2023 -- H 5868

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LC002178

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSES

     Introduced By: Representatives Felix, Bennett, Cruz, and Spears

     Date Introduced: March 01, 2023

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby amended by

adding thereto the following section:

     5-34-50. Performance of cosmetic/aesthetic dermatological procedures..

     (a) The board of nursing shall promulgate rules and regulations for the performance of

cosmetic/aesthetic dermatological procedures. As used in this section, "cosmetic/aesthetic

dermatological procedures" means a broad range of procedures including, but not limited to, the

following:

     (1) Chemical peels - Micro-dermabrasion;

     (2) Sclerotherapy - Laser for aesthetics, hair removal;

     (3) Micropigmentation;

     (4) Light treatments;

     (5) Platelet rich plasma;

     (6) Neuromodulator and dermal filler injections (e.g., Botox, Restalyne, Collagen,

Kybella); and

     (7) Non-ablative, non-vaporizing laser or light-based devices used for hair removal,

photorejuvenation, acne, spider veins, vascular and pigmented lesions, and tattoo removal.

     (b) Registered nurses shall be allowed to perform cosmetic/aesthetic dermatological

procedures pursuant to the orders of a duly authorized prescriber in accordance with the rules and

regulations promulgated by the board of nursing.

     (c) In promulgating rules and regulations, the board of nursing shall address, but not be

limited to, the following:

     (1) The orders from a duly authorized prescriber to include the patient's name, valid order

date, medication or substance name, dosage, route, anatomical site for administration, specific

administration directions and prescriber signature;

     (2) The documented knowledge, skill and competency necessary to carry out the

cosmetic/aesthetic dermatological procedure in a safe manner;

     (3) The employing agency's cosmetic/aesthetic dermatological and emergency policies and

procedures available in the facility;

     (4) The required education to include a supervised practicum resulting in a competency

evaluation commensurate with the procedure. Components of the education include, as appropriate

to the specific procedure, but are not limited to:

     (i) Anatomy and physiology;

     (ii) Pathophysiology of the integumentary system and supporting structures;

     (iii) Cosmological and dermatologic conditions;

     (iv) Wound healing principles;

     (v) Safe use of product/device/equipment;

     (vi) Side effects and management;

     (vii) Management of emergencies; and

     (viii) Patient and environmental safety.

     (5) When the procedure includes the use of non-ablative, non-vaporizing laser or light-

based devices, the requirement that the nurse have evidence of successful completion of a laser

physics and safety course that includes relative content from the Occupational Safety and Health

Administration (OSHA) and American National Standards for the Safe Use and Handling of Lasers

in Health Care Facilities (ANSI) that includes both a didactic portion and practicum;

     (6) Documentation criteria including the following:

     (i) Review and verification of informed consent that clearly informs the patient of the

operator's qualifications, licensure, and expected outcomes of the procedure;

     (ii) Assessment data inclusive of past medical, surgical, allergy and medication histories;

     (ii) Skin typing/classification;

     (iv) Sun exposure history;

     (v) Current cosmetic/dermatologic product usage;

     (vi) Exclusion from treatment criteria;

     (vii) Identification of and evaluation of test site as indicated;

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     (viii) Specifics of the procedure performed and patient response to the procedure;

     (ix) Directions for referral back to or consultation with the duly authorized prescriber of

the procedure; and

     (x) Provision to the patient of written pre- and post-procedure education which includes,

but is not limited to, self-care instructions and follow-up recommendations inclusive of continued

and emergent care needs.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSES

***

     This act would allow registered nurses to perform cosmetic/aesthetic dermatological

procedures as prescribed or ordered by a licensed health care practitioner in accordance with rules

and regulations promulgated by the board of nursing.

     This act would take effect upon passage.

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