Exploring the Interactions Between Nurses and Industry in Clinical Practice

项目摘要/摘要 卫生专业人员和行业之间的关系所产生的利益冲突正在受到 由于它们可能对患者护理的成本、质量和安全产生有害影响，因此引起了更多的关注 卫生专业人员的诚信和公众信任。1这一现象在 医生；然而，在注册护士(RN)中很少有研究。越来越多的文学作品 表明医生对与制药行业的关系持积极态度，并 这些关系与处方实践中的有害变化有关。2-4家制药公司 继续将超过三分之一的营销预算用于与卫生专业人员的互动，建议 这些互动被认为是推销产品的有效手段 最近的立法要求披露向医生和教学医院支付的所有礼物和付款 6然而，立法省略了护士，包括具有处方权力的护士。 由于政策继续限制行业对医生的准入，以及RNS对治疗和 购买决策的增长，RN可能会在其临床实践中越来越多地受到营销的影响 容易受到利益冲突的影响。7.需要进行研究以了解RN与行业的互动，以便 可以制定相关和有效的政策，以确保患者护理的质量和安全。 这项研究是多地点的，因为将有目的地选择3-4个医疗保健环境，以反映 行业关系、政策选项和雇主类型。这项描述性研究将利用从以下地点收集的数据 四个来源：1)有针对性地观察护士与行业的互动；2)RN的焦点小组；3)个人 对护士行业互动有直接经验的个人进行采访；以及4)相关 文档分析。解释现象学将被用作分析方法。这种方法论 将有助于理解上下文中的这些相互作用并考虑到社会规范， 行业关系的制约和促进者。这些定性的方法将有助于理解这些 复杂的社会关系以及文化规范、制度结构和历史如何影响护士行业 临床实践中的相互作用。 这项研究将产生关于一个未被研究的现象的新知识，并可能对 卫生保健服务的质量、安全性和成本。

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.