Can Nurses Inject Botox?
0New York, NY – The Physicians Coalition for Injectable Safety (http://www.injectablesafety.org) today advises patients that all nurse and physician assistant injectors may not be qualified to perform cosmetic injections such a Botox, Restylane or other dermal fillers. Patients should be aware that the most important factor to any nurse or physician assistant injector is their relationship with an appropriately trained, supervising physician, and how closely the nurse and physician work together. The Coalition offers these guidelines to consumers who have questions about the safety or appropriateness of cosmetic nurse injectors:
• Nurses and physician assistants performing injectable treatments should only treat under the following conditions:
• The nurse or PA is under the supervision of a board certified plastic surgeon, facial plastic surgeon, ophthalmic plastic surgeon or dermatologist who has prescribed the injectable treatment appropriate for the patient
• The nurse or PA can demonstrate appropriate medical education, licensure and training specific to the delivery of cosmetic injections
• The nurse or PA only performs injections in a medical setting supervised by the prescribing physician
• The nurse or PA follows all of the appropriate steps in performing cosmetic injections, and that all patients are given informed consent documents that clearly define the risks and benefits of the procedure.
• The patient has the option to request the doctor perform cosmetic injections
Patients should not accept treatment from nurses or any other clinician in private homes, hair salons, hotels, bars or any other non-medical setting. “It is generally safe for nurses to perform injectable treatments under the appropriate circumstances: proper training specific to cosmetic injectables, proper supervision by a qualified physician, and within the supervising physician’s office,” says Jeffrey Kenkel, MD of Dallas, TX. “I have personally trained my nurses in performing injectables. They present an option to patients who understand that regardless of who delivers the injection, I prescribe treatment and inevitably patient outcome is my responsibility. However, if a patient of mine prefers that I treat them, that is entirely the patient’s right.”
“Physicians have differing in-office philosophies. I prefer to perform cosmetic injections personally, to evaluate a patient’s goals and physical condition before prescribing treatment and to also administer that treatment.” says Roger Dailey, MD, of Portland, OR. “Like many physicians who perform their own injections, I enjoy spending time with patients whether the injection is a first-time treatment, or a treatment to refresh appearance.” A survey conducted by the Coalition in July 2007 reports that while 94.6% of physicians personally perform cosmetic injections, only 24.4% of Coalition member practices include nurse or physicians’ assistant injectors. In addition, 45.3% of complications resulting from cosmetic injections are reported to result from unqualified providers, and that 35.2% result from injections administered in a non-medical setting, such as a spa, hair salon or private home.
Whether the patient opts for cosmetic injections performed by the physician or accepts injection by a registered nurse (R.N.) or licensed physician’s assistant (P.A. or P.A.-C), it is important to make sure the patient follows the safety guidelines of DOCTOR. BRAND. SAFETY:
• Doctor: Is the injectable recommended by a qualified doctor who regularly treats similar conditions, in an appropriately licensed and equipped medical facility? Has the doctor examined the prospective patient before recommending treatment?
• Brand: Is the injectable recommended approved by the U.S. FDA, in the U.S. (and by equivalent agencies in the country of origin) for cosmetic indications and is it appropriately labeled and packaged to reflect its authenticity and approval?
• Safety: Is the setting a proper medically-equipped office, with safety and sterilization procedures? Has the physician evaluated conditions, recommended treatment, offered alternatives and clearly defined the potential outcomes including any complications?
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