TITLE
16 OCCUPATIONAL AND
PROFESSIONAL LICENSING
CHAPTER
12 NURSING AND HEALTH CARE RELATED
PROVIDERS
PART
14 NURSING PRACTICE IN AESTHETIC
HEALTHCARE FACILITIES
16.12.14.1 ISSUING AGENCY: New Mexico Board of Nursing.
[16.12.14.1 NMAC - N, 5/21/2024]
16.12.14.2 SCOPE: These rules apply to individuals
licensed by the board who are providing health care in aesthetic healthcare facilities.
[16.12.14.2
NMAC - N, 5/21/2024]
16.12.14.3 STATUTORY AUTHORITY: These rules are promulgated pursuant to
the Nursing Practice Act, Sections 61-3-1 to -30 NMSA 1978.
[16.12.14.3
NMAC - N, 5/21/2024]
16.12.14.4 DURATION: Permanent.
[16.12.14.4
NMAC - N, 5/21/2024]
16.12.14.5 EFFECTIVE DATE: May 21, 2024, unless a later date is cited at
the end of a section.
[16.12.14.5
NMAC - N, 5/21/2024]
16.12.14.6 OBJECTIVE: To promote, preserve, and protect the health, safety,
and welfare of the public and provide direction to licensees providing health
care in aesthetic healthcare facilities.
[16.12.14.6
NMAC - N, 5/21/2024]
16.12.14.7 DEFINITIONS:
A. “Definitions beginning with “A”:
(1) “Aesthetic healthcare procedure”
means a non-surgical procedure that stimulates, alters, or destroys living
tissue, with the intent to enhance appearance of skin and improve the patient’s
health and sense of wellness. This does
not include procedures that affect only the non-living stratum corneum surface
of the skin, does not affect living tissue and does not require the direction
of a licensed independent practitioner as defined in these rules or in other
accepted professional standards; and may include the practice of cosmetology or
other licensed or unlicensed services not regulated by the New Mexico board of
nursing. Examples of aesthetic
healthcare procedures include, but are not limited to, the following forms of
procedures or use of related devices:
(a) laser or energy-based skin and hair
removal;
(b) intense pulsed light;
(c) ultrasonic devices;
(d) radio frequency devices;
(e) heating or cryolipolysis
devices;
(f) electrical stimulation;
(g) micro-needling of any depth;
(h) injection of soft tissue fillers,
polydioxanone (PDO) threads or neuromodulators;
(i) intravenous
(IV) therapy;
(j) dermabrasion beneath the stratum
corneum;
(k) medium-depth chemical peels (beneath
the stratum corneum);
(l) hormone replacement therapy -
insertion of hormone pellets into subcutaneous tissue.
(2) “APRN” means advanced
practice registered nurse.
(3) “Aesthetic healthcare facility”
means a business or other practice that provides aesthetic healthcare procedures to the general public.
B. “Definitions beginning with “B”: [RESERVED]
C. “Definitions beginning with “C”: “Clinical supervisor” which may also
be referred to as a “clinical director”, means a licensed independent
practitioner, regardless of employment title, who has appropriate knowledge,
skills, and training to perform all procedures provided at the aesthetic
healthcare facility they are practicing at, and who is responsible for
supervising or directing all aspects of the facilities clinical practice,
including protocols, healthcare procedures, policy, and clinical staff.
D. “Definitions beginning with “D”: “Direct supervision” means
supervision by a licensed independent practitioner who is physically in the aesthetic
healthcare facility, and immediately available to provide in-person clinical
supervision and direction during the entire time of an aesthetic healthcare
procedure.
E. “Definitions beginning with “E”: [RESERVED]
F. “Definitions beginning with “F”: [RESERVED]
G. “Definitions beginning with “G”: [RESERVED]
H. “Definitions beginning with “H”: [RESERVED]
I. “Definitions beginning with “I”: “Indirect supervision” means
supervision by a licensed independent practitioner who is available outside of
the aesthetic healthcare facility, but within a reasonably close distance and
on-call, to immediately respond and provide verbal clinical supervision and
direction, and travel to the aesthetic healthcare facility as needed.
J. “Definitions beginning with “J”: [RESERVED]
K. “Definitions beginning with “K”: [RESERVED]
L. “Definitions beginning with “L”:
(1) “Licensed independent practitioner” means an APRN
or other licensed advanced practice health care practitioner who can
independently perform aesthetic healthcare procedures and serve as a clinical
supervisor.
(2) “licensee” means an individual
licensed by the New Mexico board of nursing.
(3) “LPN”
means licensed practical nurse.
M. “Definitions beginning with “M”: [RESERVED]
N. “Definitions beginning with “N”: [RESERVED]
O. “Definitions beginning with “O”: [RESERVED]
P. “Definitions beginning with “P”: [RESERVED]
Q. “Definitions beginning with “Q”: [RESERVED]
R. “Definitions beginning with “R”: “RN” means registered nurse.
S. “Definitions beginning with “S”: [RESERVED]
T. “Definitions beginning with “T”: “Treatment plan” means a
healthcare record that provides the diagnosis and planned treatment of a
patient.
U. “Definitions beginning with “U”: [RESERVED]
V. “Definitions beginning with “V”: [RESERVED]
W. “Definitions beginning with “W”: [RESERVED]
X. “Definitions beginning with “X”: [RESERVED]
Y. “Definitions beginning with “Y”: [RESERVED]
Z. “Definitions beginning with “Z”: [RESERVED]
[16.12.14.7
NMAC - N, 5/21/2024]
16.12.14.8 EDUCATION AND SCOPE OF PRACTICE:
A. Licensees, including APRNs, RNs and LPNs, who directly or
collaboratively provide aesthetic healthcare procedures in non-traditional
facilities not licensed by any state regulatory body specifically to provide
aesthetic healthcare procedures are required to maintain any combination of
education, clinical experience, certification, and supervision appropriate to ensure
the ongoing safety of patients and other staff.
Given the non-traditional nature of these facilities, licensees must be
proactive in maintaining the knowledge and skills necessary to perform and
assist with aesthetic healthcare procedures and work within their scope of
practice.
B. Licensees may work in an aesthetic healthcare facility
only if the facility employs a
clinical
supervisor who is an APRN or other licensed independent healthcare practitioner
reasonably known to
possess
the appropriate education, training, and skills to safely perform all aesthetic
healthcare procedures offered in the facility.
C. Licensees in any practice setting must have appropriate
training in the specific treatments they provide, as required by board rule
16.12.2 NMAC. When assuming
non-traditional specific functions and procedures which are beyond the licensee’s
basic educational preparation, licensees are responsibility for obtaining
reasonably appropriate knowledge, skills, and supervision to ensure safe and
competent performance of the function or procedure. Specific education and training components for
aesthetic healthcare procedures shall include but are not limited to, a
combination of practical and didactic instruction; national aesthetic certification;
techniques and theories; identifying and addressing complications and adverse events;
and charting and record keeping.
D. Scope of practice for APRNs may include aesthetic
healthcare procedures with the appropriate population foci,
licensure, national APRN certification and education.
E. Scope of practice for RNs may include
aesthetic healthcare procedures with the appropriate education and training
only if delegated by, and under the indirect supervision of an APRN or other clinical supervisor.
F. Scope of practice for LPNs may include aesthetic healthcare
procedures with the appropriate education and training, only if delegated by,
and under the direct supervision of an APRN or other
clinical supervisor. However, LPNs may
not perform aesthetic injections. LPNs
performing certain non-healthcare aesthetic procedures may be required to
obtain additional licensure from the New Mexico board of barbers and
cosmetologists. Independent healthcare decisions are not within the scope of
practice for LPNs.
[16.12.14.8
NMAC - N, 5/21/2024]
16.12.14.9 CLINICAL SUPERVISOR:
A. An APRN may serve as a clinical
supervisor in an aesthetic healthcare facility with the appropriate population foci, licensure, national APRN certification and education. An RN or LPN may not serve as a clinical
supervisor in an aesthetic healthcare facility.
B. An APRN serving as a clinical supervisor is responsible for
supervising all aesthetic healthcare procedures performed at the aesthetic
healthcare facility, which may include but are not limited to the following:
(1) possesses the appropriate education,
training, experience, competence, and ongoing education, to safely administer,
delegate, and supervise each aesthetic healthcare procedure;
(2) accepts responsibility for the safety
of the patients treated at the aesthetic healthcare facility;
(3) ensures that staff who perform or
assist with aesthetic healthcare procedures are trained and qualified;
(4) ensures that necessary equipment and
supplies, including those needed to address healthcare complications and
emergencies, are readily available, maintained and safely stored; and
(5) develops or approves and implements
written protocols for all aesthetic healthcare procedures performed at the aesthetic
healthcare facility. The protocols must
provide sufficient and specific details, including guidance on identifying and
responding to adverse events, to assure that making independent healthcare
decisions does not become the responsibility of individuals without the
appropriate scope of practice to make such decisions.
[16.12.14.9
NMAC - N, 5/21/2024]
16.12.14.10 PATIENT CARE:
A. Licensees providing aesthetic healthcare procedures
or related health care must establish a valid practitioner-patient relationship
and are subject to all ethical, legal, and practical obligations of such
relationship.
B. Prior to a licensee providing any aesthetic healthcare
procedure, an APRN or other licensed independent practitioner must conduct an
assessment in a face-to-face examination, determine a diagnosis and prescribe a
treatment plan for the patient. The APRN or other licensed independent
practitioner may never delegate the examination, diagnosis, or treatment plan.
(1) The initial examination must consist
of a review of the patient’s health history, and a physical examination that
includes treatment sites, and the determination of a diagnosis.
(2) The treatment plan should ensure that
the patient is a good candidate for each aesthetic healthcare procedure and must
include instruction on doses, device settings, expected duration, and specific
treatment sites.
C. Face-to-face examination by an
APRN or other licensed independent healthcare providers is required for
ongoing patients at least once every 12 months but is not required before each
visit unless there is a change in the patient’s health status or treatment
plan.
D. Telemedicine may be used by an APRN or other licensed
independent healthcare providers for assessment and face-to-face examinations
provided that such use complies with any applicable state and federal law and
that the quality of the video examination does not adversely affect the
face-to-face assessment or diagnosis.
E. Delegation of healthcare and non-healthcare duties to
licensed or unlicensed individuals must be done with care and only when the
licensee has ascertained that the scope of practice, education, training, and
experience of the individual is appropriate and sufficient to provide adequate
care to the patient. The delegating licensee must take into consideration
that individuals with the same license may not have the same qualifications or
competencies. Delegation of aesthetic
healthcare procedures cannot be delegated by a licensee to any individual who
is not licensed in a healthcare profession.
[16.12.14.10
NMAC - N, 5/21/2024]
16.12.14.11 PATIENT RECORDS, CONFIDENTIALTIY, AND
ADVERTISING:
A. Every patient encounter in an aesthetic healthcare facility must generate
a healthcare record.
B. Individuals receiving aesthetic healthcare procedures
from licensees in an aesthetic healthcare facility are considered patients and
care must be provided to ensure confidentiality of patient information and healthcare
records.
C. Use of patient information, including images, is subject
to HIPAA and other legal protections, and use of such information must be
authorized by the patient.
D. Advertising and marketing of aesthetic healthcare
procedures is regulated and may not be deceptive, false, or misleading. Licensees
must only use references to their active license and shall not represent to
offer services that they do not hold an active license to provide.
E. Licensees working at an aesthetic healthcare facility who
are aware of misuse of patient information or advertising have an obligation to
protect patient confidentiality and take reasonable steps to address such
issues with the clinical supervisor or other management.
[16.12.14.11
NMAC - N, 5/21/2024]
HISTORY OF 16.12.14
NMAC: [RESERVED]