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Spotlight on Administrators

President‘s Message:
The Value of Board Certification for Administrators

In the world of business management, value is expressed by Return on Investment, or ROI. This is true whether the business is selling products or providing healthcare. But determining ROI is not always a simple process, especially in healthcare where there is not always a direct line from dollars spent (the investment) to dollars or other values gained (the return).

How can healthcare administrators become aware of the value of hiring, retaining, and supporting Board certified wound, ostomy, continence, or foot care nurses? We need to educate them about how our certifications demonstrate knowledge that enhances patient care and improves outcomes.

One of the best ways to educate administrators is to collectively partner with them to assist with pressing healthcare and healthcare cost issues, such as Present on Admission and Catheter Acquired Urinary Tract Infections.

Just like when we pouch a wound to qualify and quantify the drainage, we can use that same model when it comes to documenting our value to our institutions. By qualifying and quantifying our positive impact on revenue, we can help our administrators better understand and appreciate the contributions of the Board certified wound, ostomy, continence and foot care nurse. The value may be in increased patient referrals and admissions, better utilization of products and prevention of complications that can occur in wound, ostomy, continence or foot care patients. The reduction in complications is exactly what regulatory agencies are looking for.

When an institution makes the financial commitment to hire a WOCNCB certified nurse, it receives knowledge and experience that positively impacts the quality of care at the institution. It is quite possible that if every hospital had Board certified wound, ostomy, continence and foot care nurses, the tough changes that administrators are experiencing in healthcare today may not have had to be instituted.

It is important that each of us communicates to administrators the positive contributions we are making at our facilities. Show them the thank you letters you receive from patients, the financial savings you obtained by switching to another product, or the guidelines you developed to prevent wound complications. Help your administrators understand the processes involved in the things that you do.

You may think that you are "just doing your job." But remember: It is the level of your education and years of experience that qualified you to become Board certified and that allow you to think outside the box to achieve positive results.

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Hire the Best

My Life, My Story: Bringing Measurable Value to Healthcare
Laura J. McCarthy, MS RN CWCN

Patient care at the hospital where I work is guided by the mantra "Your Life. Our Story."

I have a couple of favorite mantras of my own: Never underestimate your ability to influence people. Paint the big picture in vivid colors and give everyone a paintbrush. Celebrate little success stores. I'm Laura, the wound and ostomy nurse at Seven Rivers Regional Medical Center in Crystal River, Florida, and here is my story.

Yesterday
I took the long, scenic path into the WOC world. It took me 25 years to realize my passion and take active steps to get here. My first clue (I missed it) came at age 10 when my grandfather came to live with us immediately after radical surgery for eye cancer. He had half his face removed, including his left eye, and was sent home to die. After clearing the kitchen of all living creatures (mostly us 5 kids), Dad would do his daily dressings -claiming it to be too gross for any human to see. In retrospect, it was. I sat outside the kitchen each day and wailed! I wanted to see for myself and help my beloved grandfather. Well, my antics worked and within a week, I was the one doing the dressings and loving it. Years later, I realized my calling to be a nurse. The science of wound care had not evolved yet. I went to nursing school, got my bachelor's and master's and let my career take off without too much mindful control on my part.

Fast forward 25 years. After somewhat enjoyable clinical, management and education jobs in hospitals and home health (and a short stint of self-employment), I still felt there was something else out there for me to do. Some soul searching and reflection led me to the world of wound, ostomy, and continence (WOC) nursing because my most memorable moments were those I spent with wound and ostomy patients. My quest for further education began. Because I could not take time off for school, I followed the experiential learning pathway to earn my Certified Wound Care Nurse credential. It was hard work, and I sometimes had to do without benefits to get the experience I needed, but it was well worth it. The difference is in how I feel about what I do. I am finally convinced this is God's plan for me.

Today
Today, I am happily employed (with benefits) in a dual role that involves outpatients and inpatients, encouraged by two visionary superiors and a tremendously supportive nursing management team. This small rural hospital knows the value of having a Board certified nurse on the team. Both my chief nursing officer and my program director have the leadership skills and wisdom to embrace the tough challenges of this chaotic health care environment. On the outpatient side, my program director drives the vision for the center by setting goals, communicating progress and engaging all staff, including our physicians, in a truly collaborative environment. My chief nursing officer, who manages the inpatient side, is a dedicated professional who relentlessly pursues cost-effective, quality, patient-centered care. Her systems approach to change, staff empowerment and education, and process improvement delicately balances the needs of patients, physicians, and staff. In fact, the entire hospital does what is right for our patients, community, and staff. I realize how lucky I am to work for an employer whose goals and values so closely align with my own.

Tomorrow
Right now I am enrolled in Emory University's distance program working toward ostomy certification and I continue to learn about the intricacies of hyperbaric medicine with the help of my program director. My role continuously evolves, and tomorrow looks bright because I know my education, validated by board certification, prepares me to meet future challenges.

We, as Board certified wound, ostomy, continence, or foot care nurses, have a duty to fully realize the impact we have on not only our patients, but on our care settings and larger communities, both local and global. We are first and foremost expert clinicians and patient advocates, followed closely by change-agents and internal consultants. Perhaps the most important aspect to fulfilling our roles as WOC nurses is the reliance we uniquely have on evidence-based science to provide the foundation for positive change.

What Healthcare Administrators Need to Know
I urge all certificants to ask their administrators this question: You value the contributions of board certified physicians; can you honestly say you also recognize the value of Board certified wound, ostomy, and continence nurses?

Healthcare administrators need to know there is only one internationally recognized, accredited organization empowered to board certify clinicians in wound, ostomy, and continence specialties - the WOCNCB. They need to understand that national board certification through the WOCNCB recognizes nurse competency comprised of didactic education as well as clinical experience and competence. In my opinion, certification from the WOCNCB is the only certification administrators should look for when making staffing decisions that impact the needs of your patients and organization in these tough times.

Tell your administrators this: National board certification through the WOCNCB will ensure their WOC nurses are qualified to:

• Provide the most cost-effective, highest quality care possible. How? Board certified WOC nurses have the knowledge to identify subtle signs and symptoms early and can put preventative measures into place before small problems can snowball into lawsuits. Need proof? "As a result of hiring board certified nurses you have fewer malpractice claims" (Trossman, 2002) Furthermore, a retrospective analysis (Bolton et al, 2004) revealed that 78.5 percent of those patients treated by a board certified wound care nurse healed in comparison to the 36.3 percent of those treated by non-certified nurses.
• Maximize patient care reimbursements by documenting accurate assessments and care, because sometimes the doctors and staff are not experienced in what coders need reported to assure the highest level reimbursement.
• Save costs on supplies by standardizing products, training staff in their use and promoting efficiencies that minimize labor time. We know the cost-benefit side of the many products available on the market, including specialty beds and equipment. We use evidence-based research to make supply and equipment decisions.
• Collaborate on making critical process improvements to ensure all patients receive the highest standard of care.

By the way, I just came up with a new mantra:

Expect the best. Hire the best: A Board certified WOC nurse.

What's YOUR story? Certification eNews wants to hear from you. Send articles or inquiries to MarketingManager@wocncb.org.

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Point of View: Interviews with Hospital Administrators

Marsha Berenson, Marketing Manager

What's The Value of Board Certification?
Ask your neighbor about a Hyperbaric Chamber and the discussion will turn to singer/songwriter Michael Jackson. Ask Justin Everts, and the discussion will immediately go to leading-edge hyperbaric oxygen treatment for non-healing wounds. Everts, Program Director for the outpatient wound center at Seven Rivers Regional Medical Center in Crystal River, Florida, knows what he's talking about. His credentials include MSN and CHRNC, he has served as a President of the Baromedical Nurses Association, and is currently an associate member of the Undersea Hyperbaric Medical Society serving on the Accreditation Council.

Ask Everts why Seven Rivers chose a Certified Wound Care Nurse (CWCN®) to manage treatment plans for inpatient and outpatient wound care at the healthcare facility, and he'll tell you this: "Seven Rivers is a very quality driven organization committed to a continuous improvement process. Having a Board certified wound care nurse is a major key for process improvement throughout our facility."

As Everts explains, the general nursing population has only a general idea about wound and pressure ulcer care. "It is in the hospital's best interest to have a certified wound care nurse involved with a patient right from the start. Missing the early signs of a pressure ulcer can mean a major financial issue if missed on intake and later tagged as an inpatient hospital issue."

Having a Board certified wound care nurse is a proactive step the hospital took to assure wound care consistency for inpatients and outpatients. "The hospital administration realizes the value of wound care nurses - it's not just eight hours per week rounding the wounds of inpatients," says Everts. "When we interview people for management positions and see a WOCNCB certification we know it comes with credibility. The difference in abilities is a plus to administrators due to the educational standards."

Seven Rivers and Everts encourage their own nurses to pursue board certification by offering a professional development program that includes some tuition and fee reimbursement. "We look closely at these types of programs and what they offer - what value they will bring - not just 'letters behind the name.' We know the WOCN Society programs are educational programs that contribute knowledge, and our Board certified wound care nurse, Laura McCarthy, can transfer that knowledge to the hospital staff and push the information forward."

Everts sees only one disadvantage when looking for experienced, Board certified wound care nurses: They are hard to find. "In the world of outpatient wound care centers, the goal is to get certified nurses," Everts says. "Certified wound care nurses have the education and a number of years of great experience and dedication to patient care. But most certified wound care nurses,are often at the tail end. You don't see as many younger nurses who are certified. The younger nurses need to gain access to that education and certification. I encourage the WOCNCB to make that more logistically possible for nurses."

It's a Good Feeling: Interview with Cynthia Heitzman, CNO
Present on Admission. S3. CAUTIS. Pressure Ulcers. It's enough to give a busy hospital administrator a headache. Luckily, Cynthia Heitzman, Chief Nursing Officer at Seven Rivers Regional Medical Center in Crystal River, Florida, has just the right prescription: a Board certified wound care nurse.

Just like outpatient wound center colleague Justin Everts, Heitzman is enthusiastic about the experience and level of education Board certified wound nurse Laura McCarthy, CWCN, brings to short-term acute care at the hospital.

The patient population at Seven Rivers is elderly, with 72 percent on Medicare and large numbers of patients with skin issues coming from long term care facilities. "Assisting staff with the appropriate plan of care is important from the get-go," says Heitzman. "Laura does an excellent job with initial assessment and plan of care, and if a patient presents with skin care issues she implements a plan to take care of it right away."

Other values that Heitzman recognizes in a Board certified wound care nurse include cost savings from recommending proven supplies, improved staff education, and an educated resource person for staff, physicians, and patients.

"There is so much focus today on Present on Admissions and hospital acquired decubitus," Heitzman continues. "You don't want this to happen on your watch. With Laura on board, we send patients out in much better shape than when they came in. It's a good feeling."

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What it‘s Worth: WOCN Society Releases 2008 Salary and Productivity Survey

By Dea Kent, MSN, NP-C, CWOCN
WOCN Society Membership Committee Chair

In October 2008, an online survey questionnaire was emailed to approximately 4,560 WOCN Society members. In total, 1,586 completed survey forms were submitted by the end of October, representing a response rate of slightly less than 35 percent.

The information contained in the survey represents complete, accurate and up-to-date compensation and productivity data on the WOC nursing industry. The report is designed to allow a user to easily compare their compensation and productivity levels with their peers. However, remember that the statistics published in this report should be regarded as "guidelines" rather than "absolute standards." Since nurses differ depending upon their location, years of experience, type of work, and other factors, any two nurses may receive a reasonably attractive compensation package and yet be very different.

The data has been aggregated in demographic groupings so users can compare their own data to the results of similar respondents. Significant respondent groupings include Gender, Age, Years of WOC Nursing Experience, Highest Degree of Education, WOCNCB® Certified or Non-Certified, and Primary Practice Setting. A few highlights are shown below.

How can you, personally, use this survey? After careful reading of the components, the data could be useful to create work load benchmarks, compensation thresholds, and be a tool for you to use when talking with administration about your worth. Often seeing something in print is more easily comprehended and compared versus just verbal communication. It will also assist you in having guidelines for other independent work, such as consulting or case reviews. Often individuals do not want to share compensation and other sensitive data. This survey was created with anonymity, which is one way to get solid data. Use this information for negotiation and use it in creative ways. When you do so, please tell the WOCN how you did and what you gained when you used this data.

The complete Salary and Productivity Survey report (PDF) is now available on the WOCN Society Web site (http://www.wocn.org). The report is free to WOCN Society members. A hard copy can also be purchased for $30 through the WOCN National Office. Call 1-888-224-9626 for more details.

Category	WOCNCB Certified	Not WOCNCB Certified
Overall Job Satisfaction Rating: "Very Satisfied"	44.9%	38.5%
Precepted a nurse in a WOC program in the last two years	36.3%	5.2%
Median Annual salary compensation	$75,000	$73,000