Cath Lab Digest

     Within the wound care community there are currently three certifications offered:

     1) Certified Wound Care Nurse — CWCN— offered by the Wound Ostomy and Continence Nursing Certification Board (WOCNCB);
     2) Wound Care Certified —WCC— offered by the National Alliance of Wound Care (NAWC);
     3) Certified Wound Specialist — CWS — offered by the American Association of Wound Management (AAWM).

     Holding a certificate or a credential offers the clinician opportunities in employment and professional advancement. However, there are differences in costs and time commitment that make the choices less clear. Those who are best prepared to discuss the differences and to assist the applicant in choosing a program may be those who have attended two or three of the programs and/or have taken two or three of the tests.

     In November 2007, OWM published Rappl L, Fleck C, Hecker D, Wright K, Fredericks C, Mrdjenovich D. Wound care organizations, programs, and certifications: an overview.

     This follow-up information elucidates clinician experience with the certification process.

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     I have sat for the CWON test and the CWS test. I agree the CWS covers a broader scope; it is meant for physicians, PTs, and nurses. Each discipline focus is a bit different but the CWS test covers all areas — the same test for everyone.

     I thought the CWCN test covered more on treatment choices; the CWS test included more anatomy, physiology, testing/results, offloading, disease process/ etiology, and some treatment choices. Both are worthy tests. I used the Bryant chronic wound care book to review for the CWS and passed the first time with a good score. A few years ago, the CWS had only a 60% pass rate. I always wondered if physicians believed they could pass more easily (without adequate prep or focus) than a nurse with a BSN taking the same test or whether nurses focused on dressings, thinking this was a treatment-option exam. I believe the requirement for the CWS test is degree, 5-year experience, and three references; changes were being discussed recently, it may be different now.

     I do not know the pass rate on the CWOCN test. It would be interesting to see what the pass rate is for this credential as well. Anyone with a BSN meeting the criteria (education or CE and experience) can sign up to take a test; not everyone passes.

     I believe more hiring personnel understand what the CWOCN credentials bring and fewer are aware of what the CWS credentials bring. I personally believe the person, passion, and experience — not just the credentials — are what make the bigger difference in care.

     I also believe both are worthy tests, if very different. The WOCN is focused on areas of nursing (treatment options) with some limited cross-discipline reference (ie, arterial flow with ABI results or TPCO2, looking only at the result answer). The CWS seems to probe more into anatomy, ways to treat the arterial disease, other testing options (ie, arteriogram, vascular repair, mixed disease). I believe the AAWM – CWS – tested a strong science/theory base and the WOCN tested with a focus on clinical hands-on regarding the how and what to choose for treatment application.

     The WOCN refers to positive culture results and needing treatment. The CWS addresses what makes a positive result (ie, 105 before needing treatment with antibiotics).

     The WOCN refers to bx results and need for referral.