Dru Riddle, PhD, DNP, CRNA, FAAN, president-elect of the American Association of Nurse Anesthesiology (AANA), is part of a group of researchers that recently received a $1 million grant to study racial health equity. The grant, awarded by the Robert Wood Johnson Foundation, positions Certified Registered Nurse Anesthetists (CRNAs) at the forefront of driving national healthcare policy.
“As a CRNA, I see firsthand when racial health inequity impacts outcomes for patients,” Riddle said. “This research isn’t anesthesia-specific, but in anesthesia, we deal with the whole continuum of care. It would be life-changing for our patients if their outcomes can be improved because of a better understanding of delivering anesthesia care in the context of certain racial health equities and inequities.”
Riddle said CRNAs see the impacts of racial health inequities in all areas of care, but especially in maternal outcomes and access to care for minority populations. For example, according to the Centers for Disease Control and Prevention (CDC), Black women are three times more likely to die from a pregnancy-related cause than white women. Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. As part of the maternal healthcare team, CRNAs are uniquely positioned as providers to understand and advise on disparities in healthcare related to race.
“CRNAs are at the intersection of several sectors of healthcare coming together all at one point,” Riddle said. “What we do in anesthesia is critical in the sense of prioritizing a patient’s medical problems and understanding the risk in anesthesia delivery associated with comorbidities like diabetes or high blood pressure. We tailor an anesthetic to get them safely through a surgical procedure and then make sure we do things to encourage them to have a good recovery. We think about pain control, early mobility, and the things we know help patients recover better.”
Nurse anesthetists are the only advanced practice provider with a minimum of one year of critical care experience prior to beginning their anesthesia training. They practice in every setting in which anesthesia is delivered, including traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; dentist’s and doctor’s offices; the U.S. military; and more.
The goals of the group’s research include creating guidelines, developing recommendations for practice that take into account structural racism, and prioritizing research topics to advance racial health equity. The research began Oct. 1 and will continue through Sept. 30, 2023.
“The big outcome of this research is creating a national consensus on the way the United States deals with structural racism and racial health equity in research: in guidelines, in practice recommendations, and in health outcomes,” Riddle said.
Riddle, an associate professor in the nurse anesthesia program at Texas Christian University, is the principal investigator for the members and partners of the Cochrane US Network. Other researchers include Dr. Meera Viswanathan (RTI International), Dr. Vivian Welch (Campbell Collaboration), Dr. Patricia Heyn (Marymount University), Dr. Damian Francis (Georgia College), and Tiffany Duque (Cochrane). The CDC is also a partner in the research. The $1 million award is the largest to date for the Cochrane US Network, which was established in 2019.
Cochrane is an international evidence-based practice and research collaboration based in London. The Cochrane US Network works together to produce healthcare evidence and recommendations for best practices, as well as participating in systematic reviews of research. According to Cochrane, systematic reviews are a way of reviewing all the data and results from research about a particular question in a standardized way. They help give an objective and transparent overview of all evidence surrounding a particular research question. Systematic reviews are internationally recognized as the highest standard in evidence-based healthcare.
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