Can Nurses Inject Botox in Australia?

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Botox injection by nurses in Australia

In Australia both registered nurses and medical practitioners administer Botox and dermal fillers as well as other cosmetic procedures.

Regulations Regarding Botox Injection By Nurses in Australia

In Australia, as opposed to the UK regulation for nurse Botox administation, the rules and regulations in Australia are less well defined.  In practice, registered nurses can and do administer Botox and dermal filler injections to clients.  The NSW Department of Health published a guideline and study into the cosmetic medical industry in 2011 and is the only in depth publicly available document on the matter.  To summarise the information put forward by the Department of Health, nurses may administer Botox and other non-surgical cosmetic procedures as long as they have the “appropriate training, expertise and experience” in the procedure.  In addition, the guide goes on the state that when nurses or nurse practitioners are involved in high-risk procedures such as cosmetic injections, they must act “in accordance with applicable laws, protocols and best practice standards.”

Most importantly, the guide recommends that the The Nursing and Midwifery Board of Australia consider the need for the development of guidelines for nurses specifically dealing with the issue of non-surgical cosmetic procedures.  A review of the Nursing and Midwifery Board website as of May 2012 did not reveal the existence of any such document.

In general, there is currently a regulatory vacuum regarding the application of cosmetic procedures by nurses, until the Nursing and Midwifery Board of Australia comes out with a specific guideline.  In the meantime, the Australian College of Cosmetic Surgery (ACCS) has produced a protocol for the delegation of cosmetic injections.  It is important to note that Cosmetic Surgery is not currently a recognised speciality in Australia and that this body act purely as a private non-governmental self-regulating institution.

According to the ACCS guideline, nurses can administer cosmetic injectable procedures independently only following consultation with a doctor and the formulation of a written plan by the medical practitioner.  The doctor should be involved directly if any side effects occur or if the patient is dissatisfied and additionally the doctor should personally review the patient at least once per year. Their guideline is based on the Poisons Standard, which categorises Botulinum toxin and fillers under Schedule 4 (prescription only medicine).  According to the Act, Schedule 4 medications can be administered by a nurse as long as a medical practitioner has reviewed the patient and given written patient-specific directions to the nurse.

Can nurses prescribe Botox and other injectables in Australia?

Regarding the prescription of Botox and dermal fillers such as Restylane, nurses are not allowed to  prescribe such medications.  Nurses in Australia have limited to no prescribing rights and since both Botulinum toxin and hyaluronic acid are considered prescription only medicine, it is not within nurses’ scope of practice to prescribe these substances.

Advertising of Cosmetic Procedures

In Australia, whereas the regulation of cosmetic practice is relatively lax, there are strict guidelines regarding the advertising of such service to the public.  The TGA has produced a concise document that states clearly that “advertising of prescription-only products to consumers is illegal.”  This issue is defined under the Therapeutic Goods Act 1989.  The TGA guideline also includes dermal fillers under products which are not allowed to be advertised since they fall under Schedule 4 of the Poisons Standard (prescription only medicine).

The TGA defines that general terms such as “anti-wrinkle injections”, “cosmetic injections”, etc., are allowed, as long as specific medications or ingredients are not mentioned.

Botox Training in Australia

As mentioned above, both according to the Department of Health and according to the ACCS, nurses need to be adequately trained to administer cosmetic procedures.  You can find out more about Botox Training for nurses in Australia.

 

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