Bridging The Wound, Ostomy and Continence (WOCN) Gap among Graduate Nurses in an in-patient hospital setting

Gaps have been identified between academic and clinical setting preparation related to knowledge and practice skills among Graduate Nurses with less than one year of clinical experience. 

Changes in reimbursement for hospital acquired pressure ulcers (HAPU) began in October 2008.  In order to prevent HAPU, it was imperative that all nurses knew current strategies for prevention of pressure ulcers.  Bridging the Wound, Ostomy and Continence (WOCN) Gap among Graduate Nurses in an inpatient hospital setting was necessary to adequately prepare the graduate nurse for Pressure Ulcer prevention. 

The Purpose of the project was to redesign the nursing internship program to include structure information about the nurse’s role in WOCN to support the organization’s efforts for pressure ulcer rate reductions.

The objectives of this project were to improve WOCN patient outcomes and identify WOCN gaps existing between academia and professional practice.  To support outcomes of this project, new graduates were educated regarding Clinical Practice Guidelines, Clinical Practice Outcomes, Standards of Care, Clinical Pathways, Value Based nursing and assigned to quality projects related to skin care initiatives.

Outcomes were measured by Pressure Ulcer Prevalence and Incontinence Associated Dermatitis (IAD) data, Performance Survey’s and completed skills check list.  Since 2008, over 300 Graduate Nurses have completed the mandatory nursing internship program incorporating WOCN skills for prevention of pressure ulcers and other skin conditions. Currently, pressure ulcer prevalence rates are well below national average and hospital acquired IAD is non- existing.

In conclusion, Graduate Nurses benefit from the information of subject matter experts in the field of Wound, Ostomy and Continence related issues.