The following article was issued by the Nursing and Midwifery Council in November 2007. It states how and who should be allowed to administer and treat with Botox for use as a muscle relaxing injection.
The primary function of the Nursing and Midwifery Council (NMC) is to ‘protect the public’ by setting professional standards and giving advice and guidance to registered nurses,
midwives and specialist community public health nurses (registrants).
The NMC code of professional conduct: standards for conduct, performance and ethics (the Code) is designed either to be used on its own or in conjunction with other NMC guidelines.
When used with these other guidelines, the Code is a effective tool that leads to a much greater understanding of the principles of providing nursing and midwifery care. Registrants have a responsibility to deliver safe and effective care based on current evidence, best practice, and where applicable, validated research.
The Nursing and Midwifery Council (NMC) considers the administration of botulinum toxin from a Patient Group Direction (PGD), or a Patient Specific Direction (PSD) that has been signed remotely by a medical practitioner or by an independent prescriber who has not assessed the patient, is
contrary to the guidance issued within Standards for Medicine Management (2007):
The administration of botulinum toxin should only be administered following a comprehensive assessment of the patient by a registered prescriber and a prescription of botulinum toxin being written and signed for by the registered prescriber. The prescription should state the drug, dose strength and quantity. The nurse or midwife should practise to all the NMC standards of medicines management that apply. Prior to administration, all actions should be documented and the patient informed as to what to expect and whom to contact should they have any questions. Botulinum toxin like all medicines has the potential to give rise to side effects and adverse reactions. If a nurse or midwife administers this from a remote prescription they are jointly accountable for this action. If a reaction occurs, although the prescriber would be liable for prescribing the drug the nurse or midwife would be accountable for their assessment of the patient and the administration of the drug.
All nurses and midwives should refer to:
Administering medication from a remote prescription/direction to administer Standard 11 (Standards for Medicine Management (2007):
In exceptional circumstances, where medication (NOT including controlled drugs) has been previously prescribed and the prescriber is unable to issue a new prescription, but where changes to the dose are considered necessary, the use of information technology (such as fax, text message or email) may be used but must confirm any change to the original prescription. This makes it clear that remote prescribing should only be used in exceptional circumstances and therefore not as a routine means to administer botulinum toxin.