WOCN® SOCIETY 2015...WOCN-15-Core-Curriculum-Ad-JWOCN-II4U-FINAL.indd 2 5/13/15 1:45 PM Following the Curriculum Blueprint designed by the Wound, Ostomy and Continence Nurses Society

WOCN SOCIETY 2015 YEAR IN REVIEW 1

2 0 1 5WOCN® SOCIETY

Y E A R I N R E V I E W

wocn.org

WOCN SOCIETY 2015 YEAR IN REVIEW2

L E T T E R F R O M T H E P R E S I D E N T

While the Year in Review

is by no means inclusive of

all of the Society’s projects

and goals, it does provide

a few key highlights of

our efforts to expand

awareness, education,

advocacy/public policy

and clinical tools in 2015.

To our valued members,As 2015 draws to a close, I would like to express my heartfelt thanks for your considerable support of the Wound, Ostomy and Continence Nurses Society™ (WOCN®) throughout the year. On behalf of the Board of Directors, I am pleased to share with you the Society’s 2015 Year in Review which outlines how the Society is working to advance the wound, ostomy and continence specialty.

While the Year in Review is by no means inclusive of all of the Society’s projects and goals, it does provide a few key highlights of our efforts to expand awareness, education, advocacy/public policy and clinical tools in 2015. If you would like more information about any of these initiatives, including more detailed accounts of our public policy efforts, please visit wocn.org.

Without your support, it would not have been possible to complete many of the important projects featured in this report. The Society continues to search for passionate members to volunteer for special projects. Those projects include content validation, peer review, pilot testing, committees and special task forces. The more volunteers we have, the more we can do to advance the specialty. If you are interested in volunteering, please visit wocn.org/volunteer.

Thank you again for your continued commitment, enthusiasm and dedication to both the Society and the WOC specialty, and Season’s Greetings to you and your families with best wishes for the New Year!

Sincerely, Carolyn Watts, MSN, RN, CWON WOCN Society President


We’re spreading the wordOne of the Society’s key goals is to showcase the value of the WOC nurse to employers, other clinicians and the general public. Generating awareness of our specialty is vital to the continued growth and development of WOC nursing. The I Deserve a WOC Nurse campaign drew a tremendous response in 2015, as the Society worked to place our message in the most influential media outlets. One of our articles, entitled “You Deserve the Best Health Treatment Possible,” focused on the optimal patient outcomes that WOC nurses work to provide.

This article was featured in more than 1,000 media outlets, including:

A W A R E N E S S


THE PATHWAY TO BECOMING A WOUND, OSTOMY AND CONTINENCE (WOC) NURSE

wocn.org • wocncb.org

TRADITIONAL PATHWAY EXPERIENTIAL PATHWAY

REGISTERED NURSES WHO HOLD A

BACCALAUREATE DEGREE OR HIGHER

1 YEAR OF CLINICAL EXPERIENCE WITHIN 5 YEARS OF APPLYING TO A WOUND, OSTOMY AND CONTINENCE

NURSING EDUCATION PROGRAM (WOCNEP)

COMPLETE THE PROGRAM

SIT FOR THE CERTIFICATION EXAMIN EACH OF THE THREE AREAS OF PRACTICE

CHOOSE FROM 1 OF 9 WOCNEPs. ALL PROGRAMS ARE CLINICAL AND DIDACTIC!

50 CONTACT HOURS (CEs OR THE EQUIVALENT COLLEGE COURSEWORK) IN EACH SPECIALTY AREA WITHIN 5

YEARS OF APPLYING TO A WOCNEP

1,500 CLINICAL HOURS WITH AT LEAST 375 CLINICAL HOURS

IN THE PAST YEAR

BECOME A CERTIFIED WOC NURSE!

DID YOU KNOW? Accreditation by the

WOCN® Society guarantees uniform education and

experience.

• R.B. Turnbull, Jr. MD WOC Nursing Education Program (Cleveland Clinic)

• Emory University Nell Hodgson Woodruff School of Nursing Wound, Ostomy, and Continence Nursing Education Center (GA)

• Harrisburg Area Wound Care Specialty Program and WOC Nursing Education Program - Sponsored by Wicks Educational Associates, Inc. (PA)

• Rutgers University School of Nursing-Camden Wound Ostomy Continence Nursing Education Program (NJ)

• The Wound and Ostomy Education Program at The Valley Foundation School of Nursing, San José State University

• University of Virginia Graduate Program in WOC Nursing at the University of Virginia School of Nursing

• University of Washington Wound Management Education Program

• VA Eastern Kansas Wound Management Academy• webWOC Nursing Education Program

Another important goal is the promotion of the WOC nurse career path. To that end, the Society developed the WOC Nurse Career Path infographic, to highlight the educational pathways one can take to become a certified WOC nurse. The infographic was published in more than 500 media outlets, many of which were geared specifically to nurses and other clinicians. The Society also featured the infographic in a special campaign to members of the National Student Nurses Association. This campaign reached more than 50,000 student nurses, many of whom have been in contact with the Society’s national office to learn more about how they can become a WOC nurse.

i The I Deserve a WOC Nurse campaign also included the development and distribution of a new video designed to educate the general public on the important role WOC nurses play in the care of patients with ostomies. The video featured a number of ostomates whose lives have been impacted by a WOC nurse. Released in conjunction with World Ostomy Day, the video has received acclaim from clinicians and patients alike, and is the Society’s most popular video to date.

If you have not yet seen this inspirational video,

view it (and many others) on the WOCN Society’s YouTube channel: youtube.com/user/

TheWOCNSociety

A W A R E N E S S


2015 also included the Society’s most impactful WOC Nurse Week ever! This year’s theme, WOC Nurses are the Total Package, celebrated the many versatile roles the WOC nurse plays, including educator, researcher, clinical expert and decision maker.

Smith & Nephew supported Nurse Week through a restricted educational grant.

A W A R E N E S S

WOCN SOCIETY 2015 YEAR IN REVIEW6 E D U C A T I O N

We’re driving educationProviding educational resources to guide your clinical practice and professional development was a critical effort for the Society in 2015. The Society developed and released a significant number of clinical and educational documents and position statements over the year. In case you missed any, here are a few of the major releases and where to find them:

Methods of Wound Debridement: Best Practice for Clinicians, 2015

Members-only Library

The Wound, Ostomy and Continence Nurses Society Support of Medicare Coverage for Enterocutaneous Fistulas, 2015

Public Library

WOCN Society and ASCRS Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Colostomy or Ileostomy Surgery, 2014

Public Library; 2015 May/June JWOCN

WOCN Society and AUA Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Urostomy Surgery, 2014

Public Library; 2015 May/June JWOCN

The Society was especially proud to finalize and release the long-awaited Core Curriculum textbook series. These textbooks feature an incredible amount of content authored by some of the best and brightest minds in WOC research and clinical practice. They truly are the gold standard in WOC nursing education and an essential resource to understand and implement the most up-to-date practices to ensure optimal patient outcomes. If you have not yet ordered a copy of the textbooks, you may do so at lww.com.

Following the Curriculum Blueprint designed

by the Wound, Ostomy and Continence Nurses

Society™ (WOCN®) and authored by leading

educators, these reference texts are ideal for

anyone seeking wound, ostomy, and continence

nursing certification or authoritative, practical

information in these areas.

Order your copy of each text at lww.com

Core Curriculum SERIES

Introducing the New WOCN® Society

Edited by Dorothy Doughty and Laurie McNichol

ISBN 978-1-4511-9440-1

Covers wounds caused by external mechanical factors

and specific disease process, lower extremity ulcers, and the management of

enterocutaneous fistulas and percutaneous tubes.

Supported through an educational grant from Hollister Incorporated.

Edited by Jane E. Carmel, Janice C. Colwell, and Margaret T. Goldberg

ISBN 978-1-4511-9439-5

The perfect reference for healthcare professionals who

manage patients needing fecal and urinary diversions, or

ostomy management.

Edited by Dorothy Doughty and Katherine Moore

ISBN 978-1-4511-9441-8

An ideal training resource for anyone who manages

patients with urinary or fecal incontinence, as well as bowel

dysfunction.

WOCN-15-Core-Curriculum-Ad-JWOCN-II4U-FINAL.indd 2 5/13/15 1:45 PM












ISBN 978-1-4511-9440-1






ISBN 978-1-4511-9439-5



ostomy management.


ISBN 978-1-4511-9441-8



dysfunction.













ISBN 978-1-4511-9440-1






ISBN 978-1-4511-9439-5



ostomy management.


ISBN 978-1-4511-9441-8



dysfunction.


Hollister, Inc. provided support for the textbooks through an unrestricted educational grant.

WOCN SOCIETY 2015 YEAR IN REVIEW 7E D U C A T I O N

The Society has worked diligently to provide relevant and engaging content on our Continuing Education Center (CEC). The Society’s CEC Task Force is working on refreshing available content and recently completed an overhaul of the certification review courses as well as a rebranding of the CEC. Be sure to check out the new look of the CEC at wocncec.org. While you’re there, take the opportunity to view the MARSI webinar series and this year’s Partnership in Prevention webinar series – both are now available at no cost.

This continuing education program prepares a non-WOC-certified nurse, under the direction of a WOC specialty nurse, to provide optimal care for patients with acute and chronic wounds. The support of WTA Program graduates allows WOC nurses to extend their practice and provide greater overall patient impact. Visit wtaprogram.com for more information. WOUND TREATMENT ASSOCIATE

Welcome to the WOCN Society’s Continuing Education Center

CONTINUING EDUCATION CENTER

CEC

Attend LIVE broadcasts of Annual Conference Sessions and download archived webcasts in WOC care.

Earn continuing education credits in wound, ostomy and continence care.

Purchase sessions from past conferences, view PowerPoint sessions, obtain handouts and more!

Strengthen your wound care team through educational program for non-specialty nurses and military medics.

WEBCASTS CONTINUING EDUCATION

CONFERENCE LIBRARY

WOUND TREATMENT ASSOCIATE PROGRAM

Learn from leaders in WOC nursing as you prepare for certification/recertification exams.

CERTIFICATION REVIEW

Sage Products provided support for the Partners in Prevention webinar series through an unrestricted educational grant.

3M Health Care provided support for the MARSI webinar series through an unrestricted educational grant.


We’re representing your interestsThe WOCN Society continues to work to shape legislation that protects and strengthens the WOC specialty. We are YOUR voice on Capitol Hill and in legislatures throughout the U.S. The Society is committed to advancing legislative activity that promotes the benefits of WOC nurse involvement related to pressure ulcers, acute and chronic wounds, ostomy and continence care. One of our major goals is to ensure that all patients have access to appropriate supplies, equipment and services. Our 2015 public policy and advocacy program focused on the critical issues outlined below. For more information, visit the Public Policy and Advocacy section of wocn.org at wocn.org/publicpolicy.

P U B L I C P O L I C Y


The importance of Medicare coverage for compression therapyThe U.S. Senate Finance Committee announced the formation of a bipartisan working group in an effort to begin exploring solutions that will improve outcomes for Medicare patients requiring chronic care. Finance Committee members requested that stakeholders submit their best ideas on ways to improve outcomes for Medicare patients with chronic conditions. To this end, the WOCN Society submitted comments to the Committee.

Endorsement of legislation to ensure patient access to complex rehab technologyComplex Rehab Technology (CRT) is critical to the quality of life and independence of people with severe disabilities or medical conditions. Legislation has been introduced in Congress that would establish a distinct Medicare benefit category for complex rehabilitation projects. The Society submitted several letters of endorsement for this legislation.

Endorsement of legislation to allow nurses to order home health care for patientsThe Society was proud to endorse the Home Health Care Planning Improvement Act, which would help ensure that Medicare beneficiaries in need of home health care services whose providers are NPs, CNSs, CNMs and PAs would be able to directly access home health care by referral from their providers. The Society looks forward to working to see this important legislation enacted.

Removing barriers to DME orderingAlong with many members of the nursing community, the Society has worked tirelessly to alter the restrictions to DME ordering that were outlined in the Affordable Care Act. The Medicare Access and CHIP Reauthorization Act of 2015 was signed into law by President Obama on April 16 and included a provision to remove the requirement that an MD must document the occurrence of a face-to-face encounter. This will greatly reduce the burden that many members had with ordering DME in the past several years, and removing this barrier has been an advocacy priority for the WOCN Society as a result of hearing from many members on this issue.

Visiting leadership on the HillJust before the August recess, WOCN Society Past President and Public Policy and Advocacy Coordinator Kathleen Lawrence visited Capitol Hill to meet with several members of Congress on legislation impacting the Society and our patients.

Maryland ostomy coverage bill signed into lawOn April 14, 2015, Maryland Governor Larry Hogan (R) signed SB 241 into law which mandates that health insurers must provide coverage for ostomy supplies. Specifically, the bill requires an insurer, nonprofit health service plan or health maintenance organization (collectively known as carriers) that provide hospital, medical or surgical benefits to provide coverage for all medically appropriate and necessary equipment and supplies for the treatment of ostomies. The bill excludes those plans that are offered through the state exchange. Maryland is the latest state to pass legislation mandating coverage of ostomy supplies. In March 2014, Jan Colwell, WOCN past president, testified before the Maryland State Legislature in support of this legislation, and WOCN members have been active in helping to push for its passage.

P U B L I C P O L I C Y


We’re giving you the tools to succeedDeveloping clinical tools for the WOC nurse to use in practice is a major undertaking, and the WOCN Society has spent considerable time in 2015 woking to create these tools. We hope that you have embraced them in your practice and that they are contributing to better outcomes for your patients.

Skin & Pressure Ulcer Risk Assessment

Initial skin assessment

Intact skin/Within normal limits

Not at riskBraden > 18

Continue using current support

surface

Skin and pressure ulcer risk

reassessment per facility/agency

protocolTreat per facility/agency protocol

Not at riskBraden > 18

Yes, at riskBraden ≤ 18

Yes, at riskBraden ≤ 18

Trunk/Pelvis

OtherLocation

Yes No

Pressure ulcer risk assessment

Non-intact skin/Not within normal limits:

• Inflammation • MASD• Discoloration• Induration• Bogginess• Broken skin » Partial thickness » Full thickness• Healed pressure ulcer

< 12 months Consider patient weight, weight distribution, and the following comorbidities/major risk factors:

• Advanced age• Fever• Poor dietary intake of protein• Diastolic pressure < 60 mmHg• Hemodynamic instability• Generalized edema• Anemia

Pressure ulcer risk assessment

Pressure ulcer present?

An Evidence-and Consensus-Based Support Surface Algorithm

{ continue here }

{ continue here }

Preventive Support Surface

Consider Treatment Support Surface

Support surface selection algorithmThe development of the support surface selection algorithm included a comprehensive literature review, a consensus conference featuring numerous experts in pressure ulcer prevention and treatment and many hours spent outlining how the algorithm could be used in multiple care settings. The result is an evidence- and consensus-based tool that thousands of nurses and clinicians have accessed since its release. The award-winning algorithm has received acclaim from many key opinion leaders and recognition from the American Nurses Association (ANA); the ANA recently published an article in American Nurse Today which chronicled the evolution of the algorithm and how it can be incorporated into clinical practice.

If you have not yet accessed the algorithm, visit algorithm.wocn.org to try it!

N E W T O O L S

Hill-Rom provided support for the algorithm through an unrestricted educational grant.


CAUTI ToolThe WOCN Society teamed up with the ANA and other nursing groups to address the issue of catheter-associated urinary tract infections (CAUTI), the most commonly reported hospital-acquired infection. As CAUTI rates rise, so do lengths of stay in hospitals, health care

costs and patient morbidity and mortality. Using a consensus process, the organizations created a tool to empower nurses to play a greater role in reducing incidences of CAUTI. The evidence-based tool incorporates an algorithm to determine if a urinary catheter is appropriate based on nursing screening and assessments, as well as alternatives for retention and incontinence; timely removal; and a checklist on catheter insertion, cues for essential maintenance and post-removal care. Visit wocn.org/CAUTI to learn more about the CAUTI Tool.

WOCN.org video tutorialsThe WOCN Society created a video series designed to help you get the most out of our website. The series features a variety of videos, including: how to access and post on the WOCN Forums; managing your profile; and many more. Please be sure to take some time to update your member profile. This information is instrumental to the Society’s creation of new tools and educational opportunities for our members. wocn.org/videotutorials

Coming in

2016Society leadership is hard

at work as we begin to

develop new tools for

release in 2016. One of

the most exciting projects

currently underway is a

new algorithm focusing on

using compression for the

prevention, treatment and

prevention of recurrence of

venous leg ulcers. Keep an

eye out for this and other

tools throughout 2016!

Streamlined Evidence-Based RN Tool: CatheterAssociated Urinary Tract Infection (CAUTI) PreventionNurse-Driven CAUTI Prevention: Saving Lives, Preventing Harm and Lowering Cost.Key Practice Strategies to Reduce CAUTI: 1) Fewer Catheters Used, 2) Timely Removal and 3) Insertion,Maintenance and Post-Removal Care.Informed by Guidelines for Prevention of Catheter-Associated Urinary Tract Infections (CDC, 2009).

Does patient meet CDC (2009) Criteria for IUC?

Yes

Has patient urinated?Patient has urinary incontinence?(inability to control urine flow)

(See A and B below)

Yes

No

No

No

Does patient meet CDC Criteria?

Remove IUC, assessbladder emptying (See A and B below)

Prevent CAUTI (See bottom of page 2)

CDC (2009) Criteria for Indwelling Urinary Catheter (IUC) Insertion:Acute urinary retention (sudden and painful inability to urinate (SUNA, 2008)) or bladder outlet obstructionTo improve comfort for end-of-life care if needed Critically ill and need for accurate measurements of I&O (e.g., hourly monitoring)Selected surgical procedures (GU surgery/colorectal surgery)To assist in healing open sacral or perineal wound in the incontinent patient Need for intraoperative monitoring of urinary output during surgery or large volumes of fluid or diuretics anticipated Prolonged immobilization (potentially unstable thoracic or lumbar spine, multiple traumatic injuries such as pelvic fractures)

Insert IUC per Tool Checklist (See page 2)

• Assess daily for meeting CDC Criteria for IUC (Follow nurse-drivenremoval protocol, if approved by the facility)

• Prevent CAUTI after IUC Insertion (See CDC IUC Maintenance Bullets,page 2)

• Assess for/report signs/symptoms of CAUTI (See facility protocol/procedure)

Do Not Insert IUCAssess urination and bladder emptying

Prompt patient tourinate and evaluateresults (See B below)

Assess bladderemptying(See A below)

• Develop individualized toileting plan withinterdisciplinary input (e.g. prompted voiding,use of commode, use of gender-specificurinals) to regain continence.

• Use gender-appropriate collection device(e.g. external catheter, penile pouch/sheath(male) or urinary pouch (female) orabsorbent products) to manageincontinence and maintain skin integrity.

Page 1 of 2

Assess for Adequate Bladder EmptyingA. If Patient HAS urinated (voided) within 4-6 hours follow these guidelines:

• If minimum urinated volume ≤ 180 ml in 4-6 hours or urinary incontinence present, confirm bladder emptying.• Prompt patient to urinate/check for spontaneous urination within 2 hours if post-void residual (PVR) < 300-500 ml

- Recheck PVR within 2 hours.*• Perform straight catheterization for PVR per scan ≥ 300-500 ml.

- Repeat scan within 4-6 hours and determine need for straight catheterization.- Report to provider if retention persists ≥ 300-500ml.- Perform ongoing straight catheterization per facility protocol to prevent bladder overdistension and renal dysfunction (CDC,

2009), usually every 4-6 hours.• If urinated >180 ml in 4-6 hours (adequate bladder emptying), use individual plan to promote/maintain normal urination pattern.

B. If Patient HAS NOT urinated within 4-6 hours and/or complains of bladder fullness, then determine presence of incomplete bladderemptying.*• Prompt patient to urinate. If urination volume ≤ 180 ml, perform bladder scan.*

*Perform bladder scan (CDC, 2009) to determine PVR. If no scanner available, perform straight catheterization.

BOX 1

No

Yes Yes

N E W T O O L S

F R O M T H E W O C N S O C I E T Y !

Happy Holidays

1120 Route 73Suite 200Mt. Laurel, NJ 08054www.wocn.org

Documents

WOCN® SOCIETY 2015...WOCN-15-Core-Curriculum-Ad-JWOCN-II4U-FINAL.indd 2 5/13/15 1:45 PM Following the Curriculum Blueprint designed by the Wound, Ostomy and Continence Nurses Society