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WOC Nurse and WTA - What's the Connection?

JANET RAMUNDO, BSN, MS, CWOCN, APRN, RN

WOC Nurse and WTA — What’s the Connection?

As an instructor with Emory University’s WOC Nursing Education Program (WOCNEP) accredited by the WOCN® Society, I knew that our program received frequent inquiries about providing wound care education to nurses “who didn’t want to be WOC nurses”. Nursing leaders recognized the need for continuing education in wound care to assist with the assessment and treatment of wounds, as well as engaging in risk assessment and prevention of pressure injuries. Having knowledge of the strong evidence base for WOC nursing practice led visionary members of the WOCN Society to develop the Wound Treatment Associate (WTA) Program.

After completing the Program, the WTA educated licensed healthcare provider acts as a “WOC Nurse Extender,” with the idea that this person will work under the direction of a WOC specialty nurse following evidence-based international standards of care. The Program has been well received, with close to 6,400 graduates as of 2018. WTA educated professionals work in acute care, home health care, outpatient setting and long-term care.

Despite the acceptance and utilization of the WTA Program, confusion persists. Members of the WTA Advisory Committee (WTAAC) are often contacted with questions about what the WTA can do and how this Program was different from the WOC nursing specialty practice. In response to this, the WTAAC developed the Complete Guide to Role Delineation Among WOCNCB® Certified Wound Care Providers. This one-page document, based on the Society’s WOC Nursing: Scope and Standards of Practice, 2 nd Edition, helps to show the differences in the various roles. The document discusses the differences in the WTA role, WOC specialty nurse, the WOC graduate level prepared nurse and WOC Advanced Practice Nurse. The WTAAC, with assistance from the Society’s national staff members, worked hard to capture the differences in practice and level of autonomy. It is our hope that this document, along with the WTA Outcomes Infographic (view on next page), will show the value of the Program to key users, such as Nursing Leadership and Wound Care Directors.

Another purpose of the role delineation document is to assist the WOC nurse in utilization of the WTA nurse in various practice settings. “We use the WTAs to augment the wound care programs that are directed by the WOC Nurse. Since the number of WOC nurses are fewer per site, the WTAs play a pivotal role in assisting with treatment application, skin inspections on admission and throughout stay, and implement additional prevention interventions,” said Angel Sutton, a member of the WTAAC, who has provided WTA education to hundreds of nurses in longterm care across the country. Angel added: “The WOC nurse is able to commit more time then to assessments, documentation, performance improvement projects and budget management. The addition of WTAs just adds more players to the wound team.” Sheila Guither, CWOCN, and Manager of Clinical Practice and Staff Development, stated:

“In our world of home care, WTAs allow WOC nurses to extend their reach without increasing travel and time. WOC nurses, which are a scarce resource, utilize WTA expertise to be a trusted, knowledgeable pair of ‘eyes’ in the field.”

Jenna DeLegge, CWOCN, and WTA/OCA Course Coordinator at the same agency, had this to say when asked if some WOC nurses might feel threatened by the WTA educated RN, “As a team (WOC nurses and WTAs), we are able to reach more patients. Just as physical therapists (PTs) have physical therapy assistants (PTAs), CWOCNs have wound treatment associates (WTAs) and ostomy care associates (OCAs). Our team’s greatest victory is in our outcomes. I am not threatened by assistance. I am on the forefront of training these teammates (WTA and OCAs) so they can positively impact the health and safety of our patients. Insurance is changing- it has been evolving for some time now. At a time when insurance reimburses for quality of care, there is no room for me, just we.” Mary Schopp, CWOCN, and WOC Nurse Coordinator, said this about the use of WTAs and the difference from WOC nurses, “I find it imperative to have the WTAs and OCAs on our team. It assists in providing optimal care using best practice for our patients. Our agency CWOCNs and CWONs are spread very thin covering 2-3 regions each. Having WTAs and OCAs on our teams assist in giving us another set of eyes so we can work together to provide timely, appropriate care. The WTA and OCA roles can never replace the knowledge base of the CWOCN. The WTAs and OCAs still need to communicate their thoughts and “recommendations” with the CWOCN to make sure best practice is being served. They require our expertise to guide them on appropriate care. I feel we need to look at this as another “tool” in our tool kit to allow us to provide exceptional care for our patients.”

The WTA and OCA roles can never replace the knowledge base of the CWOCN.

At the hospital where I work as a CWOCN I have seen firsthand the difference WTA educated nurses can make. Working together, under the guidance of the WOC nursing team, they audit and report for the National Database of Nursing Quality Indicators (NDNQI), provide a second set of eyes for critical skin care assessments and act as a resource for the unit staff. In some of the intensive care units we have seen a reduction of hospital acquired pressure injuries (HAPIs) due to the accuracy of assessment and interventions of the WTAs. Knowing this Program was based on the strong evidence base associated with our practice and being the only Program to include hands on competency demonstration was very important to the nursing education team at my hospital.

Irene Jankowski is another member of the WTAAC who, with her partner, has successfully brought the Program to hospitals in the New York City area with higher pressure injury rates. “We are definitely using both documents with our clients and they are very well received. Anything we can show that demonstrates the importance of supporting bedside staff with excellent educational programs is great,” said Irene. Irene also noted that nursing leaders are interested in the Program but have many questions about utilization and outcomes associated with the Program.

The WTAAC is committed to guiding the WTA Program and providing the information needed for this Program to be successful for you! Please don’t hesitate to reach out to this hardworking group of accomplished professionals with any questions or comments.

In conclusion, I would like to thank the members of the WTAAC for their hard work and dedication to the WOC nursing specialty:

Sara Coverstone, RN, MA, CHC, CWON David Crumbley, MSN, RN, CWCN Donna Geiger, MSN, RN, CWON Irene Jankowski, APRN, RN, CWOCN, APN-BC Debbie Ritter, BSN, RN, CWOCN, FACCWS Angel Sutton, MSN/Ed, RN, CWOCN, CCCN, CFCN

For more information on the WTA Program, please visit wocn.org/wtaprogram or email wta@wocn.org.

8 IN IT FOR YOU ® ISSUE 8, SUMMER 2019