Aesthetic Cosmetic and Dermatological Procedures by Licensed Nurses
The North Dakota Board of Nursing seeks to safeguard the public’s health and safety by providing guidance and regulation of the nursing profession. The roles of the RN and LPN are described in the NDAC Standards of Practice for the RN and LPN.
As technology changes and practice evolves, nurses are increasingly involved in procedures of a cosmetic and/or dermatologic nature. Many of the clinical competencies required to perform these acts in a safe, effective manner are not gained through basic nursing education, but would be gained through the acquisition of additional education preparation and supervised clinical practice.
Aesthetic cosmetic and dermatological procedures may be performed by a licensed nurse as a part of an overall comprehensive plan of care treating various dermatological conditions or as a part of a self-determined health maintenance/health promotion regime.
Educational Preparation and Clinical Competency
Each nurse is required to possess the educational preparation and current clinical competency to perform the procedures. The licensed nurse must have documented education preparation, supervised clinical practice experience, and ongoing competency validation appropriate to responsibilities, treatment provided, and the client/population served. The documentation should be readily available and on file with the employer.
Licensed nurses may use established protocols that have been determined by the licensed health care practitioner. Refer to Practice Statement entitled: RN & LPN SCOPE OF PRACTICE IN THE UTILIZATION OF PRESCRIPTION PROTOCOLS IN CLINIC SETTINGS.
The licensed nurse must possess knowledge of and be able to apply in practice:
1. Anatomy, physiology, pathophysiology regarding the integument system as well as other systems that may be specific to the procedure being performed.
2. Proper technique for each procedure.
3. Proper client selection, history taking, physical assessment parameters, indications and contraindications for treatment.
4. Pharmacology including drug actions/interactions, side effects, contraindications, and untoward effects.
5. Proper selection, maintenance and utilization of equipment.
6. Ability to articulate realistic and expected outcomes of the procedure.
7. Ability to describe potential complications and side effects.
8. Nursing care required and appropriate nursing interventions in the event of complications or untoward outcomes.
9. Management of complications or adverse reactions.
10. Infection control.
11. Safety precautions.
12. Documentation appropriate to the type of the procedure being performed.
Any nurse who engages in cosmetic or dermatologic procedures has the responsibility to ensure that the following requirements are met prior to participating in those procedures.
1. A licensed health care practitioner is knowledgeable of, and provides supervision and oversight for, procedures performed by the licensed nurse.
2. The facility or practice setting maintains written policies and protocols, consistent with applicable standards of practice and evidence based practice, which includes, but is not limited to, provision of specific direction on equipment, patient monitoring, and directions for dealing with complications of procedures.
3. Evaluation and documentation of competence occurs on a periodic basis according to facility policy.