Aesthetic Nursing - Frequently Asked Questions (2023)

March 31, 2023

Please note that the content of the FAQ is currently under review. Contact us at 1-800-252-9392 or using the form below.

Modified Regulations and Standards

HeRegulation of Personal Servicesand thePersonal Service Standardsit entered into force on July 1, 2020 and establishes minimum health and safety requirements for the personnel services industry. All nurses performing cosmetic procedures and treatments should be aware of all requirements relevant to their practice, as outlined inRegulation and standards for personal services.

If you are the operator of a cosmetic care clinic and provide any of the services referred to in the Personal Services Regulations, you must notify the Regional Health Authority (RHA) by providing your name and contact details, address and location of the business and the types of personal services you offer. You must also notify the RHA before offering new personal services/activities. For more information, you should read the Regulations and Rules of Personal Services.

These FAQs were jointly developed by the Alberta College of Licensed Practical Nurses, the Alberta College of Registered Psychiatric Nurses and the Alberta College of Registered Nurses. Registrants from previous regulatory authorities should contact their respective organizations if they have any questions about this document or if they would like practical guidance on the subject.

Do cosmetic procedures fall within my nursing practice area?

The job of a registered nurse in Alberta is established within the legal framework and is further defined by the respective regulatory bodies. Performing procedures that are not within the purview of a caregiver can have significant professional and legal ramifications.

The administration of neuromodulators such as Botox and dermal fillers are post-entry level skills and are not taught in entry level programs. Neuromodulators require custom ordering after initial evaluation by a licensed physician, e.g. B. a doctor, dentist, or nurse. Because cosmetic care procedures pose a potential risk to the patient, appropriate emergency support must be available.

The caregiver performing an aesthetic procedure has a skill set consisting of the following competencies:

• a sensitive and respectful way of communicating, a positive, non-judgmental attitude, and caring behavior
• thorough knowledge of the anatomy and physiology of the skin and underlying tissues
• in-depth knowledge of the drugs and substances to be used
• strong analytical skills and clinical competence in this field of activity
• Provide honest and factual advice and advertising.

In Alberta, RPNs, RNs, and LPNs are licensed and trained to administer drugs and substances by injection. Orders from a licensed prescribing physician are required before a caregiver can administer drugs and/or Schedule 1 substances (eg, neuromodulators and dermal fillers). The nurse is responsible and responsible for making sure that she has the necessary training and experience to carry out the order.

In addition, the Alberta College of Licensed Practical Nurses requires that LPNs who provide cosmetic nursing procedures within their defined area of ​​practice must be directly or indirectly supervised by a physician or nurse. The doctor or nurse must be trained in dermatology, be on site, and available to assist if necessary when performing cosmetic procedures and treatments.

Is there a difference between aesthetic procedures and cosmetic procedures?

Yes. Many cosmetic procedures do not need to be performed by a licensed healthcare professional (eg, facials, waxing, piercing, tattooing, including semi-permanent makeup, etc.). These would not fall under the definition of nursing or health services, but are included in theRegulation of Personal Servicesunder thepublic health law. The person providing these personal services may not use the protected title of 'nurse' and these hours do not count as practice hours.

Do I need more training to offer cosmetic procedures?

Yes. Nurses must have the additional training to practice competently and ensure public safety. When admitted to practice, nurses do not have the skills or training to administer dermal fillers, plumpers, collagen stimulators, and neuromodulators (eg, Botox). Nurses must ensure that their education and training teach basic competencies, including best practices for infection prevention and control. On-the-job training may not provide the skills necessary to safely practice cosmetic nursing, as it requires specific training in the anatomy and physiology of the skin and underlying tissues, assessment, and knowledge of neuromodulators and fillers. dermal. Each nurse is responsible for ensuring that they have the necessary knowledge to practice safely, competently and ethically.

NOTE: CLPNA, CRNA and CRPNA do not endorse any particular training courseOffers that are currently related to the field of aesthetic care. It is the nurse's responsibility to ensure that any education and training she undertakes provides the basic skills to become competent to safely perform cosmetic procedures. RNs, LPNs, and RPNs are expected to acquire additional theoretical knowledge and supervised clinical practice related to procedures and treatments in the following areas (not including):

• Anatomy and physiology related to the treatment area
• specific assessment of the dermatological patient
• Medicines, pharmacology and technology for treatments
• Treatment Complications and Appropriate Interventions

Documentation and record keeping: is it mandatory?

Yes. Caregivers must document the care they provide in an accurate and timely, objective, complete, and confidential manner. All documentation and records must comply with the documentation and privacy requirements defined by your regulator, employer policies, and state laws. These documentation expectations are the same in all practice settings.

Documentation is not separate from maintenance and is not optional. It is an integral part of nursing practice and an important tool used by nurses to ensure quality patient care. Nurses document patient-centered holistic care, including relevant components of the care process:

• Assessment
• nursing diagnosis
• The plan
• implementation
• Assessment

Documentation is evidence that care has been provided and is required

• communication between health care providers;
• Compliance with professional and legal requirements;
• quality improvement; AND
• Investigation.

Do I have to obtain a declaration of consent?

Yes. It is very important that the client understands the risks, benefits and expected results of the treatment. Prior to performing any aesthetic care procedure, the caregiver must obtain informed consent from the client for the specific procedure. The consent must be valid, current and not revoked or revoked at the time of the intervention or treatment. Performing any procedure on a client without informed consent is considered illegal and may result in a professional investigation and/or criminal charges, whether or not the client is aggrieved.

For consent to be "informed", the caregiver must explain the procedure, including alternative options and disclosure of risks and complications. Consent must be voluntary and cannot be coerced by the client through undue influence or deliberate misrepresentation. It is the caregiver's responsibility to provide the service

• assess the client's ability to understand the nature of the proposed procedure, the risks and complications, and the right to opt out. The consent will only be considered valid if the client fully understands what he accepts;
• ensure that the proposed procedure is only available to a minor (under the age of 18) if prior parental/guardian consent has also been obtained and the treatment has been mutually agreed between the parent/guardian and the minor;
• Obtain consent ethically and document accordingly. Reinstate consent if there are changes to the client's initial plan of care or if the client has changed their mind; AND
• Consent for the proposed procedure must be obtained each time the procedure is performed.

It is important for the nurse to mitigate the risk of complaints and legal action by ensuring that consent is informed and the client's outcome expectations are considered before performing any procedure.

What are my infection prevention and control (IP&C) responsibilities?

Nurses must ensure client safety, including prevention of health care-acquired infections. If you practice in a clinic or have an independent practice, it is important to use IP&C best practices and follow IP&C guidelines.

The following routine practices are an important part of IP&C and must be applied at all times:

• Hand sinks and hand sanitizer stations should be available.
• Follow the four moments of hand hygiene.
• Make sure that the appropriate personal protective equipment is used for the procedure being performed.
• Surfaces and equipment must be cleaned, disinfected and/or sterilized accordingly.
• Disposable products can only be used once.
• All waste, whether general or biomedical, must be disposed of safely and properly.

Many IP&C resources are available to ensure patient and caregiver safety.

What do I need to know about civil liability and self-employment?

The Canadian Nurses Protective Society (CNPS) provides CRNA members with professional liability protection, as well as legal advice, risk management services and legal assistance. CNPS only offers liability protection if you are providing professional care services. If you work with other healthcare professionals, you should ensure that each healthcare professional has adequate liability coverage.

RNs or NPs who maintain an independent nursing practice independently, in association with other professionals, or through the employment of others are considered self-employed.

Who can prescribe neuromodulators and dermal fillers?

Medicines on Health Canada's prescription drug list can only be prescribed by licensed and regulated healthcare professionals. In Alberta, these health professionals include:

• doctors;
• nurse practitioner;
• dentists; AND
• Pharmacists licensed to prescribe by the Alberta College of Pharmacy.

Neuromodulators, such as botulinum toxin, are Schedule 1 drugs and can only be prescribed by a licensed prescribing physician, as described in the Government Organization Law and relevant regulations for each healthcare profession. Some dermal fillers are classified as Schedule 2 drugs and do not require a custom order unless required by employer policy.

Nurses must be satisfied that the physician prescribing the neuromodulator or dermal filler is licensed by their institution to practice that practice.

What rules apply to prescribers?

Licensed prescribers must adhere to standards of practice developed by their regulatory body. Standards of practice for doctors and nurses require that they personally evaluate a client before writing a prescription. Doctors and nurses may prescribe neuromodulators and other drugs from Health Canada's Prescription Drug List only after a client assessment has been completed. Physicians can only write a prescription for "practical use" if they personally care for the patients for whom they write an injection prescription. An office use medication (eg, a multi-dose vial) may be used for more than one patient visiting a clinic.

What should be taken into account when acquiring and storing medicines and substances?

Medicines and substances for administration by injection (prescription or not) must be obtained through legal channels (ie, through a pharmacy or pharmaceutical company). Medications and substances obtained by other means may not be the correct substances, may be past their expiration date, or may have been improperly stored, altering composition, safety, and potency. Pharmaceutical companies may have restrictions on who can get drugs and substances. A nurse should not use another health professional for acquisition purposes only. Caregivers should follow manufacturer's recommendations for storage and handling as outlined in standards, best practice guidelines, and manufacturer's recommendations.

Information

CLPNA

Competency Profile for Licensed Practical Nurses
Approved practical professional nursing code.

CNPS

Considerations for the provision of cosmetic services
Consent for treatment: the role of the caregiver
Professional Liability Protection
Quality Documentation: Your Best Defense

CPSA

medical prescription practice
Practice Standards: Informed Consent
Practice Standards: Telemedicine

CRNA

Documentation standards
Hand Hygiene Guidelines
Guidelines for the safety of injections of drugs and vaccines
Nursing Prescription Standards
Restricted Activity Standards

CRPNA

independent practice
Licensed Psychiatric Nurse Code of Conduct

CSASN

Proposed Standards of Practice and Guidelines for RNs, RPNs, and NPs to Administer Cosmetic Injections

alberta government

Gesundheitsberufegesetz
Prevencion and control of infections
Regulation of Personal Services
state certified nursing professional code

Government of Canada

Prescription Drug List