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Wound Care

Fellows, Jane

Journal of Wound, Ostomy and Continence Nursing: January-February 2008 - Volume 35 - Issue 1 - p 111–112
doi: 10.1097/01.WON.0000308627.60958.3d
GETTING READY FOR CERTIFICATION IN WOUND CARE
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Jane Fellows, RN, MSN, CWOCN, Ostomy Clinical Nurse Specialist, Duke University Health System, Durham, North Carolina.

Corresponding author: Jane Fellows, RN, MSN, CWOCN, Duke University Health System, Box 3677, DUMC, Durham, NC 27710 (jane.fellows@duke.edu).

The Wound, Ostomy, Continence Certification Board (WOCNCB) is an accredited organization that provides nurses with the opportunity for certification in wound, ostomy, continence, and foot care nursing. There are currently 4615 nurses certified in wound care by the WOCNCB. Nurses certified by the WOCNCB have either completed a formal Wound Ostomy Continence Nursing Education Program or qualified to take the examination through an experiential pathway.

The following reflect the type of questions on the examination.

  1. A patient has a partial thickness wound on the upper extremity caused by trauma. There is minimal drainage and no erythema in the periwound skin. The best management for this wound would include which of the following dressings?
    1. Calcium alginate
    2. Dry gauze
    3. Hydrocolloid
    4. Silver-impregnated foam
  2. A patient presents with a painful ulcer on the dorsal surface of the foot. The surface of the ulcer is covered with a black eschar and the surrounding skin appears thin and shiny. There is no edema in the foot or lower leg. This type of ulcer is most likely
    1. Arterial
    2. Neuropathic
    3. Venous
    4. Mixed venous and arterial
  3. A patient with a stage IV pressure ulcer has a granular wound bed with no measurable depth. This ulcer should now be classified as
    1. Stage II pressure ulcer
    2. A healing Stage IV pressure ulcer
    3. A Stage III pressure ulcer
    4. An unstageable ulcer
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Resources for Preparing for the WOC Certification Exam

Self Assessment Exam

  • The SAE or Self-Assessment Exam is a computer-based test available from the testing company that produces our exam. You can find this by going to www.goamp.org and clicking on “e-store.” Then select “Health Care” and then “Wound, Ostomy, Continence Nurses.” For $90 you may purchase all 3 exams or for $45 you can purchase the exams individually. The SAE has 40 questions in each specialty and you may grade it as you take the test. References and the rationale for the answers are provided. The test is available for 90 days after purchase, and when you exit from the exam for the final time, you will be provided with a score report.
  • The WOCN Society has CD-ROMs of the certification review course offered each year at their national conference. These may be purchased online at www.prolibraries.com/wocns/.
  • The WOC Nursing Education Program at Emory University has a certification review manual for sale for $65. The order form is available online at http://www.surgery.emory.edu/wocnec/order.form.pdf. You may also obtain this order form by calling 404-778-3159 or by faxing your request to 404-778-4778.
  • The Wound Care Education Program at the Medical College of South Carolina has a Wound Care Study Guide that may be purchased for $125 by contacting Carol Whelan at 843-792-265 or toll free at 866-637-6835.
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WOCNCB® Mission Statement

Promoting the highest standard of consumer care and safety by providing credentialing in the areas of wound, ostomy, continence and foot care nursing.

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WOCNCB® Purpose

The purpose of WOCNCB® shall be:

  • to set, maintain, and evaluate national standards for certification and re-certification in wound, ostomy and continence care nursing.
  • to promote the certification program for wound, ostomy and continence nursing practice.
  • to encourage continued professional growth in specialized nursing practice.
  • to provide formal recognition of individuals who meet the certification requirements.
  • to provide identification of nurses who have achieved certification in WOC nursing to employing agencies, the public and other healthcare professionals.
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Answers

  1. C (Hydrocolloid) This treatment provides a moist wound environment and protects the wound bed. Calcium alginates (A), dry gauze (B), and silver-impregnated foam (D) are indicated for wounds with a moderate to large amount of drainage. These dressings could desiccate a wound with minimal drainage causing a delay in healing. Silver is an antimicrobial and is indicated in wounds with signs of bacterial overgrowth such as increased drainage and erythema.
  2. A (Arterial) An arterial ulcer on the lower extremity is usually painful and may be covered with a necrotic eschar due to underlying impaired circulation and ischemia of the skin. The surrounding skin is often thin and fragile. A neuropathic ulcer (B) is more often found on a weight-bearing surface with thick callus surrounding the ulcer and may be insensate. A venous ulcer (C) is usually found between the ankle and the knee and edema is common. An ulcer of mixed venous and arterial etiology (D) is typically located between the ankle and the knee.
  3. B (A healing Stage IV pressure ulcer) The ulcer remains a stage IV ulcer though it is healing. Reverse staging is incorrect, and this ulcer should never be classified as a Stage II (A) or Stage III (C) pressure ulcer. The tissue loss from a stage IV ulcer is replaced with granulation tissue, but underlying structures do no regenerate in the healing process. An unstageable ulcer (D) is one that is covered with necrotic tissue and the extent of tissue damage is not visible.
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Reference

Rolstad B, Ovington L. Principles of wound management. In: Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concepts. 3rd ed. St. Louis: Mosby; 2007:410–413.
    Doughty D, Holbrook R. Lower extremity ulcers of vascular etiology. In: Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concepts. 3rd ed. CITY: Mosby; 2007:272.
      Nix D. Patient assessment and evaluation of healing. In: Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concepts. 3rd ed. CITY: Mosby; 2007:272.
        Copyright © 2008 by the Wound, Ostomy and Continence Nurses Society