elissa o'keefe - bravura education

Elissa O’Keefe RN NP FFACNP MACN

Interim Chair, Cosmetic Nursing Community of Interest

Australian College of Nursing

Future proof: Clinical governance

and education best practice for

cosmetic nursing

Outline

Context of practice

Scope of practice

NMBA position on cosmetic nursing

MBA guidelines

ARPANSA laser guidelines

Cosmetic nursing as a specialty

Standards and scope of practice for cosmetic nursing

Post graduate education

CPD

ACN Cosmetic Nursing Community of Interest

Cosmetic nursing contexts of practice

In collaboration with medical

colleagues such as with

cosmetic physicians, plastic

surgeons or dermatologists

Private or public healthcare

settings

Nurse-led clinics

Independently* in private

practice

Scope of practice

Determined by the individual’s:

– Education

– Training

– Competence

– Authorisation in the practice setting by the employer’s organisational policies and requirements

– The ultimate boundaries of scope of practice are the nurse’s confidence in their own professional capability, legislation and regulation

NMBA position on nurses providing

cosmetic procedures

MBA guidelines on cosmetic

medical and surgical procedures

ARPANSA guidelines (laser safety)

National uniformity for:

1. Minimum education (likely to include an accredited laser/IPL

safety certificate)

2. Training

3. Terminology

4. Equipment

5. Patient care and

6. Injury reporting.

Recognition as a specialty?

NMBA

Organisations representing speciality nursing

groups in Australia have developed processes for

recognising speciality practice.

This provides a sufficient means of acknowledging

specialist nursing practice in Australia, and may be

recognised by employers and the health industry at

large.

http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/fact-sheet-advanced-nursing-practice-

and-specialty-areas.aspx

International exposure

Standards and scope of practice

For an electronic copy: www.bravuraeducation.com/pages/contact

Principles of professional practice

1. Nurses are registered with the Australian Health Practitioner Regulation Agency (AHPRA)

2. Nurses should work within their scope of practice based on each nurse’s education, knowledge, competency, extent of experience and lawful authority

3. Clinical care is governed by evidence-based standard operating policy and procedures/ clinical practice guidelines or similar

4. Clients/patient presentations that fall outside the scope of practice of the nurse are referred to an appropriate, competent person

5. Participate in decision making to ensure that nurses are able to deliver the best patient outcomes.

Principles of clinical practice

1. Adhere to health practitioner

regulation

2. Unregistered practitioners

3. Work with safety and quality

frameworks

4. Maintain client/patient

confidentiality and privacy

5. Obtain informed consent

6. Maintain health records,

considering information privacy

and access

http://www.centerforhealthjournalism.org/files/title_images/transporting_medical_rec

ords_849x565_1.jpg

Principles of clinical practice (cont’d)

7. Administer medicines safely and

effectively

8. Utilise medical devices safely and

effectively

9. Maintain the principles of infection

control

10. Obtain informed financial consent

11. Utilise technology-based patient

consultations safely and effectively

12. Provide objective advice and dispense

cosmeceuticals/medical grade skin care

13. Introduce new technologies or

treatments based on best patient

outcomes and evidence

Domains of practice

Domain 1: Assess client,

plan and deliver

appropriate care

Domain 2: Administers

botulinum toxin A safely

and effectively

Domain 3: Administers

filler and related products

safely and effectively

Domain 4: Delivers laser,

intense pulsed light and

related therapies safely

and effectively

Activities of practice

1. Client care

2. Medication administration

3. Treatments

Client care

Wound care

Acne management

Scarring

Rosacea

Anti-ageing/skin fitness

Skin sensitivity

Sun damage

Pigmentation

Leg and facial capillaries

Removal of unwanted hair

Removal of benign skin lesions

Skin tightening

Fat reduction

Referral to a specialist.

Medication (EEN, RN, NP)

Dermal fillers

Muscle/wrinkle relaxants

? Deoxycholic acid (Belkyra)

Other scheduled medicines as required (e.g. topical anaesthetic)

Prescribing medication (NP).

EEN S4 administration under direct supervision of an RN

RN administer S4 medication

NP authorised to obtain, possess, supply, administer, prescribe and dispense medications

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Treatments

Intense pulsed light

Laser (including but not limited to Thulium/Erbium, Nd:YAG, Ruby, Alexandrite)

Microdermabrasion

Chemical peels (AHA, BHA, Jessner, TCA, Retinoid)

Light Emitting Diode (LED) therapy

Radiofrequency therapy

Ultrasound therapy

Dermal rollering/needling

Platelet rich plasma

Photodynamic therapy

Cosmetic tattooing

Tattoo removal

Sclerotherapy

Lipodissolve

Fat reduction

Benefits of having a framework

It sets the standard for what would be expected of nurses in an aesthetic context

It enables career pathway development

It can be used as an audit tool for both individual clinicians and supervisors and /or employers to identify strengths, areas for development and to plan professional development

Where it has been used as an audit tool it can be used as evidence of continuing professional development

It can be used as a basis for role development, job descriptions and performance evaluation.


Examples of post graduate education

Accredited Laser/IPL Safety

Certificate

Continuing professional

development modules

Diploma in Cosmetic Nursing

Graduate Diploma in Cosmetic

Nursing

Community and Primary Health

Nursing

Master of Clinical Nursing

Master of Nurse Practitioner

(Primary Health Care pathway)

Industry

CPD requirements

20 hours per year

Nurse practitioners must complete at least 10 hours per

year in education related to their endorsement

One hour of active learning will equal one hour of CPD. It

is the nurse’s responsibility to calculate how many hours

of active learning have taken place

CPD must be relevant to the nurse’s context of practice

Nurses must keep written documentation of CPD

Participation in mandatory skills acquisition may be

counted as CPD.

CPD requirements (cont’d)

CPD must demonstrate that the nurse has:

– identified and prioritised their learning needs,

based on an evaluation of their practice against

the relevant competency or professional practice

standards

– developed a learning plan based on identified

learning needs

– participated in effective learning activities relevant

to their learning needs

– reflected on the value of the learning activities or

the effect that participation will have on their

practice.


Documenting CPD

• Date

• Source or provider details

• Identified learning needs

• Action plan

• Type of activity

• Description of topic/s covered during

activity and outcome

• Reflection on activity and specification

to practice

• No./Title /Description of evidence

provided

• CPD hours

• A template for this can be found on the

NMB website.

Networks

Future opportunities for cosmetic nursing

1. Research, research, research…

2. A consistent communication platform

3. Continual development of accredited

education initiatives that demonstrate a valid

career pathway and articulate into a suite of

post graduate knowledge and skills

4. Rejuvenation of professional practice

standards and scope of practice

5. Sharing of industry trends, changes in clinical

practice etc.

6. Lobbying of government to ensure that

nurses continue to be enabled to deliver

excellent patient outcomes


COSMETIC NURSING

COMMUNITY OF INTEREST

Cosmetic Nursing Community

of Interest

elissa o'keefe - bravura education

Health & Medicine