Wound Care Organizations, Programs, and Certifications: An Overview

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Laurie M. Rappl, PT, CWS; Cynthia Fleck, MBA, BSN, RN, ET/WOCN, CWS, DNC, DAPWCA, FACCWS; Debbie Hecker, RN, MBA, WCC; Kathleen D. Wright, RN, MS, CWOCN, APRN; Cary Fredericks; and Don Mrdjenovich, DPM, CWS, FACCWS

Index: Ostomy Wound Manage. 2007;53(11):28-39.

  Wound prevention and healing are two critical aspects of patient care. Frequently, wounds are symptoms of larger underlying health issues.1 Holistic patient assessment and treatment are needed to determine the etiology of the various types of wounds and properly implement care.

  Wounds have become the focus of government regulations for long-term-care, home care, and acute care. They are among the most often-litigated health issues. The Nursing Home Quality Initiative,2 a Medicare program designed to help nursing homes improve their quality of care in key areas, lists “pressure sores” as one of five quality measures for post-acute care; “low risk pressure sores,” “high risk pressure sores,” and “pressure ulcers-short stay” are three of the 15 quality measures for chronic care. In home health, 73.1% of patients are reported to have a wound or lesion, 34% have surgical wounds, and 6.8% have pressure ulcers.3 Under pay-for-performance in home care, pressure ulcer development will negatively affect an agency’s reimbursement.3

  In an August 2007 update to the acute care inpatient prospective payment system,4 the Centers for Medicare and Medicaid Services (CMS) cite the development of pressure ulcers as one of eight conditions that will be subject to payment reductions as of October 1, 2008. The CMS considers the development of a Stage III or Stage IV pressure ulcer to be a preventable event. The update also notes that, compared to many other conditions, a pressure ulcer is a high-cost, high-volume condition. In fiscal year 2006, 322,946 Medicare patients with pressure ulcer as a secondary diagnosis were reported and their average hospital stay charge was $40,381. Therefore, healthcare professionals specializing in wound prevention and management have become sought-after employees in all areas of patient care and wound care is becoming recognized as a specialty area of practice.

  To further their knowledge, skills, and marketability, healthcare professionals at various disciplinary levels seek advanced training specifically related to wound care. Over time, various certifications have become available but people are confused about certification meaning, qualifications, accreditation, and whether a certified employee will meet their needs. In addition, credentialing programs often are confused with membership organizations that do not certify but provide a shared voice and professional development.

  This article provides an overview of currently available certification programs in order to 1) foster a better understanding of the differences between and benefits of the individual programs and certifications, 2) encourage discussion regarding the role graduates of these programs and the certifications play in the total healthcare picture, 3) assist in the selection of an appropriate program and/or certification, and 4) encourage pursuit of higher education and skill in wound care.

The Difference between Accreditation and Certification

  Accreditation is earned by a certifying or educational program after extensive review by an external, independent accrediting body. The accrediting body determines that the program has met predetermined and standardized criteria. Accreditation reflects the achievement of a level of excellence and distinguishes the program as one of quality according to industry standards. Certifying programs can vary widely in their character, composition, and quality; they seek accreditation as a measure and testament to their worth.

  The National Organization for Competency Assurance (NOCA) is the national membership organization for professional certification organizations.

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