Exploring the Interactions Between Nurses and Industry in Clinical Practice

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Project Summary/Abstract Conflicts of interest arising from relationships between health professionals and industry are receiving increased attention due to their potential for harmful impacts on the cost, quality and safety of patient care, the integrity of the health professions and public trust.1 This phenomenon has been widely researched among physicians; however, it has been little studied among Registered Nurses (RNs). A growing body of literature demonstrates that physicians hold favorable attitudes toward relations with the pharmaceutical industry and that these relations are associated with harmful changes in prescribing practice.2-4 Pharmaceutical companies continue to devote over a third of their marketing budgets to interactions with health professionals, suggesting that these interactions are regarded as an effective means for promoting products.5 Recent legislation requires disclosure of all gifts and payments made to physicians and teaching hospitals by medically-related industries.6 However, the legislation omits nurses, including those with prescriptive authority. As policies continue to restrict industry access to physicians, and the influence of RNs on treatment and purchasing decisions grows, RNs may be increasingly exposed to marketing in their clinical practice and susceptible to conflicts of interest.7,8 Research is required to understand RNs' interactions with industry so that relevant and effective policy can be developed to ensure the quality and safety of patient care. The study is multi-sited in that 3-4 healthcare settings will be purposively selected to reflect a spectrum of industry relations policy options and employer types. This descriptive study will draw on data collected from four sources: 1) targeted observation of nurse-industry interactions; 2) focus groups with RNs; 3) individual interviews with individuals that have direct experience of nurse-industry interactions; and 4) relevant documents analysis. Interpretive phenomenology will be employed as the analytic approach. This methodology will be useful in understanding these interactions in context and to take into consideration the social norms, constraints and facilitators of industry relations. These qualitative methods will facilitate understanding of these complex social relations and how cultural norms, institutional structures, and history influence nurse-industry interactions in clinical practice. This research will generate new knowledge about an understudied phenomenon with potential implications for the quality, safety and cost of health care delivery.