Myths, Implicit Bias, and Pain Medication Disparities in Emergency Department Settings: A Systematic Review of the Literature

Abstract

A disparity in healthcare is any preventable difference that impacts a patient's health outcomes. Disparities arise from health inequities which false beliefs, lack of education, and implicit bias can impact. Implicit bias is defined as holding attitudes toward others or associating certain stereotypes with groups of people without our conscious knowledge. Marginalized communities across the United States face a myriad of health inequities due to implicit biases of healthcare providers; one example being pain medication administration rate among patients of color. The registered nurse is vital in protecting patients of color from health disparities perpetuated by the hands of our profession. The CINAHL database was used to conduct a systematic review of the literature to identify reasons that pain medication disparities might occur in Emergency Department settings. It was also utilized to identify evidence-based practices that could be implemented to decrease incidents of implicit bias in the healthcare system. Significant themes are a) Myth perpetuation regarding race and pain, b) Implicit biases of healthcare providers impact pain medication administration rates for patients of color, and c) Educational and nursing leadership-driven protocols regarding implicit biases. The nursing community is in a pivotal position to help mitigate the risk of poor health outcomes associated with pain medication disparities due to healthcare provider-held implicit biases. Nursing educators and hospital leadership must create an environment that recognizes the culture of implicit biases and supports the necessary work to mitigate the negative impact on patient outcomes. Additionally, introducing a comprehensive nursing education curriculum focused on delivering equitable care while promoting a culture of change would allow future nurses to help break down barriers that impede upon patient care.