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ENA Researchers Find Emergency Nurses Underassess for In-Home Firearms

February 11, 2019 Emergency Nurses Association Patient Safety Research

Study urges improved standards for identifying at-risk patients needing further intervention    

SCHAUMBURG, Ill. (Feb. 11, 2019) – Emergency nurses need better education on the importance of assessing patients for firearms in the home and with how to inquire about the topic in a nonjudgmental, nonconfrontational manner, researchers with the Emergency Nurses Association concluded in a recent study.

The paper, “Emergency Nurses’ Perception of Risk for Firearm Injury and Its Effect on Assessment Practices: A Mixed Methods Study,” highlights the critical need for emergency nurses to identify at-risk patients in order to implement mitigating interventions. The study was published in the January 2019 issue of Journal of Emergency Nursing.

Researchers stated injury from firearms is a significant problem in the United States, accounting for 73 percent of all homicides and 50 percent of all suicides that occurred. What has been unknown are the perceptions of emergency nurses regarding the impact of in-home access on the risk for firearm-related injury and death to their patient populations, and their ability to assess and intervene to ensure patient safety.

The study aimed to explore emergency nurses’ perception of patient risk for firearm injury and in which ways those perspectives affected the process of ED patient screening, assessment, counseling and discharge education. Researchers found that emergency nurses do not ask patients about in-home firearms for several main reasons: they consider it an intrusive question about a personal behavior, there is fear of violent reactions from those in their care, and also uncertainty as to what to do based on the answers they receive.

“Given the high levels of violence directed at health care providers, especially emergency nurses, it is not unreasonable to fear violence from patients who may or may not have firearms with them. Our participants felt it was a real challenge to assess for access to firearms in the home in a way that did not feel confrontational,” said Lisa Wolf, PhD, RN, CEN, FAEN, the director of ENA’s Institute for Emergency Nursing Research. “However, there are specific patient groups that are at high risk from in-home access to firearms, specifically pediatric patients, patients with suicidality, and patients who are involved in an intimate partner violence situation. We need to be assessing for access in those situations.”

Between 22 and 43 percent of ED nurses surveyed for the study reported asking patients about access to in-home firearms, based on their presentation to the emergency department. Additional factors that played a role in inquiries included concerns about how to bring up the topic without appearing confrontational and whether other staff was available to do a risk assessment and offer safety counseling to the patient.

“By asking a few simple questions, emergency nurses have the opportunity to play a key role in reducing the number of injuries related to in-home access to firearms,” said ENA President Patricia Kunz Howard, PhD, RN, CEN, CPEN, TCRN, NE-BC, FAEN, FAAN. “This study also highlights the importance of recognizing when children have unsupervised access to firearms, and how those situations place them and others at risk for unintentional injuries.”

In addition to improved education on how to perform an assessment of in-home firearms, researchers encouraged emergency department leaders to also increase awareness of resources that are available for health care providers, patients and families to ensure that adequate safety measures are available when firearms are accessible in the home.

ENA has long been an advocate for firearm safety and injury prevention. In December, ENA’s Board of Directors approved the release of a new topic brief which includes strategies for reducing firearm-related deaths and injuries through patient education and encouraging safe storage of firearms.

Press Room Topics

All #GivingSeason AACN AAMC AANP Academy of Emergency Nursing Achievement Awards Adult Advanced Practice Advancing the Conversation Advocacy AEN American Academy of Emergency Nurse Practitioners American Academy of Pediatrics American College of Emergency Physicians American Nurses Association APRN Awards Board of Directors Brand Center Cannabis Career Development Carolyn Jones CDC Conference continuing education COVID-19 Day on the Hill DEI Disaster Preparedness Documentary Donations eBooks Education election results Emergency Department Emergency Nurse Project Emergency Nurse Residency Program Emergency Nurses Emergency Nurses Association Emergency Nurses Week Emergency Nursing Emergency Nursing 2021 Emergency Nursing 2022 Emergency Severity Index EMS EMSC EN Week ENA ENA Connection 20 Under 40 ENA Foundation ENA Podcast ENA Research ENA University ENPC ENStrong Events Fall Regional Symposium federal news Firearms Firearms Injury Prevention Geriatric Giving Season Giving Tuesday Government Relations Guidelines Hall of Honor Healthy Work Environment Human Trafficking Immunizations In Case of Emergency Industry Partner Infectious Diseases Injury Prevention insurance International JEN journal of emergency nursing Lantern Award Legislation MedEvac Mednition Membership Mission Zero MPL Association NAPNAP Nashville News No Silence on ED Violence Novel coronavirus Online Education Opioid Orlando PAHPA Patient Safety Pediatric pediatric emergency care Personal Protective Equipment Position Statement PPE Presentation Press Release Research Resources Scholarships snakebites Staffing standing orders State Achievement State Council Achievement Awards State Fundraising Challenge Suicide thank you Title VIII TNCC Trauma Trauma Nursing Core Course Triage Vaccination Washington DC Webinar Wellness Workplace Violence