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What Are the Medical Directives for Aesthetic Treatments?

Feb 25 2022

Reading Time: 4 Minutes

Author: Patricia Pezzano

To say the global growth of aesthetic medical procedures increased in recent years is an understatement.
It was immense.
Just look at this data:

Cosmetic surgical procedures rose by 266%.
Cosmetic non-surgical procedures rose by 3,158%.
That is a compound annual growth rate of 7.5% and 27.1%.

With such huge growth, a question arises.
What are the medical directives for aesthetic treatments?
How are they properly implemented?

Why is There a Need for Regulation?

Aesthetic medical procedures are growing in popularity.
They are still medical procedures.
They should be performed in medical environments.
Not in beauty salons, day spas, or shopping malls.

For example, some host “Botox parties” in private homes.
It might seem fun to reduce aging signs.
But a Botox injection is still a medical treatment.

Botox and other aesthetic services have unique liability risks.
They must be performed by a medical professional.
This includes an RN, RPN, NP, or physician.
Just like any other medical procedure.

Cosmetic services are a “controlled act.”

Ontario’s Regulated Health Professions Act 1991 defines a controlled act.
It is an activity that can cause harm.
Harm occurs if an unqualified person performs it.

So, what is a controlled act in cosmetic services?

In cosmetic nursing, controlled acts include injections.
This means administering a substance below the dermis.
It includes both Botox and dermal fillers.
Done improperly, they can cause pain or infection.
Serious adverse events can occur without qualified individuals.

Regulation of Cosmetic Nursing in Canada

A nurse can deliver a controlled act through an authorizing mechanism.
This can be a direct order for a specific patient.
Or it can be through a medical directive.
A directive is an order for many people under specific conditions.

A directive must come from a qualified health professional.
For cosmetic injections, this means a physician or NP.
Clear, accurate medical directives are key.
They ensure a successful, safe practice.

Cosmetic nurses’ scope varies by province.

RNs and RPNs can administer neuromodulators.
But the client must be initially assessed by a physician.
Injecting below the dermis is within their scope.
Initiating treatment is not.
All nurses need proper training from qualified teachers.

Different provinces have different regulations.
In Nova Scotia, a physician must be on site for the first injection.
Succeeding injections can be done by a nurse alone.

In other jurisdictions, NPs may prescribe Schedule 1 drugs.
This includes neuromodulators.
But some provinces limit NPs from prescribing cosmetic treatments.
Know the current regulations where you practice.
This is vital if you are planning to practice.

Medical Care Directives for Aesthetic Treatments

Different provinces have different regulations.
But basic medical directives are common.
They apply to both medical and aesthetic treatments.

You will find some below:

Informed Medical Consent and Discharge

Medical procedures require valid and informed consent.
This includes cosmetic nursing services.

Without consent, the procedure can be assault or battery.
The court can find criminal liability.
Damages can be awarded even without physical harm.

What makes consent valid?
Consent is valid only when:

• The client has the capacity to give consent;
• The consent has been made voluntarily; and
• The client has been properly informed about the nature of the procedure including anticipated outcome and any other risks.

The duty of disclosure is heavier in elective cosmetic services.
Outcomes are subjective.
Health professionals face civil actions or complaints.

To minimize risk, manage client expectations.
Use comprehensive planning and discussions.
For example:

• The client has been given adequate information on post-procedure care, medication, follow-up visits, possible side effects, signs, and symptoms so they can monitor and seek further medical care when needed.
• The client has been informed where they can return for intervention outside business hours.

Informed consent and discharge discussions must be documented.

Record Keeping

Client encounters must always be documented.

All regulatory bodies have documentation standards.
This applies to cosmetic services.
Client records must be retained for a set time.

Why is this important?

Proper documentation is a nurse’s best defence.
Records help reconstruct events.
They provide detailed evidence.
Complaints often happen months or years later.

Other Risk-Management Considerations

Healthcare professionals should be mindful of these points:

• Before advertising through electronic media or paper, consult appropriate regulatory standards and guidelines to check if the advertisement is compliant
• Consult with a business lawyer if you’re operating an independent practice
• Consider professional boundaries and appropriateness when dealing with client on social media

Do You Need Help With Your Medical Directives?

Failure to obtain valid consent can risk your license.
No risk is worth that.

If you need help, APT Injection Training can help.
We offer medical directives, human resource binders, and policy binders.
We help ensure your practice is compliant.
We are a world-class training facility.
We are the only facility in Canada to offer international certification in aesthetic medicine.

Message us today.
Visit our website to learn more.
Learn about medical directives and injectable treatments.