DNP Project Idea: Development of a Patient-Reported Outcome Measurement System (PROMs) in Cosmetic Nursing

Background

In cosmetic nursing and aesthetic procedures, elective treatments such as neurotoxin injections, dermal fillers, and laser therapies are primarily driven by patient satisfaction and quality of life improvements. However, standardized, systematic measurement of patient-reported outcomes remains limited. Clinics often rely on informal feedback, anecdotal reports, or online reviews, which may not capture comprehensive or accurate insights into patient experience and satisfaction. This gap undermines the ability to tailor treatments, improve patient retention, and provide evidence-based quality care.

Validated patient-reported outcome measurement tools, such as the FACE-Q, have been developed specifically for aesthetic procedures but are often underutilized in routine clinical practice. Integrating such tools into pre- and post-procedure workflows and leveraging electronic health record (EHR) systems to automate data collection could enhance clinical decision-making and patient engagement.

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Project Objectives

1. Implement a validated PROM tool (e.g., FACE-Q) tailored to the cosmetic nursing patient population.

2. Develop a workflow for collecting PROM data at key timepoints (pre-procedure, immediate post-procedure, and follow-up visits).

3. Integrate PROM data collection into the clinic’s EHR system to streamline administration and data management.

4. Analyze PROM data to identify patient satisfaction trends, guide individualized treatment planning, and improve patient retention.

5. Educate staff on the importance and use of PROMs in clinical practice.

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Methodology

1. Literature Review & Tool Selection: Conduct a comprehensive review to select the most appropriate PROM instruments validated for cosmetic/aesthetic procedures, focusing on tools like FACE-Q or similar scales measuring satisfaction, appearance-related quality of life, and adverse effects.

2. Adaptation & Customization: Collaborate with stakeholders, including cosmetic nurse practitioners, dermatologists, medical assistants, estheticians, and practice owners to adapt the PROM tool to local patient demographics and clinical workflows.

3. Workflow Design: Map out and pilot workflows for PROM administration at standardized points: before treatment, immediately after treatment, and at follow-up visits (e.g., 1 month, 3 months).

4. EHR Integration: Work with IT specialists to build electronic forms within the EHR platform, allowing patients to complete PROM questionnaires via patient portals or in-clinic tablets.

5. Staff Training: Develop training materials and sessions to ensure nursing staff understand the purpose, administration, and interpretation of PROMs.

6. Data Collection & Analysis: Collect PROM data from a cohort of patients over an 8-week to 3-month period. Use descriptive and inferential statistics to assess satisfaction trends, identify common concerns, and correlate PROM scores with clinical outcomes.

7. Quality Improvement Loop: Use findings to refine treatment protocols, patient education, and follow-up strategies to enhance overall satisfaction and retention.

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Anticipated Outcomes

• Improved systematic collection of patient satisfaction data in cosmetic nursing settings.

• Enhanced patient-centered care informed by real-time feedback.

• Identification of specific procedure-related concerns or areas for clinical improvement.

• Increased patient engagement and retention through responsive treatment planning.

• Creation of a sustainable model for ongoing PROM use in cosmetic practice.

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Significance

This project addresses a critical gap in cosmetic nursing: the lack of structured, evidence-based tools for measuring patient satisfaction and outcomes, and the impact of nurse-led care in aesthetics. By implementing PROMs, cosmetic nurses can elevate the standard of care, demonstrating measurable benefits beyond aesthetic results. This aligns with broader healthcare trends emphasizing patient-centered metrics and quality improvement. Additionally, the integration of PROMs into the EHR promotes efficiency and scalability, potentially serving as a model for other aesthetic practices.

Ultimately, this DNP project empowers advanced practice nurses with actionable data, driving better clinical decisions, improving patient trust and loyalty, and contributing to the professionalization of cosmetic dermatology through rigorous outcomes measurement.

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PhD Research Idea: Longitudinal Study on Neurotoxin and Filler Use in Diverse Populations

Background and Rationale

Cosmetic injectables such as botulinum toxins (neurotoxins) and dermal fillers have become some of the most popular aesthetic procedures worldwide, valued for their minimally invasive approach and immediate cosmetic benefits. However, much of the existing safety and efficacy data has been generated from studies predominantly involving lighter skin types (Fitzpatrick I–III). People with melanin-rich skin (Fitzpatrick IV–VI) and those with certain dermatologic or systemic conditions, including autoimmune diseases like lupus erythematosus, pigmentary disorders like vitiligo, or a genetic predisposition to keloids (conditions that disproportionately impact skin of color), remain underrepresented in the literature.

This lack of data leaves clinicians without clear evidence-based guidelines tailored to these populations, raising concerns about potential differential risks such as pigmentary changes, inflammatory responses, scarring, and other adverse effects unique to these patients. Understanding the long-term safety profile and clinical outcomes of neurotoxin and filler treatments in diverse skin types and comorbidities is critical to advancing equitable, personalized aesthetic care.

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Research Objectives

1. To assess the long-term safety and efficacy of neurotoxin and dermal filler procedures among patients with diverse skin types (Fitzpatrick IV–VI).

2. To characterize and compare the incidence, type, and severity of adverse events, including pigmentary changes, hypertrophic scarring, delayed inflammatory reactions, and other cutaneous side effects.

3. To evaluate procedural outcomes and patient-reported satisfaction over time in individuals with dermatologic comorbidities such as lupus, vitiligo, and keloid-prone phenotypes.

4. To stratify data by skin phototype, underlying comorbidities, and procedural variables (e.g., type of product, injection technique, anatomical site).

5. To generate evidence-based clinical guidelines that promote safer aesthetic practices for diverse patient populations.

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Methodology

1. Study Design: A prospective, longitudinal cohort study enrolling patients presenting for cosmetic neurotoxin and filler treatments at multiple clinical sites with a diverse patient base.

2. Sample Selection: Purposeful sampling to ensure adequate representation of Fitzpatrick IV–VI skin types and patients with relevant comorbid conditions. Inclusion criteria will include adults 18+, with informed consent, and willingness to participate in follow-up assessments.

3. Data Collection:

o Baseline Data: Demographics, medical and dermatologic history, skin phototype classification, comorbidity status, and treatment plan specifics.

o Procedural Data: Type and amount of neurotoxin/filler, injection technique, site(s) treated, practitioner experience.

o Follow-up Assessments: Scheduled at 1 month, 3 months, 6 months, 12 months, and annually thereafter for up to 3–5 years. Assessments include clinical examination, standardized photographs, patient-reported outcome measures, and adverse event surveillance.

o Adverse Event Monitoring: Identification and classification of reactions such as pigmentary alterations (hyper/hypopigmentation), inflammatory nodules, keloids, granulomas, and systemic symptoms.

4. Data Analysis:

o Descriptive statistics to characterize the cohort and incidence of adverse events.

o Comparative analyses (e.g., chi-square, logistic regression) to evaluate associations between skin type, comorbidities, procedural variables, and outcomes.

o Survival analysis for time-to-event data regarding adverse reactions.

o Qualitative analysis of patient-reported experiences and satisfaction.

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Anticipated Outcomes

• A comprehensive safety profile of neurotoxin and filler use in diverse skin types and medically complex patients.

• Identification of specific risk factors linked to adverse cutaneous reactions or suboptimal aesthetic results.

• Evidence-based recommendations to modify procedural techniques, product selection, or patient counseling tailored to high-risk populations.

• Enhanced understanding of long-term patient satisfaction and quality of life following cosmetic injectable treatments.

• Contribution to closing the knowledge gap in cosmetic dermatology for underrepresented groups.

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Significance

This research represents a critical step toward healthcare access in aesthetic nursing and dermatology by addressing the significant underrepresentation of diverse populations in injectable treatment research, particularly nursing research. PhD-prepared nurse scientists are uniquely positioned to lead such interdisciplinary investigations that blend clinical expertise, patient-centered outcomes, and epidemiologic rigor. The findings will inform safer, culturally competent cosmetic nursing practice and influence training curricula, regulatory policies, and industry standards.

By generating high-quality longitudinal data, this study could transform how cosmetic procedures are approached in patients with melanin-rich skin and dermatologic comorbidities, reducing adverse events and improving outcomes. It also elevates the role of nurse scientists as innovators and advocates for inclusive research that drives evidence-based care and ultimately enhances patient safety and satisfaction in the rapidly growing field of cosmetic injectables.

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Recommendation for Cosmetic Nurse Practitioner Entrepreneurs

In today’s rapidly evolving aesthetic landscape, NP who embrace entrepreneurship have a unique opportunity to transform not only their careers but the entire industry. Cosmetic NP entrepreneurs are no longer just providers, we are innovators, educators, and business leaders driving advances in patient care and technology. By leveraging our clinical expertise alongside emerging tools and digital solutions, we can build scalable businesses that improve patient outcomes while creating sustainable, impactful revenue streams.

One promising avenue lies at the intersection of artificial intelligence and personalized aesthetic medicine. Developing AI-driven tools that tailor cosmetic treatment plans to the individual’s unique skin type, concerns, and medical history could revolutionize how practitioners and patients approach aesthetic care. Imagine a software platform that analyzes patient photos and integrates clinical data to recommend optimized treatment protocols, enhancing accuracy, efficiency, and satisfaction.

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AI-Driven Cosmetic Treatment Planning Tool

This innovative business concept involves designing or collaborating on software that uses AI algorithms to deliver customized cosmetic treatment recommendations. Such a tool could be licensed to aesthetic practices or offered directly to patients, positioning the entrepreneur at the forefront of digital health transformation.

First step: Partner with a tech developer or explore existing AI platforms to prototype the core treatment recommendation algorithm.

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Reference

Read the previous article: The Aesthetic Edge: How Nurse Practitioner Entrepreneurs Can Master the 2025 Landscape

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Kimberly Madison, DNP, AGPCNP-BC, WCC

I am a Board-Certified Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research™, I aim to expand access to dermatology research, business acumen, and innovation using artificial intelligence and augmented reality while also leading professional groups and mentoring clinicians. Through engaging and informative social media content and peer-reviewed research, I empower nurses and healthcare professionals to excel in dermatology and improve patient care.

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