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Original Research: Nurses' Knowledge and Comfort with Assessing Inpatients' Firearm Access and Providing Education on
Kimberly Smith Sheppard1, Kathryn Hall, Julia Carney
1Kimberly Smith Sheppard, Catherine Griffith, and Elise Gettings are clinical research nurses at Massachusetts General Hospital (MGH), Boston, where Kathryn Hall is the nursing director, Julia Carney is the clinical research coordinator, and Meaghan Rudolph is a psychiatric clinical nurse specialist. Megan Zelinsky is a doctoral candidate at Northeastern University, Boston. The authors acknowledge Sara E. Looby, PhD, RN, ANP-BC, FAAN, at the Yvonne L. Munn Center for Nursing Research, MGH, for her mentorship and support of this research. They also thank Matthew Miller, MD, ScD, MPH, professor of health sciences and epidemiology, Bouvé College of Health Sciences, Northeastern University, and Marian Betz, MD, MPH, associate professor and assistant research director, Department of Emergency Medicine, University of Colorado School of Medicine, and deputy director of the Program for Injury Prevention, Education and Research, Colorado School of Public Health, Denver, for sharing the surveys used in their research. Funding for this study was provided by Everytown for Gun Safety, https://everytown.org, New York, NY; the Yvonne L. Munn Center for Nursing Research, MGH; and the National Center for Advancing Translational Sciences (Harvard Catalyst/Harvard Clinical and Translational Science Center), Grant Number 1UL1TR002541-01. Contact author: Kimberly Smith Sheppard, ksmithsheppard@mgh.harvard.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com.
Purpose:
This study sought to evaluate nurses' knowledge and comfort with assessing inpatients' access to firearms and providing education on firearm safety and storage. Facilitators and barriers to such assessment, as well as best methods for educating nurses and patients on firearm safety and storage, were also explored.
Methods:
Nurses from a general medical unit and a psychiatric unit at a large urban hospital were invited to complete a 22-question online survey. Descriptive statistics were computed to analyze survey responses for each unit.
Results:
Forty-two nurses-21 from each unit-participated. More than 50% of nurses on each unit were unfamiliar with state law on safe gun storage, and none had prior training in educating others on firearm safety and storage. Compared with nurses on the psychiatric unit, those on the general medical unit were less comfortable asking patients about firearm access and safe gun storage. Several facilitators and barriers to assessment emerged. Facilitators identified by similar numbers of nurses on each unit included receiving relevant education and having educational information available for patients. Nurses on both units also endorsed having a safety protocol and a documentation policy in place. Barriers identified by similar numbers of nurses on each unit included lack of adequate knowledge about firearm safety and lack of patient educational materials. More medical unit than psychiatric unit nurses also named lack of time and not knowing what to do with collected information. More than 80% of nurses on each unit reported that they would feel comfortable providing patients with information on safe firearm storage if it were available; a pamphlet was endorsed most often as the best method. A one-hour class involving the security department and other disciplines was the top endorsed nurse learning strategy.
Conclusions:
Findings from this study highlighted several factors, including nursing specialty, that may influence inpatient assessment of firearm access and safe gun storage. These results can help inform hospital policies and nursing education initiatives aimed at improving safe gun storage practices among patients and the general public.
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