Wound Ostomy Continence Nursing Explained

Wound Ostomy Continence Nursing is a nursing specialty that involves treating patients with acute and chronic wounds as well as ostomy patients, which are patients that have had on or other bowel or bladder diversion. Nurses who practice wound ostomy continence nursing are generally referred to as WOCNs (wound, ostomy, continence nurses).

Wound, Ostomy and Continence Nurses are specialists who have completed advanced training and have knowledge and expertise in the management and prevention of various conditions involving the skin, bladder and bowel. In excess of 6,500 nurses have validated their specialized knowledge in wound, ostomy, continence and foot care nursing by voluntarily becoming certified over the past 30 years.

The American Nurses’ Association affirmed in 2010 that WOC nursing meets their very high standard for a nursing specialty, and the Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) adheres to very high and strict standards of quality, thereby ensuring that the public is protected from unsafe and incompetent providers.

What Does A Wound, Ostomy And Continence Nurse Do?

Wound Ostomy Continence Nursing, previously referred to as Enterostomal Therapy, incorporates principles and practices that promote, maintain and restore health for patients who have wounds caused by ulcers, injuries, or disease, and who suffer with continence problems throughout their lives.
WOC nurses specialize in the care of individuals with disorders of the genitourinary and integumentary systems and the gastrointestinal tract, and their job is to provide postoperative care and support for patients who need alternative methods of eliminating bodily waste. They also treat patients with fecal and urinary incontinence.

Main Duties Of A Wound, Ostomy, Continence Nurse

These duties include:

  • Assisting patients who have urinary and fecal incontinence
  • Dressing wounds
  • Educating patients and their families on how to manage the artificial waste elimination devices
  • Supporting patients who have colostomy bags or use other methods of artificial waste elimination

WOC nurses provide acute and long-term support to more than one million individuals who undergo ostomy surgeries in the U.S. every year. They also play a huge part in managing urinary incontinence amongst the approximately 13 million Americans who have this condition. WOC nurses are particularly skilled at managing complex cases of fecal and urinary incontinence in frail elderly patients, which is what makes them so valued.

Nurses who have specialized training in wound care are of particular value to the long-term, home-care and acute settings due to their ability to treat surgical incisions, tubes and fistulas, pressure ulcers, and draining and traumatic wounds.Wound Ostomy Continence Nursing

Where Does A Wound, Ostomy And Continence Nurse Work?

Wound ostomy continence Nursing takes place wherever there is a need for support for patients with incontinence and artificial waste elimination devices; generally in hospitals, but also in various other healthcare facilities.

Wound, ostomy, continence nursing has always been a critical component in acute care settings. The demand for WOC nurses is becoming greater as health care shifts from acute care in a hospital setting to care in the outpatient setting, and as long-term care and home health care grow due to the aging of the baby-boomer population. There has never been a better time to get into this kind of specialty, and there are many programs aimed at helping you to achieve this goal.

Wound, Ostomy, And Continence Nursing Education

Wound, Ostomy, Continence Nursing specialty is a continuing nursing education activity, and various programs are available that are approved by the American Nurses’ Association and accredited by the Wound Ostomy Continence Nurses Society (WOCN).

The components of WOC nursing practice include:

  • Direct care and consultation
  • Patient and family education and counselling
  • Staff development
  • Research and management activities

Admission Requirements

Admittance to a Wound Ostomy Continence Nursing program, an individual is evaluated on all portions of the application, as admission is competitive. In order to be considered for the certificate program an individual must:

  • Be in possession of a master’s degree in nursing from a nationally accredited school as a prerequisite or co-requisite
  • Be in possession of an unencumbered RN license for the state where you intend to do your practical
  • Have a minimum cumulative grade point average of 3.0 on a 4.0 scale in undergraduate and graduate studies
  • Submit three acceptable academic and professional recommendations
  • Submit a copy of your Curriculum Vitae or resume
  • Be available for an interview if requested
  • There are additional requirements for international students

Nursing Education Program

The Wound Ostomy Continence Nursing education program is a postgraduate study program, and it prepares graduates to provide specialty care for patients who have acute and chronic wounds, standard and continent diversions, and urinary and fecal incontinence.
The educational methods for these programs generally include approximately 40% clinical and 60% didactic training, and include major areas of instruction such as:

  • Anatomy and physiology of GI, GU, and integumentary systems
  • Nursing management of patients with adapted patterns of elimination such as alternative procedures, ostomies, and incontinence
  • Nursing management of patients who are at risk for breakdown of their skin, as well as those who have acute and chronic wounds such as neuropathic ulcers, venous ulcers, pressure ulcers, and arterial ulcers
  • Pathophysiology and medical or surgical treatment for selected disorders within the integumentary, GI, and GU systems
  • Rehabilitation concepts that include principles of sexual counselling, teaching and counselling theory, as well as growth and development issues
  • Role implementation issues that include principles of leadership, change theory, research guidelines, and reimbursement issues are also included
  • Students will also complete 160 clinical hours in GNUR 6383 at a reputable medical institution.

Upon completion of the program, the graduate will be eligible to sit for the Wound Ostomy Continence Nursing certification from the Wound Ostomy Continence Nursing Certification Board.

Wound Ostomy Continence Nursing Certification

The Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) began certifying nurses as far back as 1978 as a way of recognizing and differentiating the value of expert nurses from those at an entry level. Becoming Board Certified is a voluntary process that requires consistent and periodic evaluation of a nurse’s current professional skills and knowledge.

WOCNCB certified nurses are fundamental members of the health care team, who:

  • Accurately assess patients and provide critical documentation
  • Develop strategies to prevent complications
  • Implement cost-effective, evidence-based plans of care
  • Guide the selection and use of cost-effective DME goods and pharmaceutical formulas and methods of preparation
  • Provide comprehensive education to patients as well as medical, nursing and auxiliary staff
  • Train, coach and advocate for patients and their families

A survey conducted by the American Board of Nursing Specialties reported that nurse managers expressed a preference for hiring certified nurses due to their documented experience and proven knowledge base and in a given specialty. This survey also indicated that certification is perceived as influencing growth, specialized knowledge, accomplishment, accountability, and a level of recognition among peers, consumers and employers.

Advanced Practice Certification

WOCNCB offers Advanced Practice certification exams in wound, ostomy and continence nursing. This certification validates that you have passed a national exam that accurately reflects the skill and knowledge as required by the specialty. Certification can be gained in one, two or all three of the wound, ostomy or continence specialties.
In order to be eligible to take the WOC Certification Exams, you must complete the following:

  • Hold current Registered Nurse licensure
  • Be in possession of a bachelor’s degree

Fulfill either of the following educational and clinical practice requirements:

Traditional Pathway
You must have completed a WOCN Society accredited WOC Nursing Education Program within the last five years.

Experiential Pathway
You must have completed the experiential pathway, which means that you have completed the required 50 contact hours or equivalent in college course work, post-bachelor’s degree, per specialty, within the last 5 years. This pathway also requires that you have completed a minimum of 1,500 clinical hours within the past 5 years, with 375 of those hours being completed within the past year.

Types Of WOCNCB Certifications

There are various types of Wound Ostomy Continence Nursing, and the Wound Ostomy Continence Nursing Certification Board offers the following certifications:

  • Certified Wound, Ostomy, Continence Nurse (CWOCN)
  • Certified Wound Care Nurse (CWCN)
  • Certified Ostomy Care Nurse (COCN)
  • Certified Continence Care Nurse (CCCN)
  • Certified Wound Ostomy Nurse (CWON)
  • Certified Foot Care Nurse (CFCN)
  • Certified Wound Ostomy Continence Nurse – Advanced Practice (CWOCN-AP)
  • Certified Wound Care Nurse-Advanced Practice (CWCN-AP)
  • Certified Ostomy Care Nurse-Advanced Practice (COCN-AP)
  • Certified Continence Care Nurse-Advanced Practice (CCCN-AP)
  • Certified Wound Ostomy Nurse-Advanced Practice (CWON-AP)

Each of the above certification programs is accredited by the National Commission for Certifying Agencies (NCCA).

The Wound, Ostomy, and Continence Nursing Certification Board provides a national certifying examination designed for entry level into the field for graduates of accredited educational programs. Although Board Certification is not compulsory, it is highly valued as a means of credentialing practitioners of wound ostomy continence nursing. Certification is valid for five years, after which re-certification may be obtained, either by re-examination or via the Professional Growth Program (PGP), which is based on a point system deduced from activities such as continuing education, publication, research, program or project development, involvement in professional organizations, teaching, and academic education.

It must be noted, however, that although certification is not required for wound ostomy continence nursing, employers do give preference to those who have received certification; it is proof-positive of their qualifications and skills as a wound ostomy continence nurse. Employers also see certification as serving to validate your commitment to leadership, excellence, evidenced-based and safe care in foot care and wound, ostomy, continence nursing. Certification ensures that a Registered Nurse is knowledgeable and more than qualified to provide specialized care.

Nursing Education Programs

Wound Ostomy Continence Nursing programs are offered by the following institutions amongst others:

Emory University School of Medicine, Atlanta, GA Wound Ostomy and Continence Nursing Education Center

  • Onsite – A 10-week program; 6 weeks of on-site campus instruction and 4 weeks of clinical preceptorship
  • Split-option – A 6-week program with didactic on-campus, plus Precepted clinical instruction in your own geographic area
  • Distance learning – Self-study modules completed at your own pace, plus 40 hours of precepted hours for each clinical focus

Wicks Educational Associates – Harrisburg Area WOC Nursing Education Program

  • A split-option – Consists of 4 Weeks of didactic instruction (onsite) plus 160 hours of clinical instruction in your geographical area or in the region where the class is held
  • A Home Study Program – Consisting of Four Home Study Modules plus 160 hours of clinical instruction in your geographical area

La Salle University School of Nursing

  • Split Option – Consisting of weekly classes held onsite at Philadelphia campus with off site clinical preceptorships near to where you live
  • Online Distance Learning – Consists of web-based distance learning classes plus three clinical immersion days in Philadelphia per course and off-site clinical preceptorships following the two required courses

School of Nursing University of Virginia Graduate Program in WOC Nursing

  • On-site and individually selected sites – 3 Graduate Level courses that may be taken as electives for master’s in nursing programs or taken as a post-Master’s certificate. MSN student pursuing a CNS or ACNP may choose to focus on WOC as their area of specialization. The program can be completed within 12 months.

WebWOC Nursing Education Program

  • Online Distance Learning – Online didactic coursework for a Full Scope of practice; delivered over one semester (14 – 15 weeks) including weekly live online classes. Single and Dual Scopes may be completed in a shorter time-frame

There are also other institutions of learning that offer ostomy programs or wound care programs, and wound treatment programs separately, either on-site or via distance learning.
Remember that licensing requirements vary from state to state, so it is incumbent upon you to find out whether the certification is acknowledged in the state in which you intend to practice. Contact your State Board of Nursing to ascertain what their requirements are for Wound Ostomy Continence Nursing Certification.

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