Firearm Safety Screening in the Pediatric Hospital Setting: A Quality Improvement Initiative.

Area of Science:

• Pediatric Medicine
• Public Health
• Injury Prevention

Background:

• Firearm injuries are a major cause of death and disability in US youth.
• Secure firearm storage is proven to protect children, yet screening rates remain low.
• Pediatric providers, especially in hospitals, underutilize firearm safety screening.

Purpose of the Study:

• To enhance the frequency of firearm safety screening for admitted patients within a Pediatric Hospital Medicine service.
• To implement and evaluate interventions aimed at increasing firearm safety screening in an inpatient pediatric setting.

Main Methods:

• An electronic health record (EHR) tool was integrated into the history and physical note template.
• Interventions included nursing education, email reminders, and resident training on gun violence.
• Data were collected via chart review and resident surveys to assess screening rates and barriers.

Main Results:

• Inpatient firearm safety screening rates rose from 0.01% to 39% over 25 months.
• A significant increase was observed shortly after the initial EHR intervention.
• Persistent barriers identified by residents included time constraints and perceived appropriateness of screening.

Conclusions:

• An EHR-integrated approach effectively improved firearm safety screening in a pediatric hospital.
• Hospitalization presents a critical window for pediatric providers to conduct firearm safety screening and counseling.
• Empowering inpatient providers to screen for firearm safety is crucial for injury prevention.