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Certification Review: Foot Care

Ellefson, Laurie

Journal of Wound, Ostomy and Continence Nursing: March-April 2010 - Volume 37 - Issue 2 - p 206–208
doi: 10.1097/WON.0b013e3181d12e52
GETTING READY FOR CERTIFICATION
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Laurie Ellefson, BSN, RN, CWOCN, CFCN, Nursing Assistant Faculty, Western Technical College, North, La Crosse, Wisconsin.

Corresponding author: Laurie Ellefson, BSN, RN, CWOCN, CFCN, Nursing Assistant Faculty, Western Technical College, 400 7th Street North, La Crosse, WI 54601 (ellefsonl@westerntc.edu).

The WOCNCB created the Certified Foot Care Nurse (CFCN) credentialing process to validate the knowledge and expertise of nurses with an interest in this area. For 2010, the WOCNCB is offering a 50% exam fee discount for initial certification as a CFCN. To be eligible for the discount, applicants must meet WOCNCB's standard certification eligibility criteria and be currently certified with one or more WOCNCB credentials.

The CFCN exam is based on the Detailed Content Outline in the “Foot and Nail Care Certification Candidate Handbook.” Here are some examples of the type of questions that you can expect on the certification exam for the foot care:

1. Which of the following would be considered most important when conducting an initial assessment of a person with diabetes mellitus?

A. arthritis status

B. smoking habits

C. vision problems

D. shoulder pain

2. Which of the following causes maceration between the toes?

A. inflammation

B. allergy

C. excessively dry skin

D. excessively moist skin

3. You are instructing a foot care patient on proper shoe fit. Which of the following is most important to emphasize?

A. Shoes should be selected based on the printed shoe size provided by the manufacturer.

B. Shoes should be tested for fit early in the morning before the patient is too fatigued.

C. Shoes should be made of heavy, stiff leather to provide maximum support.

D. Shoes should be selected based on how they conform to the shape of the patient's foot.

4. When teaching a high-risk foot care patient, which of the following is the most important point to reinforce?

A. daily examination of the feet

B. wearing clean, white socks

C. seeing the doctor every 6 months

D. maintaining hemoglobin A1C levels less than 7%

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▪ Discussion

1. B. While each of these factors is important, smoking and diabetes place this patient at higher risk of arterial disease.

Content location area: 1A1

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Reference

Wound, Ostomy and Continence Nurses Society (WOCN). Guideline for Management of Wounds in Patients With Lower-Extremity Arterial Disease, WOCN clinical practice guidelines series #1. Glenview, IL; 2002, Author. p. 3.

2. D. Maceration is overhydration of the skin that is characterized by a white, “waterlogged” appearance. The prolonged presence of moisture on the skin will precipitate maceration.

Content location area: 1B8

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Reference

Bryant R, Nix D. Acute and Chronic Wounds: Nursing Management, 3rd ed. St Louis, MO: Mosby Inc; 2007:342.

3. D. Trace the foot, cut out the tracing, and place it on the sole of the shoe. Or, put the sole of the shoe against the bottom of the foot. These actions can help you see whether the shape of the shoe matches the shape of the foot.

Content location area: 3A1d

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Reference

Ahroni J. 101 Foot Care Tips for People With Diabetes. Alexandria, VA: American Diabetes Association; 2000:40, 42.

4. A. Although all are important, daily inspection of the feet is the most critical skill that a high-risk patient can employ to identify early problems.

Content location area: 1A1

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Reference

Guideline for Management of Wounds in Patients With Lower-Extremity Arterial Disease, (2002), p. 3.

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Not Recertifying Due to Economic Issues?

The WOCNCB created a Benevolence Fund in 2007 to cover exam fees in times like this. Don't let your certification lapse. Contact info@wocncb.org. All inquiries are treated with the utmost confidentiality.

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Resources for Preparing for the WOC Certification Exam

Free Sample Test Try, a user-friendly online test at http://www.lxr.com/webtest/login.aspx.

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Self-Assessment Exam

Order a computer-based test from the testing company that produces our exam. Go to www.goamp.org and click “e-store,” select “Health Care,” and then “Wound, Ostomy, Continence Nurses.” Each individual practice exam costs $30, which gives you 90-day access.

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WOCN Society Review Courses

Each year the WOCN Society offers CD-ROMs of the certification review course presented at their national conference. You can buy these online at www.prolibraries.com/wocns/.

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New 2009 Certification Review Manual

The WOC Nursing Education Program at Emory University has a new certification review manual for sale for $65. Go to http://www.surgery.emory.edu/wocnec/order.form.pdf or contact Brenda Michael at brmicha@emory.edu.

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Wound Care Study Guide

The Wound Care Education Program at the Medical College of South Carolina offers a guide for $125. Contact Carol Whelan at 843-792-265 or toll free at 866-637-6835.

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The Value of Foot Care Certification

Diana L. Gallagher, MS, RN, CWOCN, CFCN

Certification in foot care is making giant strides for both nurses and the patients they serve. This specialty plays an active role in reducing the risk of complications and improving patients' quality of life. The WOCNCB's Certified Foot Care Nurse (CFCN) credential, one of the newest WOCNCB certifications, is available to any registered nurse who completes the requirements and successfully sits for an exam. Once this is accomplished, the possibilities for enhanced practice are limitless.

Eligibility for the exam involves completion of a formal program that blends both didactic and clinical practice OR can be accomplished through an experiential route. Both options are fully explained in the “Foot and Nail Care Certification Candidate Handbook,” which can be downloaded from www.wocncb.org. The handbook provides an application, test blueprint, and a wealth of useful information.

Another tool available at www.wocncb.org is the Self Assessment Examination. This sample exam is balanced in both content and complexity to the certification exam and provides candidates with an opportunity to test their knowledge and focus their studying before taking the actual examination.

A specialization in foot care is truly a specialty area of nursing that impacts a wide variety of patients. It is one that is not taught in any depth in general nursing education but represents enhanced knowledge and a specialized skill set. It involves a comprehensive understanding of the foot's anatomy and physiology, biomechanics, pathologies and common injuries, as well as nail care. A CFCN will be able to assess for any problems and intervene appropriately and by doing so will develop the opportunity for teaching colleagues and others.

Currently, these specialty nurses are practicing in a wide variety of settings that range from acute care to extended care. Some work in the inpatient arena and others in outpatient clinics or home health. Others work in collaboration with their local podiatrists and yet others self-contract with individuals or facilities for direct care services. The opportunities are truly open, from traditional models to models that are geared for nurses wanting to control and guide their own careers.

The value of this certification cannot be underestimated. For the nurse, added knowledge and enhanced skills build a sense of satisfaction and pride. For employers, having a CFCN available will help reduce falls, improve patient and family satisfaction, enhance a patient's sense of well-being, and serve as a marketing tool.

The real value, however, is in what this specialty offers to the patients. Patients getting routine foot and nail care reap a wealth of rewards. They have reduced incidence of falls, possess a better understanding of when they need to contact their physicians for problems, and also appreciate that they are on solid ground because of partnership with their CFCNs.

Diana L. Gallagher, MS, RN, CWOCN, CFCN

Board Liaison, WOCNCB Foot Care Examination Committee, Fayetteville, Arkansas.

The WOCNCB created the Certified Foot Care Nurse (CFCN) credentialing process to validate the knowledge and expertise of nurses with an interest in this area. For 2010, the WOCNCB is offering a 50% exam fee discount for initial certification as a CFCN. To be eligible for the discount, applicants must meet WOCNCB's standard certification eligibility criteria and be currently certified with 1 or more WOCNCB credentials. For more information about WOCNCB certification as a Certified Foot Care Nurse, visit www.wocncb.org or contact the WOCNCB office at 888-496-2622 or info@wocncb.org.

Copyright © 2010 by the Wound, Ostomy and Continence Nurses Society