Title : Improving nurse competency in vascular occlusion prevention and management

Background: Vascular occlusion is a rare, but serious complication of dermal filler injections that can lead to severe adverse outcomes, including tissue necrosis and vision loss. As the demand for minimally invasive cosmetic procedures increases, proper nurse education and preparedness in managing vascular complications remain essential to ensuring patient safety.

Purpose: To evaluate the effectiveness of a structured educational session combined with simulation-based training on nurses’ knowledge, confidence, and clinical competency in recognizing and managing vascular occlusion associated with dermal filler injections. 

Methods: A pretest-posttest educational intervention design was used. Four registered nurses (N=4) employed at a medical spa participated voluntarily. The intervention consisted of an in person educational session covering facial vascular anatomy, safe injection techniques, and vascular occlusion management protocols, followed by a simulation training. Outcomes were measured using a 7-item multiple choice knowledge assessment, a 10-item Likert-scale confidence survey, and a competency based simulation checklist evaluated across five clinical skills. 

Results: Mean knowledge scores increased from 5.25 to 6.75 out of 7 following the intervention. Mean confidence scores increased from 3.25 to 4.85 on a 5-point scale, reflecting a mean increase of 1.60 points. All four participants demonstrated full competency across all five simulation checklist criteria.

Conclusion: A structured educational session combined with simulation-based training effectively improved nurses’ knowledge, confidence, and competency in vascular occlusion management. 

Keywords: Dermal Fillers, Vascular Occlusion, Simulation-Based Training, Hyaluronidase, Nurse Competency, Cosmetic Injections, Patient Safety

Arielle Madayag is a registered nurse injector practicing in the San Diego region with a passion for helping patients feel confident, refreshed, and naturally beautiful in their own skin. She specializes in cosmetic injectables with a focus on subtle, balanced results that enhance each patient’s natural features rather than change them.

She values building strong relationships with her patients and creating an experience where they feel comfortable, heard, and cared for throughout their aesthetic treatment goals.

Arielle is currently completing her Doctor of Nursing Practice, Family Nurse Practitioner (FNP) degree at the University of San Diego, further strengthening her clinical foundation and commitment to evidenced-based care within the growing medical spa industry.