Establishments and independent licensees providing advanced esthetic

32-03-01-10.2. Establishments and independent licensees providing advanced esthetic procedures. Authorization to perform procedures. Advanced esthetic procedures may be performed only by advanced estheticians licensed under North Dakota Century Code chapter 43-11 who possess any applicable certifications required by law or rule. 1. Facility requirements. Advanced esthetic procedures must be performed in a room that: a. That is enclosed by floor-to-ceiling walls and a door; b. That is physically separated from any area used for hair or nail services; c. In which no food or beverages may be consumed by any person in the room; and d. In which devices, instruments, and supplies are properly cleaned and stored. Operational and personnel records must be maintained and made available to the board upon request. 2. Equipment and instrumentation. Device tips must be single use only. Once affixed to a handpiece, a device tip must not be removed and reused. Whether used or unused, the tip shall be disposed of in an appropriate waste container. All reusable instruments and equipment must be cleaned and disinfected in accordance with the manufacturer's instructions and applicable state and federal guidelines. 3. Laser procedures. Establishments or independent licensees performing nonablative laser procedures shall develop and maintain a laser safety program consistent with the American national standards institute Z136.3 guidelines. The laser safety program must be in writing and made available to the board upon request. 4. Information and disclosure. Educational and aftercare information must be readily available. Each client must be provided with written appropriate aftercare instructions, and include at minimum: a. The name, address, and telephone number of the establishment and licensee; and b. A statement advising the client to seek medical attention if necessary. 5 5. Recordkeeping requirements. Records must be maintained for all clients receiving advanced esthetic procedures for a period of no fewer than three years. Records must be stored securely in either physical or digital format to prevent unauthorized access. Each client record must include, at a minimum: a. A signed informed consent specific to the procedure performed; b. The date, type, and area of the procedure performed; c. The name and license number of the performing licensee; d. Relevant medical history and screening for contraindications; e. Acknowledgment of risks associated with the procedure; and f. Documentation of any adverse event and actions taken. 6. Infection control and safety protocols. Establishments and independent licensees shall implement a written safety plan addressing at minimum: a. Protection of clients and personnel from bloodborne pathogens; b. Handling, storage, and disposal of regulated waste; c. Disinfection and sterilization of reusable instruments; d. Use of single-use disposable instruments if appropriate; e. Procedures for minimizing cross-contamination; and f. Equipment maintenance and service logs. The infection control plan must comply with the occupational safety and health administration standard 29 CFR 1910.1030 and include: a. An exposure control plan; b. Safety data sheets for all regulated products; c. Regulated waste pickup receipts; and d. Red bag documentation if applicable. 7. Emergency preparedness. Establishments or independent licensees shall develop and maintain written protocols for responding to common adverse events associated with advanced esthetic procedures, including: a. Allergic reactions; b. Burns; c. Excessive bleeding; and d. Chemical or product-related sensitivities. Protocols must: a. Be posted in a conspicuous location within the procedure room; 6 b. Include emergency contact information, including supervising health care provider if applicable; c. Ensure availability of first-aid supplies appropriate to the procedures performed; d. Be reviewed and understood by all personnel involved in advanced esthetic procedures. 8. Adverse event reporting. Any licensee or establishment aware of a serious adverse event resulting from an advanced esthetic procedure shall report such event to the board within ten business days. Serious adverse events requiring mandatory reporting include: a. Any outcome requiring medical or surgical intervention beyond routine aftercare; b. Second degree or higher burns; c. Significant or atypical scarring; d. Infection requiring prescription medication; e. Pigmentary changes requiring medical intervention; f. Hospitalization due to the procedure; and g. Permanent injury or disfigurement. Reports must be submitted on a form provided by the board and must include: a. Client initials or unique identifier, age, and gender; b. Date of procedure and date the event was discovered; c. Type of procedure and products or devices used; d. Name and license number of the performing licensee; e. Supervising physician's name, if applicable; f. Description of the event and body area affected; g. Interventions performed and followup actions taken; and h. Known medical treatment received by the client outside the facility. Client confidentiality must be preserved in all reports. Identifying information beyond initials or unique identifiers must not be submitted unless specifically requested by the board as part of an official investigation. All reporting must comply with applicable state open records laws. History: Effective January 1, 2026. General Authority: NDCC 43-11-05 Law Implemented: NDCC 43-11-15