Issue 1 • 2011
Departments
Features
President’s Letter . . . . . . . . . . . . . . . . . 2
Annual Conference . . . . . . . . . . . . . . . 12
Regional News . . . . . . . . . . . . . . . . . . . . 6
Member Benefits . . . . . . . . . . . . . . . . . 28
Member Spotlight . . . . . . . . . . . . . . . . 14 Public Policy . . . . . . . . . . . . . . . . . . . . . . 18 Education . . . . . . . . . . . . . . . . . . . . . . . . 20 Director’s Corner . . . . . . . . . . . . . . . . 26
Cover Story Ensuring a properly fitting ostomy appliance is not the only consideration when evaluating a patient. Find out the comprehensive assessment necessary to develop a proper plan of care. www.wocn.org
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President’s Letter
Harvest Time By Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP, FAAN President, WOCN Society
The Gift of a Life’s Work
As I prepare this President’s letter for the first issue of WOCNews in 2011, it is during the Holiday Season and the beginning of another new year. During this time of gift giving, it seems a natural time for reflection on the many gifts that life presents to us and the opportunities to share those gifts or use them in a meaningful way to enrich not only our own lives but those . of others.
“Having a, life’s work, is a gift to be treasured, enhanced, and shared.” In a recent article, Dr. Laurel Archer (2010), Dean Emeritus of the School of Nursing at University of North Carolina at Chapel Hill, queried, “What is your life’s work?” She reflected
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on how our “life’s work” shapes our lives as she described a patchwork of opportunities seized that guide that our work. For many, a career or occupation is not a life’s work, while for others, such as WOC nurses, their specialty practice is the work of a lifetime as evidenced by the longevity of so many WOC nurses in the practice. Having a “life’s work” is a gift to be treasured, enhanced, and shared.
WOC Nurses Make a Difference WOC nurses are drawn to this work because WOC nurses make a difference in peoples’ lives every day in large as well as small ways. WOC nurses are often behind the scenes, behind closed doors and behind pulled curtains as they work privately with the patients who have wound, ostomy or continence needs and sometimes this work may go unnoticed by others. However, the difference that WOC nurses make is recognized by patients and their families. This difference was evidenced by recent statements
by Dana Jennings (2010), an editor at the New York Times and a book author, who had been hospitalized six times for prostate cancer and ulcerative colitis. In his New York Times blog, Mr. Jennings writes, “I love nurses. Oncology nurses and ostomy nurses. Radiation nurses and post op nurses”... those essential round the clock nurses who are always there when you need them, who are warm, real and look you in the eye. Despite that accolades might not come or financial awards might not be commensurate with education and effort, passionate and dedicated WOC nurses share the gift of their “life’s work” with those special patients who need special nurses every day.
Are We All That We Can Be?
As we are carried along by the inevitable passage of time in this new year and the other years to follow, are we embracing the full essence of our “life’s work?” As we strive to Continued on page 4
WOCN Society Board and Committee Chairs Board
Committee Chairs
President 2009 – 2011 Phyllis Bonham, PhD, MSN, RN, CWOCN, DPNAP, FAAN Charleston, S.C. bonhamp@musc.edu
Accreditation Committee Bonny Flemister, MSN, RN, ANP, GNP-BC, CWOCN Kilgore, Texas bonnygae@mac.com
Nominations Committee Margaret T. Goldberg, MSN, RN, CWOCN DelRay Beach, Fla. margoldb@comcast.net
President-Elect 2009 – 2011 Kathleen G. Lawrence, MSN, RN, CWOCN Rutland, Vt. etnurse@rrmc.org
Continence Committee Laurie Callan, MSN, ARNP, CWOCN Clinton, Iowa llcallan@msn.com
Ostomy Committee Ginger Salvadalena, PhD(c), RN, CWOCN Libertyville, Ill. gsalva1@uic.edu
Secretary 2010 – 2012 Phyllis T. Kupsick, MSN, FNP-BC, CWOCN Albemarle, N.C. phylliskupsick@carolina. rr.com
Development Committee Laurie L. McNichol, MSN, RN, GNP, CWOCN Greensboro, N.C. mcnichol@triad.rr.com
Professional Practice . Committee Myra F. Varnado, BS, RN, CDE, CWOCN New Orleans, La. mvarna@lsuhsc.edu
Treasurer 2010 – 2012 Ben Peirce, BA, RN, CWOCN Plantation, Fla. benjamin.peirce@gentiva. com
Education Committee Marilyn Murphy Shepherd, MSN, RN, CDE, CWOCN, CNE Quincy, Ill. mshepherd@brcn.edu
2010 – 2012 Carole Bauer, MSN, ANPBC, OCN, CWOCN Detroit, Mich. bauerc@karmanos.org
Marketing and . Communications Committee Diane R. Maydick Youngberg, EdD, RN, ACNS-BC, CWOCN Staten Island, N.Y. dmaydick@gmail.com
2009 – 2011 Mary Jo Conley, BSN, RN, CWOCN Hackensack, N.J. mjc998@comcast.net
Membership Committee Dea Kent, MSN, RN, NP-C, CWOCN Kokomo, Ind. dea.kent@mail.com
2009 – 2011 Elizabeth Hiltabidel, MSN, RN, CWOCN Riverside, Calif. ehiltabidel@charter.net
National Conference Planning Committee Carolyn S. Watts, MSN, RN, CWON Nashville, Tenn. carolyn.watts@vanderbilt. edu
Directors
2010 – 2012 Regina F. Holmes, MSN, RN, FNP-BC, CWOCN, CFCN Loris, S.C. rholmes@lorishealth.org
Public Policy Committee Suzanne Collins, MS, BSN, RN, CWOCN Norcross, Ga. suzanne.collins@molnlyckeus.com Scholarship Committee Kay Rickey, MS, RN, CNS, CWOCN Troy, Ohio krickey@uvmc.com Wound Committee Diane Deitz, MSN, ACNP, CWON Neptune, N.J. ddeitz49@aim.com
WOCN Society Mission The WOCN Society is a professional nursing organization that supports its members by promoting educational, clinical, and research opportunities to advance the practice and guide the delivery of expert healthcare to individuals with wounds, ostomies and incontinence. Educational Editor Marjorie Groom, MSHCA, BSN, RN, CWOCN et2@norcom2000.com Executive Vice President Nicolette Zuecca, CAE nzuecca@ahint.com Assistant Executive Director Vincent Gangemi III vgangemi@ahint.com WOCNews is a publication of the Wound, Ostomy and Continence Nurses Society (WOCN) 15000 Commerce Parkway Suite C Mt. Laurel, NJ 08054 888/224-WOCN www.wocn.org www.wocnfoundation.org Publication Date: February, 2011
www.wocn.org
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President’s Letter • Continued from page 2 make the most of our gifts, each delivered to better serve needs of us can ask ourselves: of patients. Among the top recommendations of the report: • What do I want most in my • Nurses should practice to the professional life? full extent of their education, • What are my special gifts? training and licensure, which • How am I using my gifts? requires removal of scope of • Am I making the most of my practice barriers. gifts? • Nurses should achieve higher • What possibilities am I missing levels of education and or ignoring? training through an improved • Can I change what’s possible? education system that promotes seamless academic These questions and reflections progression, including nurse on the responses are important residency programs and to us as WOC nurses and the lifelong learning. overall profession as we face the • Nurses should be full partners, challenges of an ever-changing with physicians and other health care system. Health care health professionals, in is at a turning point and nurses redesigning health care in the are seen to be key players. It United States. is recognized that nurses can • Effective health care workforce play a role in transforming health planning and policy making care and the Affordable Health require better data collection Care Act calls for a larger role and an improved information in delivery of health care in the infrastructure, particularly future (ANA, 2010). as it relates to nursing’s contribution to care.
• Think about where you want to be in your practice in a few years--set career goals and identify what you will need to get there. • Commit yourself to lifelong learning. Pursue advanced education through CE, certification, and academic education. • Stay informed and apply for grants, scholarships, and other programs that can enhance your opportunities and support a larger role for nurses. • Don’t let policy happen to you-get involved in the policy committees at work. • Your experience and expertise is needed to help design and implement improved care environments and new ways to provide patientcentered care at your facility, organization, or in your own work. No one knows what patients want and need better than nurses. Leading Change: can we as WOC nurses get • Participate in workplace Advancing Health How involved in leading the change planning surveys and data As result of a two-year study and advancing health? As we collection opportunities within sponsored by the Robert Wood prepare to celebrate WOC Nurse your practice setting. Data Johnson Foundation, the Institute Week and National Nurses Week collection is imperative to of Medicine (2010) released its this spring, the American Nurses reform the current health care report: The Future of Nursing: Association (ANA) challenges system. As nurses, we must Leading Change, Advancing nurses to consider the following measure the value of what we Health. The goal of this initiative (ANA, 2010): do. Nurses are counted upon, is to improve how health care is
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yet if we don’t count what nurses do, nurses don’t count. • Stay informed about and participate in the activities of your professional associations. A few hours of your time can make a big difference; remember there is strength in numbers. • Embrace your power!
Are We At the Leading Edge?
As we seek to use the gift of our “life’s work” in the most meaningful and productive manner, we are challenged to change what is possible by getting involved. What can we as WOC nurses do individually and collectively to change the future of WOC nursing? What creative innovations in practice in our specialty have we made or can we make? Do we have “Edge Runners?” Edge Runners, a program sponsored by the American Academy of Nursing, recognizes practice innovators who have led the way in bringing forth new ideas and methods to meet health care challenges. There is one CWOCN (certified wound ostomy continence nurse) currently listed in the Edge Runner Directory, Suzy Scott
Williams, who is recognized for her innovative effort to prevent pressure ulcers in surgical patients (http://www.aannet. org/custom/edgeRunner/index. cfm?viewAll=1). As we enrich our ongoing life’s work, do we have other new and creative care models or interventions that can make a significant difference in clinical and financial outcomes? Who will be the next WOC nurse Edge Runner? u
Reference: American Nurse Association. (2010). National nurses week talking points on future of nursing. Unpublished communication Archer, L. (2010). What is your life’s work? Journal of Professional Nursing, 26, 322. Jennings, Dana. (2010). In praise of nurses. Retrieved January 1, 2011 from http://well. blogs.nytimes.com/2010/12/29/in-praiseof-nurses/?partner=rss&emc=rss. Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved Jan. 1, 20ll from http:// www.iom.edu/Reports/2010/The-Futureof-Nursing-Leading-Change-AdvancingHealth.aspx.
WOCN Bulletin Board: WOCN 43rd Annual Conference June 4 - 8, 2011 Early Bird Registration Deadline April 15, 2011 Call for Research Proposals February 21, 2011 Spring Scholarship Application Deadline May 1, 2011 WOCN 44th Annual Conference June 9 - 13, 2012
www.wocn.org
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Regional News
News From the WOCN World Southeast Region
The Southeast Region’s (SER) conference, “WOC Nurses... Closing the Gap with Evidence, Knowledge, and Practice,” was held in Concord, N.C., just outside of Charlotte, N.C. This
year there were 237 attendees, 26 first-time attendees, 39 registered for the preconference and 54 exhibitors. Elections were held during the membership meeting. Elected for second terms were President Laura Shafer and Vice-President
Mary McNeil. Newly elected were Director of Awards Cindy Norris and Director of Communication Patti Haberer. Carol Parker was the recipient of the SER Nurse of the Year award, Alice Lowery was the recipient of the SER Rookie of the Year award and Leanne Richbourg was the recipient of the Honorary Scholarship award. Dr. Katherine Jeter, one of the SER’s founding members is cycling across the U.S. for WOCN’s Cycling for Scholarship fundraiser. After Dr. Jeter enlightened us about her upcoming adventure, the SER quickly raised almost $3,000.
Are you recertifying this year?
The SER is offering a Certification Review Webinar. Dorothy Doughty, past president of the WOCN Society and current program director of Emory University WOCNEP . will be presenting an all day webinar. Visit the SER website . at www.serwocn.org for . more information. 6
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Mark your calendars – the 2011 SER conference will be held Sept. 15-18, 2011 in Chattanooga, Tenn. Martha Davidson and her committee are diligently planning for next year’s conference, “WOCN on the River: We go with the Flow.” Check the SER website (www. serwocn.org) for further details.
Garner and the Conference Planning Committee: Joanne Biddix, Sue Creehan, Terri Decker, Linda Droste, Diane Whitworth and the Central Virginia Affiliate. It truly energized us all to become more active in our facility, affiliate and region. Mark your calendar now for Nov. 4-5, 2011 at Rocky Gap State Park and Lodge in Flintstone, Md.
was held at the Paris/Bally Hotel and unlike the Las Vegas catchphrase “What happens in Vegas stays in Vegas” our title was “What you Learn in Last Vegas, Don’t Keep it in Last Vegas: Spread the Word Annual Conference 2011.” Our attendees may not have come home a little richer in their wallets but they did come home richer in knowledge. We enjoyed Western Maryland the lectures of Paula ErwinAffiliate Congratulations to Joan Selekof Toth, MSN, RN, CWOCN, CNS Greetings from Western on her election to president on Sexuality and the Osmate Maryland! This year our affiliate and to Sue Grafton on her as well as Cyrus Tobari, Esq is host to the annual Midelection to secretary of MAR. speaking on the Million Dollar Atlantic Region fall conference. Congratulations also go out Heel. Other topics were the The Conference Planning to Ann Roney who received Care of the Complicated Acute Committee is already busy the MARWOCN Nurse of the Care Patient by Tom Wolvos, at work planning a wonderful Year. Ann Roney has also been MD, FACS. Valarie Kalding, conference focusing on appointed president-elect by MSN, PMHNP-BC spoke elements of wound, ostomy, the MAR board. about Performing at Your Best continence care as well as In the next few months, the When Your Work Environment professional practice. Mark your board will be meeting to Becomes Hostile, Incontinent calendars for Nov. 4-5, 2011 develop strategic initiatives for Pads: A Research Study by for Rocky Gap State Park and the coming year. We will also Karen Lou Kennedy-Evans, Lodge in Flintstone, Md. It is a be updating information on our RN, CS, FNP and Ostomy Tool beautiful location where learning website. Visit our website at: Project was presented by Ann will take place in a very relaxing www.marwocn.org for more Page, BA, . atmosphere! Hope to see you information on educational RN, CWOCN. there! www.marwocn.org/ events and regional updates. affiliate.php We also held lunch and dinner with our vendors with a silent Pacific Coast Mid-Atlantic auction. Our next conference Region will be held in February 2012. Region The Pacific Coast Region (PCR) Please watch our website www. The fall conference in had our annual conference pcr.org for details. Richmond, Va. was fabulous!! this year in Las Vegas Feb. Kudos to Ann Roney, Lidia 11-13, 2011. The conference www.wocn.org
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Regional News Rocky Mountain Region
The dedicated members of the Rocky Mountain Region (RMR) made it possible to hold our annual fall conference in conjunction with the National Pressure Ulcer Advisory Panel (NPUAP). The conference was held in Denver and was very well attended. Speakers included Diane Langemo, PhD, RN, FAAN, Joyce Black, PhD, RN, CWCN, CPSN, Steven Reger, PhD, CP, Mary Ellen Posthauer, RD, CD, LD. Speakers presented a variety of programs focusing on Evidence Based Pressure Ulcer Prevention and Treatment, Evaluation of Urinary Incontinence, Parastomal Hernia Treatment, Basic Ostomy Care, and Evaluation of Lower Extremity Ulcers. During the fall conference, Candace Cotton, CWOCN from Colorado was honored as Rocky Mountain Region WOC Nurse of the Year. Candace was nominated for this honor by her colleagues who have recognized her dedication and many contributions to wound and ostomy nursing. Fall elections gave us new officers for the RMR board of directors. Pam Waychoff, of Arizona, was elected president.
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Jody Gabaldon of Colorado was elected secretary. Cathryn Reimanis of Colorado was appointed vice president. New officers took office Jan. 1, 2011.
Affiliate (NIA), for the 2011-2013 term! Malou de Ocampo and Marlene Balik continue in their positions as president and . vice president.
During our holiday season both Colorado and Arizona raised money for our Regional Scholarship funds. A total of $1,800 was raised. Arizona has also elected to use a portion of their fundraising efforts to support children participating in ostomy camp.
The members of the Community Education Committee under the leadership of Christine Baker, RN, APN, CWOCN, have spearheaded an exciting educational program for May 17, 2011 at Ashton Place in Willowbrook, Ill. This is designed for RNs throughout the Chicagoland area with an average attendance of 200 in past years.
The RMR has worked hard to improve communication. One of the resulting efforts is our new website, www.rmr-wocn. com. For the first time ever, the RMR was able to offer online registration for the fall conference. The RMR is now able to post current volunteers and events online, enhancing our ability to communicate across state lines. RMR is looking forward to the year ahead and has already started planning the 2011 fall conference that will take place . in Utah.
Northern Illinois Affiliate
Congratulations to Usha Patel, who was reelected as secretary and Mary Vercellino, elected as treasurer, of the Northern Illinois
Our website, www.niawocn. org, has bloomed (thanks to the efforts of our Vice President Marlene Balik, BSN, RN, CWCN). It contains a wealth of professional information and resources for our members. We invite you to visit our website. We are proud of the accomplishments of our members. Many of our members will present their posters at the WOCN Society’s 43rd Annual Conference June 4-8, 2011 in New Orleans. Sharon Baranoski, MSN, RN, CWCN, FAAN is working with a Canadian nurse, Kim LeBlanc, MSN, RN, CETN on developing an improved documentation system for skin tears. They hope to have the document completed sometime in 2011.
Wicks Educational Associates will be offering WOCN education in the Chicagoland area at Northwest Community Hospital, Arlington Heights, Ill. Visit their website at www. wickseducationa.com/index.htm to see their 2011 schedule.
Mideast Region
The snow is drifting, the holiday decorations are down and put away. Resolutions have been made and some already broken. Some of us are spending a few quite moments reading a new novel or mastering a continuing education course through our favorite journal or perhaps online. Many of us are looking forward to spring and warm weather. Some of us have already booked our conference room for the WOCN Society’s 43rd Annual Conference in New Orleans this June. Then there are the really organized individuals who have booked their rooms for the 2011 Mideast Region (MER) conference at the Louisville Marriott Downtown Kentucky from Sept. 29 to Oct. 1, 2011. Visit the MER website at . www.mideastregion.org for . more information. I look forward to hearing from those of you who are industrious as Jeremy Honaker from Lexington, Ky. Jeremy has developed
a grading scale for SDTI, which he will be presenting at NPUAP in February 2011. It is great to have one of our members achieve such an accomplishment. You will remember Jeremy as he ran for MER trustee this past fall; however, Linda Stricker was elected. We anticipate seeing Jeremy’s name on the upcoming ballot this fall. The MER holds the distinction of being the birthplace of WOC nursing. 2011 marks 50 years of WOC Nursing Education. WOC Nursing Education was founded at Cleveland Clinic in Cleveland, Ohio in 1961 with Norma Gill as the first program director, whose perseverance and dedication paved the way for this very unique nursing specialty. Today there are nine WOC Nursing Education Programs (WOCNEP) across the U.S.:
In honor of this special occasion, the WOCNEP at Cleveland Clinic is holding an educational event on Wednesday, April 20, 2011. The list of speakers include: Program Director Paula ErwinToth, MSN, RN, CWOCN; Dr. Victor Fazio; Barbara Hocevar, BSN, RN, CWOCN; and Linda Stricker, MSN/ED, RN, CWOCN. Topics will include complex case studies, sexuality with an ostomy, pelvic pouch surgery, and a preview of the newly launched online WOCNEP at Cleveland Clinic. The cost will be $50. For more information, please contact Barbara Mandato, administrative assistant at Cleveland Clinic’s WOCNEP at mandatb2@ccf.org.
• Cleveland Clinic • Emory University • Harrisburg Area (WICKS) • La Salle University School of Nursing • Medical University of South Carolina • Metropolitan State University School of Nursing • University of Virginia • University of Washington School of Nursing • VA Eastern Kansas Wound Management Academy www.wocn.org
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Regional News Cleveland Clinic is pleased to announce the first graduate, Shawn Taylor, of the newly launched online WOCNEP. Shawn is a director of nursing for Stein Hospice in Sandusky, Ohio. He completed the didactic part of the program online, and the required 120 clinical hours with WOC preceptors at Cleveland Clinic. Shawn was already certified in wound management through the American Academy of Wound Management, but still had a goal of graduating from a WOCNEP. With all of his work and home responsibilities it was a goal that would be difficult to attain, but with the new online program, he could complete the course requirements while maintaining his full-time job and caring for his family. The online program will be graduating six more WOC nurses within the next few months. So as we look forward to our new year with new goals and resolutions, I ask you to send any exciting information about yourself and your colleagues so that I can share it with the region to: jkruslin@tds.net. As you look forward to sharing your expertise with your region, I ask you to consider serving as a MER board member. This will give you the opportunity to meet new people, plan for future events for our region and earn 10
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those wonderful PGP points. If you are thinking about taking us up on this offer, even if it is just a twinkle in your eye, please contact Linda Stricker, MER trustee at lndstrckr55@gmail.com.
Northeast Region
The Northeast Region (NER) would like to extend our thanks to our outgoing officers: Treasurer Mary Jo Nethaway and Secretary Leslie Wilson, for their hard work and dedication to the region. Congratulations to our newly elected officers: Treasurer Susanne Bell and Secretary Kelly Klucsarits.
We invite and encourage all members to attend or help sponsor the Metro New York Affiliate WOCN’s in the 8th annual “Colon Cancer Challenge” on March 27, 2011 in Central Park, New York. Visit our website at www.nerwocn. com to keep up to date on . our activities.
South Central Region
The new year is here and the South Central Region (SCR) council met to say farewell to the past officers and committee chairs and welcome new faces. Our new executive board The Garden State Affiliate hosted includes: President Janet Davis; the 2010 NER conference in Vice President Rosalie Johnson; Atlantic City, N.J. Oct. 22-24, Treasurer Jean Cefalu; Secretary 2010 “Surviving the Waves of Pat Thompson; Nominations Change.” It was great fun and Tina Meyers; Communications the members received very Chair, Kathy Murphy; informative educational lectures Operations Chair Janet Field; by experts in the WOCN field. PR Chair Catherine Short; Ad Please give a word of thanks Hoc Chair Cindy Barefield; CPC for the hard work by the Garden Chair Coni Ellis; and President State Affiliate to make the 2010 Ex-Officio Jill Conwill. conference a success. The 2011 conference will be hosted by the Capital New York Affiliate. The conference will be held at the Desmond Hotel and Conference Center, 660 Albany Shaker Rd., Albany, NY, 518869-8100, 800-448-3500, Oct. 28-30, 2011. The theme for the 2011 conference is “WOC This Way Follow us to the Future.”
A mentoring initiative is the primary goal this year. It will . be in development and be . rolled out before WOCN . Society’s 43rd Annual . Conference. We also discussed focusing on the educational needs of our membership. We will be adding links to the SCR “Educations/Events” website
(www.scrwocn.org) categorizing conference rooms and exhibit Falls, Idaho, as the 2010 continuing education according hall areas. It has a free breakfast Outstanding WOCN. to the four tracts of our practice. each morning (it was good!). It has accessibility for those Jetta graduated from the MD Another area we need to beef driving to conference and Anderson Education program in up is our fund raising efforts. parking is next to the hotel. The 1996. Jetta has presented two Currently, the SWAT Toolkit is added bonus is that it is just posters at the WOCN Society’s available from our SCR store walking distance to shopping, annual conferences. She has website but we sold out of restaurants and the River published an article on venous everything else last fall. We will Walk. There is a variety of local stasis ulcer management in the be utilizing the “Survey Monkey” sightseeing options for those OWM journal. to get a consensus on possible bringing family members all fund raising choices. Please within walking distance. She is active with the local respond when you receive it. UOAA chapter in Idaho Falls, We discussed having greeting We also want to welcome . Idaho, actively participates in cards for sale and having a again the Memphis, Tenn. educating health care students contest among our members for WOCNs to our region. They and toured with the WOCN the design of the cards. More are busy working on their sponsored Russian tour in information will be forthcoming conference which will be April 2005. She has established the but the winner will receive a free 8-9, 2011 “Heal on Beale.” . Eastern Idaho Regional Medical fall SCR conference registration. Visit www.scrwocn.org for . Center Wound/Ostomy annual more information. conference. This eight-year-old Our fall conference will take conference is highly successful. place in San Antonio, the Northwest Region She is viewed as a mentor by latter part of September. In The Northwest Region proudly regional WOCN members. u preparation the San Antonio selected Jetta Tressel, Idaho WOCNs scoped out potential conference venues. After looking at 15 locations the best choice was the La Quinta near the River Walk. This hotel is brand new and built on the location of the very first La Quinta Hotel. There is a wall devoted to the history of the hotel leading to the conference area. This hotel was chosen for our transitional meeting to see if it would meet our conference needs. The staff took us on a tour of the site, showing us the various hotel room choices, Jetta Tressel, NW Region’s 2010 Outstanding WOCN award recipient www.wocn.org
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Honoring Achievement and Success at the WOCN Conference You are cordially invited to the Great Comebacks® National Awards Event at the WOCN Society’s 43rd Annual Conference. This year, the . Great Comebacks® National Awards Event will be held in New Orleans at the La Nouvelle Orleans Ballroom at the Ernest N. Morial Convention Center on Saturday, June 4, 2011 – conveniently scheduled the night before the conference begins so that our attendees could be a part of this . great event.
Keeping Dreams Alive
colitis, and colorectal cancer, successfully transitioning to life after ostomy surgery and . going on to pursue their dreams. Their stories can be . a valuable resource in your efforts to encourage and support your patients. They come from all walks of life and from many different backgrounds. Athletes. Authors. Entrepreneurs. Farmers. Firefighters. Park Rangers. Students. Teachers. Grandparents, moms, dads, teens, and children.
Ostomy surgery can leave people feeling isolated, fearful or uncertain about the future. But it shouldn’t be that way. At Great Comebacks, we’re here to tell everyone that life after surgery can be full – not of limitations, but of possibilities.
What binds them together is more than their struggles or their triumphs. It is their desire to give back, sharing their experiences so that others facing similar situations will know – you aren’t alone, you can get through this, and life can be full and rewarding.
For 26 years, Great Comebacks Award recipients have shared their stories of overcoming serious intestinal diseases such as Crohn’s disease, ulcerative
This inspirational event recognizes the achievements of people who have overcome Crohn’s disease, ulcerative colitis, colorectal cancer and
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other conditions that can lead to ostomy surgery – and the caregivers whose guidance is so instrumental in building their confidence and getting them back involved in living life again.
About the Great Comebacks ® Program The mission of the Great Comebacks Program is to provide information and inspiration to people facing the emotional, as well as physical, challenges of serious intestinal diseases and ostomy surgery. The program also aims to raise awareness about living with Crohn’s disease, ulcerative colitis, colorectal cancer and other diseases that can lead to ostomy surgery and life with an ostomy. People are often afraid of things they don’t really understand. By educating patients, their families and friends, as well as the general public we can help remove the stigma associated with these diseases and having an ostomy.
Great Comebacks is sponsored by ConvaTec, a leading developer of innovative medical technologies, in partnership with the Crohn’s & Colitis Foundation (CCFA), the United Ostomy Associations of America, Inc. (UOAA), the Intestinal Disease Education and Awareness Society (IDEAS), Youth Rally, the Wound, Ostomy and Continence Nurses Society(WOCN) and the American Society of Colon and Rectal Surgeons (ASCRS). u
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Member Spotlight
Let’s Get the Pedals Moving! By Dea Kent, MSN, RN, NP-C, CWOCN Chair, Membership Committee
Often WOCN Society members are seeking out opportunities to become more involved in the organization. Of course there are numerous activities at all levels of the WOCN Society. However, we have a very unique opportunity in 2011, thanks to Dr. Katherine Jeter. Dr. Jeter is concerned about providing means to nurses who would like to become educated in wound, ostomy and/or continence (WOC) issues. As a founding member of the WOCN Society, and as a consumer of health care, she knows first hand all the changes that have occurred through the years surrounding WOC issues. It is her desire to draw attention to current and future needs of our consumers where WOC nurses are concerned. Dr. Jeter is planning to bike cross country, from California to Florida. All the while, she is asking you to pledge money that will be utilized for the WOCN Society’s Scholarship Fund. Also, because she is passing through many cities, there are multiple stops where events can be organized locally to celebrate her idea and commitment to raise money for WOCN 14
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scholarships. We are currently looking for WOC members to show their support for the WOCN Society and Dr. Jeter, by welcoming her to her stop for the day. In addition, members may be present to send her off on her journey in San Diego, and meet her at her final stop in St. Augustine, Fla. No stop in your area? Members may choose to organize their own fundraisers, or partner with their own specific region/affiliate to do something special for the fund during this feature event. Dr. Jeter’s passion for WOC nursing remains evident. Each
day you serve patients because of your passion. I urge you to partner with us to display our passion around the country, by focusing our energy on the future! Please consider a personal donation (which is tax deductible), to invest in the next WOC nurse. Please visit . www.wocnfoundation.org for information about Cycling for Scholarships and the event surrounding it. You can also donate online at this secure site. Thank you for investing your time in this members’ event that everyone can be a part of! u
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Public Policy
Essential Politics for Partnerships and . Professional Success Kate Lawrence, MSN, RN, CWOCN (Photo, Left) President-Elect, WOCN Society • Co-Chair, Public Policy and Advocacy Task Force
Marilyn Magoffin, BSN, RN, APRN-BC, CWOCN (Photo, Right) Co-Chair, Public Policy and Advocacy Task Force
When times change, organizations need to change with them. To be an effective advocate for its members the WOCN Society works hard to evolve and change with the times. During the WOCN Society’s Strategic Planning Session for 2010-2013 it was identified that given the 24/7 information cycle that drives our country, active inter-facing with our vital stakeholders is important. Reevaluating the role of public policy became . a key component of the strategic plan. Having a vigorous public policy agenda is essential to any successful organization. Members benefit when their organization is an active participant in legislative and regulatory issues that focus on advocacy for patient care, and for issues that directly impact the professional practice of the
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membership. A Public Policy and Advocacy Task Force was created to examine the role of public policy for the WOCN Society. The task force was charged by the WOCN Society board of directors to assess the effectiveness of current public policy approaches, explore what it means to build political capital both nationally and locally and recommend future approaches to engage regulators, payers, and policy makers. To accomplish this, the Public Policy and Advocacy Task Force was selected from members of the current Public Policy Committee and the WOCN Society Council. Identified early were the guiding questions “How can the WOCN be nimble and strategic in dealing with legislative, regulatory and credentialing agencies?” and “How can the WOCN as an organization and
the membership engage in Public Policy and Advocacy to the fullest?” Three areas of concern emerged from early work of the task force: 1. Development of a legislative and regulatory agenda/core messages. 2. Analysis of committee structure and function. 3. Enhancement of communications processes. All the current activities of public policy were looked at including how best to utilize WOCN Society’s legislative consultants, what is the WOCN Society’s relationship with legislative and regulatory bodies and, most importantly, what are the elements of being an effective organization in advocating for its members and their patients.
As part of their data collection the Public Policy and Advocacy Task Force designed three surveys:
needed to develop public policy/government affairs committees or to support current ones.
• WOCN Member Survey • WOCN Screening Survey Public Policy Advocacy of Alliance Organizations. Task Force. The first survey Organizations that are part of for members was sent in WOCN’s alliance were sent a September 2010 to ascertain survey to inquire about their what was important to each public policy and advocacy individual member with regard activities. From this screening to public policy and advocacy survey eight organizations . issues. Members were chosen were chosen for in depth at random to receive this interviews, which are being survey. conducted now at the writing of this article. • WOCN Regions Survey Public Policy Advocacy The task force will make Task Force. A second survey, recommendations with tactics also sent in September 2010, for action from the information was sent to current and past gathered from these surveys, presidents of regions and environmental scanning and affiliates to determine what resultant analysis of current the regions and affiliates WOCN activities.
With the current health care environment and the expected changes in the future it is imperative that the WOCN Society works hard to advocates for patients and the nurses who care for them. Being “nimble and strategic” is also important so that members have the most current regulatory information and the knowledge of how to utilize it to implement change. Additionally, responding rapidly to a local or national issue that impacts wound, ostomy and continence nursing practice ensures the survival of safe practices and needed equipment to do our jobs effectively. Providing opportunities for WOCN members to be involved . and engaged in this process . is imperative. u
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Education
A Comprehensive Assessment: Thinking By Sonya Clark, RN, CWOCN Co-Chair, Professional Practice Committee
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Ostomy Outside of the Box Mrs. Hoover has been referred to the ostomy nurse for skin complications around her ileostomy. The staff reports a wear time of six to 12 hours. You enter the room ready for a basic ostomy assessment. Ensuring a properly fitting ostomy appliance is not the only consideration when evaluating a patient with an ostomy. Sometimes you must think outside the box to gather the information needed in order to help the patient and prevent further complications. A comprehensive assessment is necessary so a proper plan of care can be developed which will ultimately help Mrs. Hoover with this life changing event in her life. First, either review or obtain a complete medical history. Other pertinent medical information may include vision problems, dexterity complications, and memory issues. You should also prepare a list of the patient’s medications, keeping in mind that some medications can affect stool consistency, color of urine, skin, and healing. Ask
questions about the type of surgery, reason for the ostomy, and whether the ostomy is permanent or temporary. This is a great way to ascertain if the patient is knowledgeable about his/her situation or if further education is required. It is also helpful to list postoperative complications or current problems the patient is having, unrelated to the ostomy. Other important facts to consider include the patient’s insurance and whether the patient has access to home health, since this could affect the type of appliance the patient is able to use. It will not help to recommend an appliance that . is neither affordable . nor unavailable. Diet information is extremely important when discussing ostomy problems and patients can have many diet issues and questions. Asking “Are you eating well?” or “Do you have an appetite?” does not provide the best data. Instead, ask for a brief diet recall of the last few
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meals, including supplements and protein intake. For all ostomy patients you should inquire about adequate fluid intake, by determining type of fluid and amount per day. Lack of adequate fluid intake could cause constipation, dehydration and should be addressed before problems can occur. Including questions about appetite and recent weight gain or weight . loss can uncover other areas . of concern. Additional variables to consider during a comprehensive assessment include activity, clothing and care of the ostomy. A patient’s activity or occupation can affect how they adapt to life with an ostomy. A patient may have no immediate bathroom access, may be exposed to extreme temperatures, or may be required to lift heavy objects for their job. Including a question, not only about their current activity but potential activity in the future could help prevent future problems. If the patient is a child, ask questions about school activities and access to private areas for the child to use if needed. Does the patient have clothing issues due to waste bands or belts at the level of the stoma, clothing that is too restrictive, or a special
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uniform that interferes with the ostomy? Does the patient prefer shorter pouches so nothing is visible beneath? If possible adjust the ostomy appliance to meet the patient’s preferences and lifestyle instead of altering the patient’s lifestyle to meet the needs of the ostomy.
“Sometimes you must think outside the box to gather the information needed...” Of course with every ostomy, a thorough assessment of the effluent is important. For colostomies and ileostomies ascertain out if the patient believes odor or gas is a problem? Is effluent texture and volume appropriate for the ostomy? For urostomies, is mucous a problem, is odor an issue, and is coloring appropriate? While the ultimate goal is for a patient to be self-care with
their ostomy, it is frequently necessary for the patient to have a caregiver to assist them in the immediate post-operative period or when a patient is having pouching problems. Before instructing a patient on their ostomy, determine who does the current ostomy care. If a patient is not participating in their care you should try to determine the obstacles and the reasons a patient requires a caregiver. Next, determine which steps a patient can do without assistance and those in which they need assistance. Sometimes a patient is not doing their own care because no one has given them a chance or perhaps a patient is not currently willing to do their own care. Using a clip may be too difficult for a patient so a caregiver has been doing the care for the patient. With this knowledge, you can develop a plan for the patient to become self-care with their ostomy. The next step for your assessment should be the ostomy appliance and supplies. Ostomy appliances can be complex and sometimes overwhelming for any patient or caregiver. When gathering information about a patient’s appliance it is very beneficial
for the patient to bring the supplies to the visit. Remember caregivers and patients may not always recall things they were taught in the hospital or early on in the post-operative phase. First, identify what type of products the patient is currently using. Then identify any products the patient has used in the past without success. List items used including order numbers and types of appliance. (See Table 1 for a checklist of types of appliances and helpful information.) Always ask a patient what things they like and dislike about their current pouching system.
is using a product incorrectly causing appliance failure. List any other products being used such as adhesive removers, ostomy pastes, barrier rings, convex rings, barrier strips, powders, barrier wipes, cement, and adhesive sprays. Asking how these products are used may give further information needed to solve the patient’s problems. Furthermore, verify size of the ostomy opening being used. Be sure to ask questions about other products the patient may be using that are not standard ostomy products. Occasionally patients will use home remedies, special ointments, or duct tape to assist The procedure a patient currently with maintaining an appliance. uses when changing their appliance also reveals clues to Determine normal wear time current pouching problems. The of the appliance including the patient may be using skin prep pouch and the wafer. Is the to clean the area or stoma paste patient changing the appliance with a urostomy. Ask the patient on a routine schedule, due to explain their current appliance to leaking, due to odor, or changing procedure starting randomly? Does the patient with removal and until finished. consider odor or gas to be a Document if patient applies problem? Questions about pouch appropriately. Determine pouch emptying should be cleaning products being used, included in every comprehensive shaving products, procedure, assessment. Is patient emptying and any skin care products that pouch regularly and what is the are used under the appliance. current emptying procedure? Determining the actual order Does the patient remove pouch of procedure may give you to empty or does the patient information on how a patient sit on toilet when emptying?
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Include questions about whether a patient rinses the pouch which can affect the appliance seal and the odor control of the appliance. Are odor neutralizing drops or odor deodorants being used? Frequently, a patient will be using objects or substances in the pouch that may affect the appliance seal or cause skin irritation. Examples might include fabric softener, mouthwash, aspirin, bleach, or mineral oil. It is finally time to evaluate the patient and the patient’s stoma. The stomal plane is the abdominal area around the stoma, which gives you a layout of the “terrain” around the stoma. Document creases, lesions, wounds, scars, hernias, pregnancy, obesity, incisions, and hair on the abdomen. Assessing the patient while sitting, standing, and lying can give helpful information since the stomal plane can change depending on position and movement. Note how the patient’s stomal plane changes with movement, twisting, bending, or even breathing. Evaluate peristomal skin for any problems or concerns that should be addressed. Is the skin denuded, over moist, dry, inflamed, infected, loose, or hairy? Check for rashes, wounds, mucosal islands, 24
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mucocutaneous sutures, or loop holders. The patient may be cutting ostomy openings inappropriately based on the above assessment findings. Finally, assess the stoma. Describe the stoma as moist, dry, pink, necrotic, edematous, prolapsed, flush, budded, retracted, stenosed, double barrel, round, or oval. Be sure to include the presence of polyps, lacerations, and lesion. Does peristalsis change the dynamic of the stomal plane? Does the patient notice the stoma changing size during bowel movements? Assess the location of the opening of the stoma, sometimes referred to as the os, to determine if it is centered, slanted, or if it changes sizes during peristalsis. You may decide that the os changes locations and causes leaking with peristalsis. Is the stoma located too low for patient to visualize without mirrors or assistance? Is the stoma located under an abdominal fold, in a crease, or over a herniated area? A comprehensive ostomy assessment is time-consuming and often complicated. It takes a thorough knowledge of surgeries, nutritional issues, skin care problems, and complex medical conditions in order to gather the information needed
to complete an assessment. Remember as you conduct your assessment to think outside the box. The ultimate goal is to help your patient through a life-changing and sometimes frustrating time in their lives. You may find the patient has issues that must be referred to the surgeon or it may be something as simple as “Mrs. Hoover, you must remember to take the paper off of the wafer before putting it on.” Special thanks and . appreciation goes to Mike D’Orazio. I read Mike’s comments on the WOCN . forums about comprehensive ostomy assessments. He included an ostomy questionnaire that I have adapted to my current . practice and has inspired me to broaden my assessment for ostomy patients. u
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Directors Corner
Who Will Help Us Accomplish Our Mission? By Mary-Jo Conley, BSN, RN, CWOCN Director, WOCN Society
“The WOCN Society is a professional nursing society that supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and incontinence.” During a Strategic Planning Session of the WOCN Society several years ago, the President opened the session by reading the above, the WOCN Society mission statement. It was not the first time that I heard or read it, but it was truly the first time that I understood it. I came to realize not only how important our mission is, but how our leadership truly strives to uphold it and keep it forefront in all of the organizations’ activities. The statement includes four ways in which we strive to accomplish our mission: • “Supporting members with access to the most up-to26
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date professional information in the field through annual conference, products and publications and website.” • “Creating ample opportunities for members to network.” • “Working to move the profession forward on behalf of its members through its involvement on Capitol Hill.” • “Offering research opportunities through the WOCN Center for Clinical Investigation (CCI).” “Supporting members with access to the most up-todate professional information in the field through annual conference, products and publications and website.” The WOCN Society’s annual conferences are not to be missed. The quality of the speakers and the educational level of the presentations is unsurpassed. Conference locations are chosen based on issues that remain important to members, which include: cost,
ease of access, transportation, local area and safety. The 2011 conference will be held from June 4-8, in New Orleans. Registration information can be found on the WOCN Society website (www.wocn.org) or visit the WOCN Society’s 43rd Annual Conference website (www.2011. wocn.org). The WOCN Society offers many educational products which can be accessed on the WOCN website (www.wocn.org): • Online Store: • Clinical Practice Guidelines • Best Practice Documents • Portable Instructional Education (PIE) • WOCN Scope & Standards • Educational Essentials CD • Patient Guidelines and Marketing Tools • WOCN Library: • Journal of Wound, Ostomy and Continence Nursing • Position Statements • Fact Sheets • WOCNews • Guidance on OASIS-C
“Working to move the profession forward on behalf of its members through its involvement on Capitol Hill.” The WOCN Society is active in promoting legislative awareness for its members. Resources on the website include: • Advocacy and Policy News • Provides up to date information regarding issues on the Hill relevant to WOC nursing practice • Advocacy and Grassroots “Creating ample opportunities Toolkit for members to network.” • Provides information and guidance for During the annual conference, communicating with the WOCN Society includes legislators and navigating many opportunities for members the legislative process to network, including regional • Guide for impacting the and affiliate meetings and social political process gatherings. The National Public Policy Online forums are available to Committee along with two members and allow networking legislative consultants remain and communication of ideas for active in addressing and wounds, ostomies, continence, supporting current issues professional practice and public relative to WOC nursing practice, policy. The forums are monitored including reimbursement, the by members in leadership roles APRN role, and the “WOC Nurse and issues are communicated in Washington” program. back to the executive board. The forums are a great method of “Offering research exchanging ideas and posting opportunities through the questions to colleagues. WOCN Center for Clinical Investigation (CCI).” CCI’s role includes developing WOC nurses as clinical
• Advocacy and Grassroots Toolkit • Whitepapers • Free to members (available through the Member Center): • WOCN Image Library • Best Practice Documents • Professional Practice Documents • Global Learning Center (GLC) • Numerous continuing education sessions offered providing contact hours
investigators, to support research and strengthen evidence based practice. CCI accomplishes this through: • The small grants program: proves funding for seven research projects annually. Grants are funded by WOCN Society corporate partners and members of the WOCN Society. CCI is available to assist members in designing research proposals. • Spotlight on Research: section in each Journal of Wound, Ostomy and Continence Nursing; highlights research topics and findings relevant . to WOC nursing practice. • Consultation and close partnership with each of the WOCN Society committees to develop toolkits and guidelines to facilitate research and evidence based practice. Truly one of the most amazing facts regarding our organization and the wonderful resources it has to offer is that the work is done primarily by volunteers. From the board of directors, to the committee chairs and members, each volunteers . their time, expertise and knowledge to ensure that . our mission is upheld. u
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Member Benefits
YOU’VE BEEN ACCEPTED! After careful examination and consideration, the National Guideline Clearinghouse (NGC) has accepted WOCN’s two newest clinical guidelines into their database! The Guideline for Prevention and Management of Pressure Ulcers and the Best Practice Guideline in Management of the Patient with a Fecal Ostomy both met the rigorous criteria required by the NGC and are now listed among the most respected research guidelines in American health care. WOCN would like to extend a sincere congratulations to all those who were involved in the creation of these documents. Your contributions will surely aid the delivery of quality health care to patients for generations to come. We are very proud of your accomplishments.
Congratulations!
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Join the WOCN Society’s march on New Orleans by registering for the 43rd Annual Conference! Register by visiting www.2011.wocn.org and click on the “Registration/Housing” tab. Experience the most diverse and cutting edge WOC education available with sessions covering regenerative medicines, urostomies, gluteal cleft skin damage, vascular issues in wound care and much more. Register before April 15th, 2010 to get the Early Bird discount! The flavors, the music and festivities…Enjoy all that New Orleans has to offer while attending the WOCN’s 43rd Annual Conference. Register today! Accreditation Statement: The Wound, Ostomy and Continence Nurses (WOCN) Society is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Provider approved by the California Board of Registered Nursing, Provider Number CEP 15115 Disclaimer: Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity.