Grundy Quinn, Rudner Nancy, Klein Tracy, Ladd Elissa, Hart Dana, MacIsaac Meghan, Bero Lisa
Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
J Am Assoc Nurse Pract. 2025 Jan 1;37(1):51-60. doi: 10.1097/JXX.0000000000001077.
With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website.
To gauge APRNs' familiarity with, and perceptions of the Open Payments database and discuss whether and how APRNs should respond.
Virtual workshops consisting of a didactic presentation and interactive exercises with APRNs recruited through professional networks, associations, and conferences. Transcripts were analyzed using a qualitative interpretive approach, grounded in an everyday ethics theoretical framework.
Thirty-six APRN clinicians, students, and faculty participated in nine workshops. Seeing sponsored meals reported in Open Payments as "payments" prompted participants to see familiar interactions in a new way. Participants valued the enhanced transparency as a way to identify risks of bias but were concerned that reporting might undermine public trust in APRNs. Emphasizing awareness as a precursor to action, participants desired greater preparation for ensuring independence in practice.
The importance of tackling the ethical issues associated with industry interactions is heightened within the context of an existing climate of distrust within health care. However, many participants were concerned about the effects of transparency on public trust rather than how APRNs individually or collectively can be more trustworthy.
Open Payments can serve as a useful tool to catalyze broader conversations about ethics, integrity in decision making, and health policy advocacy.
随着高级实践注册护士（APRN）专业自主权和处方权的扩大，他们与行业的互动受到了更严格的审查。截至2021年7月1日，制药和医疗器械公司必须通过医疗保险和医疗补助服务中心的“公开支付”网站公开报告向APRN的所有付款。
评估APRN对“公开支付”数据库的熟悉程度和看法，并讨论APRN是否以及应如何做出回应。
通过专业网络、协会和会议招募APRN，举办由教学演示和互动练习组成的虚拟研讨会。使用基于日常伦理理论框架的定性解释方法对会议记录进行分析。
36名APRN临床医生、学生和教师参加了9次研讨会。将“公开支付”中报告的赞助餐视为“付款”，促使参与者以新的方式看待熟悉的互动。参与者重视提高透明度，认为这是识别偏见风险的一种方式，但担心报告会损害公众对APRN的信任。参与者强调意识是行动的前提，希望为确保实践中的独立性做好更多准备。
在医疗保健领域现有的不信任氛围背景下，解决与行业互动相关的伦理问题的重要性更加凸显。然而，许多参与者担心透明度对公众信任的影响，而不是APRN个人或集体如何能够更值得信赖。
“公开支付”可以作为一个有用工具来推动关于伦理、决策诚信和健康政策倡导等更广泛的对话。
