1539 Maximizing the Role of the WOC Nurse in Today's Healthcare

Judith Mosier, RN, MS, BSN, CWOCN, Indiana University Health (Methodist), Certified Wound, Ostomy, Continence Nurse, Indianapolis, IN, Lori Arnold, RN, BSN, CWOCN, IU Health Methodist, CWOCN, Indianapolis, IN and Joyce Pittman, PhD, FNP-BC, CWOCN, Indiana University Health- Methodist Hospital, Wound/Ostomy Team Leader, Indianapolis, IN
With the increased demands to improve efficiencies, hospitals will be challenged to evaluate differentiated practice roles.  Pressure prevention requires maximizing the role of the Wound Ostomy Continence (WOC) nurse in driving evidence-based practice and translating knowledge to nurses.  The WOC Team in a large urban Level I Trauma Center examined current practice to redefine and maximize the WOC nurse role.  WOC Team goals were to reduce non-value added work, hospital acquired pressure ulcer(HAPU) rates (2.8%) and state reportable events.  Initial evaluation demonstrated high variation in core processes leading to inefficiencies, duplication of services, and overall provider dissatisfaction.  The WOC team reviewed practice scope and standards and identified core components of the role (1).  A one-day event was conducted to review work requirements, patient outcomes, and overall team satisfaction resultsConcepts were developed to achieve the aims of the redesign (2).  The group rated each member’s concept to the current state.  A hybrid concept was developed with resulting action plan.  The plan included geographical structuring, streamlined documentation, and clearly defined role responsibilities for all disciplines.  Post redesign, hospital acquired pressure ulcer rates reduced from 2.8% to 1.8% with overall HAPU rates below the National Database for Nursing Quality Indicator 25th percentile.  State reportable events reduced from 5 events to 2 events.  WOC nurses and other providers rated higher satisfaction with their work and work environment as evidenced by employee commitment survey results.  Nurses are accountable to steer nursing’s professional identity to maximize the scope of their role to achieve the best outcomes for their patients and thrive in an engaged work environment (3). Through team-led care redesign, WOC nurses were able to reduce non-value added work, improve collaborative relationships, and influence patient and provider outcomes to validate the contribution of the WOC nurse role.