A nurse has been found guilty of professional misconduct and her licensed suspended for three months after she administered Botox and other cosmetic injections to customers at a day spa, in North Sydney.

The NSW Civil and Administrative Tribunal handed down its decision last week, in a move that is likely to ripple through the cosmetic surgery industry, according to reports in Fairfax.

Under a protocol established in 2005, cosmetic injections such as Botox, which is restricted under Schedule 4 of the Poisons List, and dermal fillers are meant to be supervised by a medical practitioner.

The procedure is often offered by day spas in Sydney and several advertise that a doctor is onsite. However, it is unclear whether unsupervised administration in day spas is common.

The nurse, Rosalie Piper, had worked in cosmetic surgery for 10 years. She worked at a clinic at Epping one day a week and in a day spa at Collaroy.

The tribunal found Ms Piper entered into an arrangement with a medical practitioner, Peter Haertsch, who ordered supplies of Botox and dermal fillers that Ms Piper administered to patients both at the doctor’s surgery and the day spa, according to reports in Fairfax

“The nurse reimbursed Dr Haertsch for the medications with a sizeable share of the fee she received from the patients receiving the injections from her,” the tribunal said.

Between 2009 and 2011, Ms Piper treated 29 patients at the doctor’s practice and 97 patients at the day spa.

The tribunal noted evidence from Dr Haertsch that, when Ms Piper began working at his clinic, she adopted a system that had been in place for 18 years, and that most clients had been treated by the previous nurse.

“While she would not have been able to have engaged in such conduct without the restricted substances supplied by Dr Haertsch, the tribunal does not consider the nurse took sufficient responsibility to ensure that she was operating within the terms of the law,” it said.

“The tribunal is particularly concerned about the nurse’s treatment of patients at the day spa, given there was not even the possibility for a medical practitioner to become involved in the management plan and treatment of those patients.”