New Foot and Nail Exam

[Examination Committee] [Handbook and Application] [Exam Eligibility Requirements] [Foot and Nail Care Education Courses] [Locating Test Centers] [SAE] [Examination Content Outline] [References] [Optional Learning Tools] [CEUs] [Home]

Foot and Nail Care Certification

Beginning in January 2005, the Wound, Ostomy and Continence Nursing Certification Board (WOCNCB^®) is offering a new certification credential to Registered Nurses (RNs) who perform foot and nail care. The WOCNCB^® is dedicated to providing consumer safety and protection by offering this new credential – CFCN^® (Certified Foot Care Nurse). Please review this website for complete information on eligibility, educational preparation, exam content, review references, and the testing process.

The WOCNCB^® multiple-choice foot and nail examination was developed by the Foot & Nail Care Examination Committee – a group of nurses with expertise in foot and nail care – in collaboration with the testing firm Applied Measurement Professionals (AMP). The committee writes and reviews all questions for relevancy, consistency, accuracy and appropriateness, and we wish to thank them for their hard work.

Foot and Nail Examination Committee

Tiffany Frost, RN, BSN, CWCN, CFCN, Chair
Diana Gallagher, RN, MS, CWOCN, Board Liaison
Jim McLean, RN, BSN, CWOCN, CFCN
Kathy J. McDonald, RN, CWON, CFCN
Laurie Ellefson, RN, CFCN
Kathy Cullett, RN, CFCN

How to Obtain an Examination Handbook and Application

The current Candidate Examination Handbook and application can be downloaded from this Web site, printed and used to apply for the examination. Mail the completed application with all appropriate fees and documentation to: WOCNCB^® Examination, Applied Measurement Professionals, Inc. (AMP), 18000 W. 105th Street, Olathe, KS 66061-7543, USA.

To download Candidate Examination Handbook and Application click here. (Acrobat Reader required)

The Candidate Handbook is a 20 page document.

To download Acrobat Reader click here.

If you wish to order a printed copy of this Handbook, call AMP at (913) 895-4600 or fax your request to (913) 895-4650.

Exam Eligibility Requirements

1. Current RN license, and either #2 or #3:
2. Completion of formal foot and nail program including five hours didactic; three hours of clinical practice with direct foot and nail care, or
3. Completion of experiential pathway including five hours CE; three hours of clinical practice (under supervision of expert). Effective January 1, 2007, the number of clinical hours will be increased to eight hours of clinical practice under the supervision of an expert.

Foot and Nail Care Education Courses

The WOCNCB^® does not endorse or monitor the educational programs listed. This list is not all-inclusive.

3rd Annual Foot & Nail Care Conference
June 24-26, 2007
Keynote Speaker: Dr. Teresa Kelechi
PCC’s Institute for Health Professionals
Portland Community College
1626 SE Water Avenue
Portland, Oregon 97214
Telephone: 503-731-6628
Email: cmichalc@pcc.edu

Complete Foot Care Course
by
American Orthopaedic Foot & Ankle Society
September 13-15, 2007
Rio All-Suite Hotel & Casino
Las Vegas, NV
Information and registration form are available at www.aofas.org.
Questions should be directed to the AOFAS at aofasinfo@aofas.org or 847-698-4654.

The WOC program contains a course section on Foot Care
at
Emory University School of Medicine
Wound Ostomy and Continence Nursing Education Center
and
Current Approaches to Diabetic Foot Care
2-day Foot & Nail course
The Emory Clinic, Room AT732
1365 Clifton Road, NE
Atlanta, GA 30322
tel: 404/778-3650
http://www.surgery.emory.edu/wocnec/programs.htm

The WOC program contains a course section on Foot Care
at
University of Virginia Graduate Program in WOC Nursing
UVA School of Nursing
Attention: Catherine Ratliff
P.O. Box 800782
McLeod Hall
202 15th Street SW
Charlottesville, Virginia 22908
Telephone: 434/924-0141 or toll free 1-888/283-8703
Fax: 434/924-2787
Email: www.crr9m@Virginia.edu
http://www.nursing.Virginia.edu/programs/admissions/wocpost/default.asp

Foot Care for Registered Nurses
presented by
Medical University of South Carolina
College of Nursing, Office of Continuing Education
99 Jonathan Lucas St.
Charleston, SC 29425
Tel: 1-866/637-6835
http://www.musc.edu/nursing/departments/continuingeducation/courses.htm
     (This course will be offered online in summer/fall 2004.)

Foot and Nail Care Review Course
4-part DVD Series
prepared by the Medical University of South Carolina
5.0 CEUs
For more information, click here:
http://www.musc.edu/nursing/departments/continuingeducation/footcaredvd.htm

Foot and Nail Care Education for Nurses
Two-day course offered by
University of Wisconsin in Eau Claire
Continuing Education Dept.
210 Water St., Box 4004
Eau Claire, WI 54702-4004
Tel: 1-866/893-2423
http://www.uwec.edu/ce/healthCare/footnail/index.htm

Nurses Foot Care & Business Program
By NFCS Associates Services, LLC
Ann Arbor, Michigan
For this Year's Two Day Course Dates Check:
http://www.nursescare.net/nfcbusprogram.htm

Diabetic Foot Care Program
Michigan Diabetes Outreach Network (MDON)
http://www.diabetesinmichigan.org/pdf/Foot%20Care%20Guideline%202004.pdf

Nurse Foot Care Training Program
November 10, 2007
Washington State Podiatric Medical Association
PO Box 22368
Seattle Washington 98122
Tel: 1-866/343-6999
http://wspma.org/nursefootcare.html

"da Agony of de Feet"
A Complete Foot Care Course
Ongoing courses offered in San Diego and Calabasas, California
15 CEU's
For More Information Contact
Shelly R. Burdette-Taylor
RN, C, MSN, CWCN, CFCN, PhDc
Taylor'D Health Education & Consultation
shelly@taylordhealth.com
www.taylordhealth.com
858-663-4150 mobile
858-672-9148 office/fax

Locating Test Centers

To access the locations of AMP test centers, click the link below:
https://www.goamp.com/sched/w_aspen_acn.display_map?p_exam_id=9497

Self Assessment Examination

Now available for purchase - the WOCNCB^® Foot and Nail Self Assessment Exam (SAE)! The SAE provides self assessment (or practice) to measure your professional knowledge and prepare you for the actual credentialing exam. This web-based SAE gives you instantaneous scoring and resultes, along with feedback on your answers.

Accessing the WOCNCB^® Self Assessment Examination:

• Click on the link to the SAE, http://store.lxr.com/dept.aspx?id=40
• Purchase the WOCNCB^® SAE for $30 per specialty
• Take the SAE
• Score the exam
• Review your score reports
• Schedule your computer-based test through AMP, www.goamp.com
• Good luck on your exam!

Examination Content Outline

Overall Cognitive Level Distribution: 17 Recall, 46 Application, 17 Analysis

1. ASSESSMENT   40 items
1. History
1. Collect health history
2. Assess medication history
2. Physical Assessment
1. Assess patient for functional disabilities
   (e.g., gait, mobility, balance, visual, cognitive)
2. Assess patient for health habits
   (e.g., smoking, exercise, hygiene, nutrition)
3. Assess foot circulation by palpation
   (e.g., pulses, blanching, capillary refill)
4. Assess foot circulation by Doppler
5. Assess legs and feet for temperature
6. Assess hair growth on legs and feet
7. Assess foot skin integrity
   (e.g., fissures, ulcers, corns, calluses, dermatitis)
8. Assess physical/musculoskeletal function of the foot
   (e.g., range of motion, deformities, strength)
9. Assess sensation
   (e.g., monofilament testing, vibration)
10. Assess toenails and cuticles
11. Determine ankle brachial index (ABI)
3. Risk Assessment
1. Establish risk of ulceration on assessment
2. Establish risk of amputation based on assessment
3. Assess for issues of quality of life related to foot pathology
4. Footwear and Mobility Aid Assessment
1. Inspect footwear and socks/stockings
2. Inspect mobility aids (e.g., canes, walkers)



2. NURSING INTERVENTIONS   25 items
1. Skin care
1. Perform hygiene
2. Identify appropriate interventions for managing hyperkeratrotic areas
3. Implement off-loading
4. Apply padding
5. Identify the need for compression therapy
   (e.g., to manage edema)
6. Apply moisturizers to skin
7. Perform cuticle care
8. Identify and make recommendations for skin conditions:
1. Blisters
2. Plantar warts
3. Trauma
4. Tinea pedis
5. Paronychia
6. Maceration
7. Other skin conditions
9. Identify the need for use of therapeutic interventions (e.g., topical therapy) for skin conditions
2. Nail care
1. Define free nail border (i.e, remove debris)
2. Conduct debridement of toenails
3. Perform cleaning and sterilization of equipment
4. Use personal protective equipment
5. Maintain infection control for tinea pedis and candidiasis
6. Identify and make recommendations for the following conditions:
1. Onychomycosis
2. Trauma
3. Ingrowing/ingrown toenail
4. Other conditions of the toenails



3. EDUCATION AND REFERRAL   15 items
1. Education
1. Provide patient/caregiver education related to:
1. foot care (e.g., hygiene, skin care, inspection, nail care)
2. pathophysiology affecting the foot
3. age-specific changes of the foot
4. proper footwear
5. problems that should be reported
6. anatomy and physiology of the foot
7. plan for follow-up care
8. weight management
9. prevention of specific problems
2. Referral
1. Identify the need for appropriate referrals
(i.e., primary care provider, podiatry, orthopedics, dermatology, endocrinology, vascular surgery, general surgery, physical therapy, occupational therapy, pedorthist/orthotist, home health, pain management, diabetes education, smoking cessation, case/care manager or social worker, wound care)
2. Act as patient advocate regarding issues of foot care

Total Items* 80
* Plus 10 unscored pretest items

References

This list does not attempt to include all acceptable references, nor is it suggested that the WOCNCB^® foot and nail care examination is necessarily based upon these references.

Books

Ahroni, Jessie H. 101 Foot Care Tips for People with Diabetes. Canada: American Diabetes Association, 2000.

Awad, Elias; Tremaine David. The Foot and Ankle Sourcebook. Los Angeles: Lowell House, 1998.

Birrer, Richard; DellaCorte, Michael; Grisafi, Patrick. Common Foot Problems in Primary Care. Philadelphia: Hanely & Belfus, Inc., 1992.

Bowker, John H. and Pfeifer, Michael. Levin and O'Neal's The Diabetic Foot, Mosby Publishing

Bryant, R. Acute and Chronic Wounds: Nursing Management, 2nd Edition. St. Louis, Mosby, Inc., 2000.

Dillman, Erika. The Little Foot Care Book. New York: Warner Books, 2000.

Kane, Peggy; Schlefman, Barbara S.; Vickers, Nancy Sinnott. Podiatric Office Management and Procedures. St. Louis: Mosby-Year Book, Inc., 1992.

Kelechi, T. J. (2001). Management of the skin and nails of the foot. In C. Sussman and B. Bates-Jensen (Eds.) Wound care: A collaborative practice manual for physical therapists and nurses. Gaithersburg, MD: Aspen.

Levine, Suzanne M. Your Feet Don't Have to Hurt. New York: St. Martin's Press, 2000.

Merry, G.M.; Rutherford, L. The Foot Care and Management Manual for Health Care Professionals. Third Edition. 1989.

Mix, Godfrey. The Salon Professional's Guide to Foot Care. Albany: Milady/Salon Ovations Publishing, 1999.

Management of Wounds in Patients with Lower-Extremity Arterial Disease (2002) WOCN Practice Guideline, page 5

Management of Wounds in Patients with Lower-Extremity Venous Disease WOCN Practice Guideline (2004)

We encourage you to read the journals and related articles pertaining to foot care listed on the www.wocncb.org website. The information is provided as optional learning tool, and does not suggest that the foot and nail care examination is necessarily based upon these references.

Optional Learning Tools

(Click here)

Continuing Education Offerings

Continuing education course listings are provided as a helpful tool, and are not endorsed by WOCNCB, and do not represent a complete listing of all current activities available.

Healthpoint
"Diabetic Foot Ulcers "
CEUs: 1.0
http://www.healthpoint.com/compEducation.cfm
1-800-441-8227

Kinetic Concepts Inc. (KCI)
“Guidelines Regarding Negative Pressure Wound Therapy (NPWT) in the Diabetic Foot:”
“Wound Healing: Diabetic Foot Ulcers” 1.0 CEUs
“Wound Healing: Diabetic Foot Surgery” 1.0 CEUs
http://www.kci1.com/983.asp

Lippincott-Williams' Nursing Center for CE
“Physical Assessment of the Diabetic Foot Advances in Skin & Wound Care”, March/April 2003
3.0 CEUs (Expires 4/30/2006)
and
Stepping up care for diabetic foot ulcers, Nursing2005, October issue
2.5 CEUs (Expires 10/31/2007)
http://nursingcenter.com/prodev/ce_list.asp?flag=search

Association of Rehabilitation Nurses
“Incorporating Foot Care Education into Diabetic Foot Screening” (Yetzer EA) (CEU, pictorial, tables/charts) 2004 May-Jun; 29(3): 80-4 (21 ref) May/June 2004; Volume 29, Number 3
1.0 CEUs
Expiration date: June 30, 2006
http://www.rehabnurse.org/education/cearticles.html

Cleveland Clinic, Cleveland, Ohio
Online courses
https://www.clevelandclinicmeded.com/online/topics.htm

Podiatry Today magazine
“How To Manage Heel Ulcers In Patients With Diabetes” - By Jonathan Moore, DPM, and Pamela Jensen, DPM — March 2005
(Course #128)
1.0 CEUs
http://www.podiatrytoday.com/podtd/displayArticleaa.cfm?articleID=article3702

Medscape from WebMD
Has various online CE opportunities relating to foot care
http://www.medscape.com

Wisconsin Medical Society
Madison, Wisconsin
“Medicare Foot Care”
http://www.wisconsinmedicalsociety.org/physician_resources/educational/

Temple University School of Podiatric Medicine
Online CME Program
Wound Care (Lower Extremity Wound Management)
The Diabetic Foot (Evaluation of the Diabetic Foot and Biomechanical Management)
http://podiatry.temple.edu/cme/cme.html

Wild Iris Medical Education, Nursing CE
Skin and Wound Care for Clients with Diabetes
3.0 CEUs
http://www.nursingceu.com/courses/88/index_nceu.html

South Central College Conference Center, Minnesota State University (Mankato, MN)
Lower Extremity Ulcers and Diabetic Foot Care
March 2, 2006 
3.0 CEUs
http://www.mnsu.edu/cahn/contdEdu/jan2005.html

Pacific Lutheran University, Tacoma, WA
Foot Care Skills for Nurses
Thursday, May 11, 2006
7.5 CEUs
http://www.plu.edu/~ccnl/courses/foot-care.html

Sault College of Applied Arts & Technology, Sault Ste. Marie, Ontario, Canada
Foot Care, Basic
Foot Care, Advanced
Foot Care Advanced II Workshop
Diabetic Foot Care Workshop
From 8 to 22 hours courses
http://www.saultc.on.ca/CECourseGuide/HealthSciences.htm

St. Clair College, Windsor, Ontario, Canada
Basic Foot Care For RN & RPN
Advance Foot Care For RN & RPN
Two Day courses
http://www.stclaircollege.ca/programs/coned/WINDSORFALL05/Health.htm#Foot