263 - Standardized firearm screening and firearm safety education during pediatric hospital admissions

Publication Number: 2253.263

Amanda Mosher, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Claire Hildebrand, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Ashley Frye, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Katherine Cavanaugh, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Lucas Neff, Atrium Health Wake Forest Baptist, WINSTON SALEM, NC, United States; Leila Dewitt, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Rebecca Palmer, Wake Forest Baptist Health - Brenner Children's Hospital, Winston Salem, NC, United States

Background: Firearm injuries are the primary cause of death in children in the United States. Inadequate firearm storage increases firearm access and thus increases risk of death by firearm. Storage/education programs in outpatient settings are effectively increasing safe behaviors thus decreasing morbidity. Efficacy of inpatient firearm screening/educational programs is unknown.

Objective: We aim to expand the established firearm safety and education program studied in the outpatient setting to the inpatient pediatric population at Atrium Health Levine Children’s Brenner Children’s Hospital and hypothesize that caregivers will be amenable to increasing safe firearm behaviors and utilization of firearm safety locks after education measures are implemented in the inpatient setting.

Design/Methods: Caregivers of admitted pediatric patients were screened. Those with firearm(s) in their home/vehicle were asked a series of questions. A Gun Safety Score (GSS) was based on all storage methods. Participants received +1 for each safe behavior: 1)firearm locked; 2)firearm unloaded; 3)ammunition separate. Scores were determined on least-safe storage method with safest storage earning a 3.

Results: The mean age in this series was 6.2 years. 53.9% of patients were male. 73.7% were Caucasian; 19.7% Black; 14.5% were Hispanic. 63% had Medicaid insurance. 76 caregivers consented. Only one declined to answer– a 98.6% response-rate. 61% of patient families screened positive for firearms at home (n= 46). The firearm ownership rate of pediatric trauma patients was higher, at 68%, however the n =22 participants. Complete GSS were challenging to obtain as not all storage questions were answered. 27/42 participants stored their firearms locked (64%) and was most frequently answered of the three questions.
93 gunlocks were provided. 83% of firearm-owning families accepted at least one gunlock (38/46; 1.92 gunlocks per family). 28% of non-firearm-owning families accepted gunlock(s) (8/29; 1.375 gunlocks per family).

Conclusion(s): The firearm ownership rate in our study surpassed state average ownership estimates and demonstrate individuals often don’t adhere to all safe firearm storage guidelines which indicates critical need for firearm safety/education interventions. The firearm ownership rate was higher in the pediatric trauma population which will need to be investigated at a larger scale. Further investigation of longitudinal metrics to understand changes in firearm storage behaviors after discharge home is warranted.