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Entry Level Wound Ostomy Continence Practice

INTRODUCTION
Wound, Ostomy and Continence Nursing (WOCN) is a distinct and well-defined field of nursing practice, which is national in scope and based on a tested body of specialty-related, data-based knowledge. Consistent with the American Board of Nursing Specialties (ABNS) definition of a nursing specialty, there is an identified need for the WOCN specialty and for nurses who devote most of their practice to this area of nursing expertise.

The Wound, Ostomy and Continence Nursing Certification Board (WOCNCB^®) is a professional organization dedicated to providing consumer safety and protection by offering credentialing in areas of wound, ostomy, and continence nursing.

The National Commission for Certifying Agencies (NCCA) accredits the WOC certification programs. Accreditation by NCCA demonstrates the highest standards in certification, exceeding the requirements of the American Psychological Association and the U.S. Equal Employment Opportunity Commission.

The WOCNCB^® believes that although certification is voluntary, nurses who hold WOCNCB^® credentials have demonstrated their commitment to and knowledge of WOC nursing practice by meeting stringent, predetermined standards and passing a rigorous comprehensive wound, ostomy, and/or continence examination(s). WOCNCB^® credentialing provides formal recognition of this commitment to high standards in wound, ostomy, and continence nursing care. Certification provides formal recognition of knowledge as a wound, ostomy and/or continence nurse beyond traditional nursing programs.

The nurse who chooses to certify demonstrates a commitment to WOC nursing practice and patient protection. Credentials are awarded for a five-year period. Recertification can be achieved by means of examination or Professional Growth Program (PGP) program.

The WOCNCB^® stands firmly in its belief that WOC certification is key to improving the level and quality of patient care by defining and maintaining competency within the WOC specialties. Certification furthermore provides a competitive advantage for employment and promotes job satisfaction.

The certified WOCN serves primarily as a consultant, educator, and/or administrator/manager in multiple healthcare settings, including inpatient, outpatient, long-term care, home health, and acute care. In addition, the certified WOCN provides expert care in the management of patients with wound, ostomy and/or continence issues.

ELIGIBILITY FOR CERTIFICATION
The WOCNCB^®'s predetermined eligibility requirements must be met before a candidate is permitted to take the initial examination. Eligibility requirements include nurse licensure as a registered nurse with a baccalaureate degree. Additionally, the nurse must document one of the following:

• Graduation from an accredited WOC educational program which requires 120 hours didactic and 120 clinical hours.
• Completion of 1,500 hours of clinical practice and 50 continuing education units within the last five years for each specialty for which certification is being pursued. These clinical practice hours and continuing education units must be directly related to the specialty for which certification is sought.
• Completion of a graduate-level program in nursing with documentation of clinical course work equivalent to two semester hours in WOC nursing content. Note: Clinical practice hours, continuing education credits, and clinical course work must be directly related to the specialty for which certification is being pursued.

CREDENTIALS
CWOCN® CCCN®, COCN®, and CWCN® are registered trademarks and the only recognized credentials of the WOCNCB^®.

CWOCN ® Certified Wound Ostomy Continence Nurse
CWCN ® Certified Wound Care Nurse
COCN ® Certified Ostomy Care Nurse
CCCN ® Certified Continence Care Nurse

Candidates who successfully complete the WOCNCB^® examination are eligible to use CWOCN® (tri-specialty), CWCN® (wound), COCN® (ostomy), or CCCN® (continence) after their licensing credential. Appropriate use of credentials is based upon the examination taken.

REFERENCES
American Board of Nursing Specialties. (2000). ABNS Standards. Aurora , OH

WOCNCB^®. (2001). Candidate Examination Handbook. Milwaukee, WI.

National Commission for Certifying Agencies. (2004).

Advanced Practice in Wound Ostomy Continence Nursing

INTRODUCTION
The role of the Advanced Practice Registered Nurse (APRN), including those of the Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP), was established by the American Nurses Association in 1965 (ANA, 1996).

Wound, Ostomy and Continence Nursing (WOCN) practice is a distinct and well-defined field of nursing practice, which is national in scope and is based on a tested body of specialty-related, data-based knowledge. Consistent with the American Board of Nursing Specialties (ABNS) definition of a nursing specialty, there is an identified need for the WOCN specialty and for nurses who devote most of their practice to this area of expertise (ABNS, 2000).

APRNs functioning in the WOCN specialty serve as clinical patient care experts in the care of patients with disorders of the integumentary, gastrointestinal and/or urinary systems. Roles include those of direct care provider, consultant, mentor, educator, researcher and/or administrator. Working with various members of the health care team to coordinate patient-focused care, APRNs develop evidence-based programs, protocols and tools to facilitate provision of optimal health care.

The Wound, Ostomy and Continence Nursing Certification Board defines an Advanced Practice Registered Nurse (APRN) in the WOCN specialty as one who minimally:

• Has completed Graduate preparation (Master's or Doctoral degree in a related specialty area of nursing).
• Is clinically active in the WOCN specialty.
• Demonstrates advanced knowledge of the WOCN specialty via a valid and reliable measurement of competency (e.g. a psychometrically sound examination or professional portfolio).

CORE COMPETENCIES
The Wound, Ostomy and Continence Nursing Certification Board (WOCNCB^®) is a professional organization dedicated to providing consumer safety and protection by offering credentialing in the areas of wound, ostomy and continence care nursing.

• The WOCNCB^® acknowledges the Essentials of Graduate Education documented by the American Association of Colleges of Nursing (AACN, 1996) which includes theoretical foundations, inquiry skills, empirical and practical knowledge that focus on phenomena of concern (e.g. wounds, ostomies, or continence), nursing therapeutics, evaluation methodologies and systems thinking (AACN, 1996).
• The APRN Uniform Requirements adopted by the Delegate Assembly of the National Council of State Boards of Nursing note that, through graduate level education, a nurse can further develop abstract and critical thinking, the ability to assess at an advanced level, as well as other essential therapeutic skills. The WOCNCB^® supports this perspective, noting that the APRN educational preparation should encompass both knowledge and the clinical component unique to the specific role (NCSBN, 2002).
• The WOCNCB^® further recognizes the essential characteristics outlined by the National Association of Clinical Nurse Specialists Statement on CNS Practice and Education as integral for the effective practice of all APRNs. Skill sets identified include professional attributes (e.g. self-knowledge, self-confidence, self-scrutiny and personal mastery), leadership skills (e.g. communication/interpersonal skills, disciplined inquiry, systems thinking and ethical reasoning); collaboration skills; and consultation skills. Spheres of influence encompass patients/clients, nursing personnel, and organizations/networks (NACNS, 1998).
• Consistent with the discussion of professional accountability as outlined in the American Academy of Nurse Practitioners statement on Scope of Practice, the WOCNCB^® believes that the autonomous nature of all APRN practice requires accountability for health care outcomes. The commitment to optimal quality health care requires certification, peer review, and evidence of continuing professional development (AANP, 2002).
• THE WOCNCB^® recognizes that measurement of APRN competency in the WOCN specialty requires both measurement of core APRN competencies along with those of the WOCN specialty. Further, it must be noted that the measurement of competency in a generalist scope of knowledge (e.g. via a Medical –Surgical CNS or Adult NP examination) does not assure advanced nursing competency in the WOCN specialty.

WOCNCB^® POSITION ON WOCN ADVANCED NURSING PRACTICE

• The WOCNCB^® supports and promotes WOCN practice as a defined specialty area of advanced practice nursing.
• The WOCNCB^® believes specialty nursing certification boards have the right and responsibility to define advanced nursing specialty practice and to institute certifying procedures for the measurement of advanced specialty competency.
• WOCNCB^® recognizes and supports the State Boards of Nursing as the governing bodies for nursing licensure and regulation.
• WOCNCB^® supports efforts to standardize APRN licensure requirements nationally, with recognition of input from all stakeholders.
• WOCNCB^® supports legislative efforts to promote reimbursement for APRN services, along with autonomy and the option for prescriptive authority for all APRNs.

REFERENCES
American Nurses Association. (1996). Scope and Standards of Advanced Practice Registered Nursing. Washington, DC .

American Board of Nursing Specialties. (2000). ABNS Standards. Aurora, OH.

American Academy of Nurse Practitioners. (2002). Scope of Practice for Nurse Practitioners. Austin, TX.

National Association of Clinical Nurse Specialists. (1998). Statement on Clinical Nurse Specialist Practice and Education. Harrisburg, PA.

American Association of Colleges of Nursing. (1996). The Essentials of Master's Education for Advanced Practice Nursing. Washington, DC .

National Council of State Boards of Nursing. (2002). Uniform Advanced Practice Nurse Licensure/Authority to Practice Requirements. Chicago, IL.