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Clinical Practice > Cosmetic Product Administration

Frequently Asked Questions

 Is it within Psychiatric adult NP to prescribe and do botox injections?  Not changing population foci. Course not done in academic setting.

Is the Dermatology Nurses Association affiliation recognized by the NHBON for independent practice?

Is it within the nurse and nurse assistant scope of practice to administer Botox?

Is it within the nurse or nurse assistant scope of practice to administer laser treatments?

Is Botox administration within a nurse's scope of practice?

Is administration of non-ablative laser treatments (as opposed to laser surgery) in the office setting within the nurse scope of practice?

Can APRN's prescribe and thus purchase (a) dermal fillers (e.g.) Restylane, Perlane, Juvederm, etc.) and (b) botulinum toxin type A (e.g., Botox, Reloxin)?

If these products may be prescribed, are there any limitations on the APRN's authority to prescribe them other than appropriate scope of practice (e.g., specific practice settings, indications for use, etc.)?

Can an APRN certified as an Adult Psychiatric and Mental Health NP by ANCC administer botox injections to separate group of patients in different clinical setting after successfully completing a training program and obtaining certification to administer botox?

Can a Nurse Practitioner administer Botox Injections for Migraine headaches?

Is an LPN allowed to administer cosmetic injectables (dermal fillers, botox) under MD supervision?

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 Is it within Psychiatric adult NP to prescribe and do botox injections?  Not changing population foci. Course not done in academic setting.

The board accepted the recommendation of the APRN committee that this is not within the population foci of adult psychiatric NP and therefore, not within the scope of this practice.

Is the Dermatology Nurses Association affiliation recognized by the NHBON for independent practice?

NHBON opined that Dermatology Nurses Association is not recognized by the NHBON and require MD supervision.

Is it within the nurse and nurse assistant scope of practice to administer Botox?

No. It is not within the nurse assistant or medication nurse assistant scope of practice to administer Botox.

Is it within the nurse or nurse assistant scope of practice to administer laser treatments?

Board Response: Yes.
It is within the nurse scope of practice to administer non-ablative laser treatments (non-ablative does not cause tissue destruction) provided appropriate training and competency are completed. It is not within the nurse assistant nor the medication nurse assistant scope of practice to administer non-ablative laser treatments.

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Is Botox administration within a nurse's scope of practice?

Practice and Education Committee recommends "yes" as a medical practice delegation act, Practice and Education Committee also recommends introduction of the language from S. Dakota which states: "The S.D. Board of Nursing has received numerous inquiries regarding the performance of dermatological procedures such as microdermabrasion. Botox injections, sclerotherapy, laser hair removal, collagen injections and chemical peels is within the registered nurses scope of practice. The Board affirms that the performance of these procedures is not the practice of nursing. These procedures are delegated medical acts, which could be performed by a registered nurse with additional training under the supervision of a licensed physician."

Additional information for this advisory based on guidelines from the Vermont Board of Nursing: The administration of permanent fillers is not within the scope of nursing practice for an RN or LPN. The administration of absorbable fillers or Botox may be within the scope of nursing practice of an RN if the following guidelines are observed:

A. The RN may administer the cosmetic injectable medication with a valid written order form a provider (Physician, PA or APRN) who is authorized to practice in New Hampshire.

B. RN’s, may administer these injectables only during the procedure and when the Physician, PA or APRN has assessed the client immediately prior to the procedure.

C. An RN may not independently select the medication or dosage to be administered during a procedure. The actual medication, dosage and site must be specified in the provider order.

D. In executing the procedure, the RN communicates changes in patient status to the authorized provider who is directing/ or supervising the procedure and to other appropriate personnel in a timely manner. The provider must be available by phone at all times and be able to assess client within 4 hour of the procedure if requested to do so.

Is administration of non-ablative laser treatments (as opposed to laser surgery) in the office setting within the nurse scope of practice?

Committee recommends: "Yes" to APRN and "Yes" to RN, LPN as a delegated medical task provided that the LPN has appropriate training and competency.

It is within the scope of practice for a nurse to administer non-ablative laser therapy for removal of tattoos and other cosmetic applications designed for non-ablative laser. Non-ablative laser therapy is less invasive, avoids burning of the epidermis and designed to work beneath the top layer of epidermis. Licensed nurses cannot independently diagnose, prescribe or treat and must be delegated to through provider order to perform this task. The provider is responsible for consultation, assessment and ordering of procedures for the client. The nurse is responsible to perform the task as ordered.

"No" to LNA because LNA has tasks delegated by the licensed nurse and not the MD.

Can APRN's prescribe and thus purchase (a) dermal fillers (e.g.) Restylane, Perlane, Juvederm, etc.) and (b) botulinum toxin type A (e.g., Botox, Reloxin)?

If these products may be prescribed, may they be prescribed autonomously (i.e., under the APRN's own prescriptive authority without a collaborative or supervisory agreement).

If these products may be prescribed, are there any limitations on the APRN's authority to prescribe them other than appropriate scope of practice (e.g., specific practice settings, indications for use, etc.)?

The Board accepted the APRN Committee's recommendation that it is within the prescriptive authority as long as the APRN has the national certification, education and competencies to support this practice.

Can an APRN certified as an Adult Psychiatric and Mental Health NP by ANCC administer botox injections to separate group of patients in different clinical setting after successfully completing a training program and obtaining certification to administer botox?

The Board consensus is that administration of botox injections would not be within the scope of practice of psychiatric/mental health NP as it is not within the population focus of that national certification. Continuing education does not expand APRN scope of practice.

Can a Nurse Practitioner administer Botox Injections for Migraine headaches?

Board opined that an NP can administer Botox injections for migraines consistent with approved standards of practice.

Is an LPN allowed to administer cosmetic injectables (dermal fillers, botox) under MD supervision?

Following advisory based on guidelines from the Vermont Board of Nursing: “The administration of absorbable fillers or Botox may be within the scope of nursing practice of an LPN if the following guidelines are observed:

A. The LPN may administer the cosmetic injectable medication with a valid written order form a provider (Physician, PA or APRN) who is authorized to practice in New Hampshire.

B. LPN’s, may administer these injectables only during the procedure and when the Physician, PA or APRN has assessed the client immediately prior to the procedure.

C. An LPN may not independently select the medication or dosage to be administered during a procedure. The actual medication, dosage and site must be specified in the provider order.

D. In executing the procedure, the LPN communicates changes in patient status to the authorized provider who is supervising the procedure on-site and to other appropriate personnel in a timely manner.”

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