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Administering Botox

As an RN, can I administer botulinum toxin (e.g. Botox)?

Yes, you may administer botulinum toxin if there is an appropriate order in place.  Administering botulinum toxin falls under the controlled act of administering a substance by injection. This is one of the controlled acts that RNs and RPNs are allowed to perform with an order from an authorized health care professional, such as a NP or physician.

What if I work in an independent practice setting? Can I still administer botulinum toxin?

You may still be able to administer botulinum toxin in independent practice settings with proper authorization. RNs and RPNs need to work in a practice setting or collaborate with at least one prescriber, such as an NP or physician, to obtain the proper authorization to perform the procedure.

What should I consider when determining if I should administer botulinum toxin? 

Having the authority to perform a procedure does not necessarily mean it is appropriate to do so. For example, the Medication practice standard requires you to consider the patient, the medication and the environment when assessing if it is appropriate to administer a drug.

CNO’s Medication and Decisions About Procedures and Authority practice standards both contain decision trees that can help you decide whether you should administer a medication and perform a procedure. They ask questions such as:  

  • Are you the appropriate care provider to perform this procedure?
  • Is there an order in place?
  •  Is the order clear, complete and appropriate?
  • Do you have the knowledge, skill and judgment to perform and manage any adverse outcomes?
  • Is this medication appropriate for your patient?
  • Does your patient consent to the procedure? 
  • Is this procedure routinely performed in your practice setting
  • Do you have the resources available to monitor and intervene if needed?

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Page last reviewed July 21, 2021