Exploring the Interactions Between Nurses and Industry in Clinical Practice

项目总结/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 由于其可能对患者护理的成本、质量和安全产生有害影响， 卫生行业的诚信和公众信任。1这一现象已被广泛研究， 然而，它在注册护士（RNs）中的研究很少。越来越多的文献 表明医生对与制药业的关系持积极态度， 这些关系与处方实践中的有害变化有关。2 - 4制药公司 继续将超过三分之一的营销预算用于与健康专业人员的互动，这表明 这些互动被视为推销产品的有效手段。 最近的立法要求披露所有的礼物和支付给医生和教学医院， 6然而，立法忽略了护士，包括那些具有规定权力的护士。 由于政策继续限制行业获得医生，以及RNs对治疗和 购买决策的增长，RN可能会越来越多地暴露于营销在他们的临床实践， 7，8需要进行研究，以了解注册护士与行业的互动， 可以制定相关和有效的政策，以确保病人护理的质量和安全。 该研究是多地点的，因为将有目的地选择3 - 4个医疗机构，以反映 行业关系政策选择和雇主类型。这项描述性研究将利用从以下方面收集的数据： 四个来源：1）有针对性地观察护士与行业的互动; 2）与RN的焦点小组; 3）个人 与有护士行业互动直接经验的个人进行访谈;以及4）相关 文件分析。解释现象学将被用作分析方法。这种方法 将有助于理解这些相互作用的背景，并考虑到社会规范， 行业关系的制约因素和促进因素。这些定性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 临床实践中的互动。 这项研究将产生关于一个未充分研究的现象的新知识， 医疗服务的质量、安全和成本。

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.