurseWOCNCB 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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)


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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).


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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


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Marketing Yourself as WOCNCB Certified Nurse

  • 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 Nurse

  • 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’ Nurse

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


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COCN/ CWOCN vs Other ‘C’s’ Nurse

URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm


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CCCN/ CWOCN vs Other ‘C’s’ Nurse

URL: http://www.nursing2007.com/pt/pt-core/template-journal/nursing/media/cert.htm


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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


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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)


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Communicate Key Research Findings the WOCNCB Brochures

  • “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 the WOCNCB Brochures

  • 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.


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Communicate Key Research Findings the WOCNCB Brochures

  • 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.


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Communicate Key Research Findings the WOCNCB Brochures

  • 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.


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Communicate Key Research Findings the WOCNCB Brochures

  • 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.


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Evaluate competitors the WOCNCB Brochures

  • 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?


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Identify your Market the WOCNCB Brochures

  • 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 ( the WOCNCB Brochuresclient) 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 the WOCNCB Brochures

  • 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


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Provide Family & Patients with WOCNCB Expert Care Brochure the WOCNCB Brochures

  • 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


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WOCNCN Evaluation Form the WOCNCB Brochures

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


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WOCNCB Evaluation Form the WOCNCB Brochures

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


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Document Your Contributions to Facility the WOCNCB Brochures

  • 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


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Conclusions the WOCNCB Brochures

  • 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


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