Firearms Screening in the Pediatric Inpatient Setting

Area of Science:

• Pediatric Health
• Public Health
• Preventive Medicine

Background:

• Firearm-related deaths are a leading cause of mortality in US children and adolescents.
• The American Academy of Pediatrics recommended firearm availability screening in 2012.
• Pediatric inpatient settings present opportunities for firearm safety education.

Purpose of the Study:

• To evaluate the frequency of home firearm screening in a pediatric tertiary-care hospital inpatient setting.
• To identify patient diagnoses and admitting services associated with firearm screening.
• To assess the rate of anticipatory guidance provided to gun-owning families.

Main Methods:

• Retrospective chart review of pediatric patients admitted between 2006 and 2015.
• Inclusion criteria: asthma, bronchiolitis, cellulitis, jaundice, single liveborn infant, pneumonia, and mood disorders.
• Search terms included "firearm," "gun," "pistol," "handgun," "bullet," "ammunition," and "rifle" in admission history and physical notes.

Main Results:

• Firearm screening was documented in 2.94% (1196/40,658) of patient charts.
• Mood disorders and child psychiatry service showed the highest screening rates (37.3%).
• Only 19.8% of identified gun-owning families received specific anticipatory guidance.

Conclusions:

• Firearm screening and safety education are infrequent in the pediatric inpatient setting.
• Inpatient encounters offer potential for increased screening due to resources and provider/family presence.
• Further research is needed to understand barriers and improve inpatient firearm safety interventions.