Emergency Nurses’ Perceptions of Risk for Firearm Injury and its Effect on Assessment Practices: A Mixed Methods Study

Lisa A. Wolf*, Altair M. Delao, Cydne Perhats, Paul R. Clark, Michael D. Moon, Kathleen Evanovich Zavotsky, Zoran Martinovich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Introduction: Injury from firearms is a significant problem in the United States, accounting for 73% of all homicides and 50% of all suicides that occurred among US residents. What is not known are the perceptions of emergency nurses regarding the impact of in-home access on the risk for firearm-related injury and death in their patient populations. The purpose of this study was to explore emergency nurses’ perception of patient risk for firearm injury and in which ways that perception affected the process of ED patient screening, assessment, counseling, and discharge education. Methods: We employed a mixed methods, sequential, explanatory design using quantitative survey data and qualitative focus-group data. Results: Between 21.8 and 43.5% of respondents reported asking patients about access to in-home firearms, depending on presentation. Statistical analyses showed the single most significant factor correlated with nurses asking about the availability of a staff person who could further assess risk and offer assistance and safety counseling to patients. Another important influence was identified from focus-group discussions in which nurses reported that they felt challenged to bring up the topic of firearms in a way that did not seem confrontational. Discussion: Access to firearms poses risk to patients, and patient safety and the continuum of care depends upon the emergency nurse assessing patient firearms risk and taking appropriate action. The findings from this study suggest that emergency departments (1) normalize and standardize the assessment of firearms, (2) designate an ED staff member on each shift to further assess risk if a positive response is elicited, and (3) continue to improve workplace safety.

Original languageEnglish (US)
Pages (from-to)54-66.e2
JournalJournal of Emergency Nursing
Issue number1
StatePublished - Jan 2019


  • Emergency care
  • Firearms
  • Lethal means assessment
  • Mixed methods
  • Nursing workload
  • Workplace safety

ASJC Scopus subject areas

  • Emergency


Dive into the research topics of 'Emergency Nurses’ Perceptions of Risk for Firearm Injury and its Effect on Assessment Practices: A Mixed Methods Study'. Together they form a unique fingerprint.

Cite this