Screening for Access to Firearms by Pediatric Trainees in High-Risk Patients.
Screening for Access to Firearms by Pediatric Trainees in High-Risk Patients.
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DOI：
10.1016/j.acap.2019.03.002
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发表时间：
2019-08
影响因子：
3.1
通讯作者：
Flaherty MR
中科院分区：
文献类型：
--
作者：
Naureckas Li C;Sacks CA;McGregor KA;Masiakos PT;Flaherty MR
获得枪支是自杀和杀人的独立风险因素，美国儿科学会建议儿科医生对枪支获取和安全储存进行筛查和咨询。本研究调查了儿科住院医生对有自杀或杀人念头的患者进行枪支筛查或降低风险咨询的频率。2016年1月至12月在某三级学术医疗中心儿科急诊科（ED）就诊的年龄小于19岁患者的回顾性图表分析。如果根据《国际疾病和相关健康问题统计分类》第10次修订代码，患者最终出院诊断为“自杀意念”、“自杀企图”或“杀人意念”，并且患者在精神病学评估前由儿科住院医师就诊，则就诊符合条件。采用描述性统计对结果进行分析。98名患者在研究期间由儿科住院医师进行医学评估，然后由精神病学小组进行评估，因此符合纳入条件。98例患者就诊中有5例（5.1%）儿科住院医师记录了枪支接触筛查。25名患者（25.5%）在急诊科就诊期间没有任何提供者对枪支接触进行记录筛查，包括5例患者出院回家时。儿科住院医师很少记录在急诊科就诊的已知有自杀或杀人念头的患者是否接触过枪支。进一步了解筛查的障碍以及改善筛查和咨询的潜在策略，对于为高危儿科患者提供适当的护理至关重要。
Access to firearms is an independent risk factor for completed suicide and homicide, and the American Academy of Pediatrics recommends that pediatricians screen and counsel about firearm access and safe storage. This study investigates how often pediatric residents screen for access to firearms or counsel about risk-reduction in patients with suicidal or homicidal ideation. Retrospective chart review of visits by patients younger than the age of 19 years presenting to the pediatric emergency department (ED) of a tertiary academic medical center from January to December 2016. Visits were eligible if there was an ultimate ED discharge diagnosis of “suicidal ideation,” “suicide attempt,” or “homicidal ideation” as identified by International Statistical Classification of Diseases and Related Health Problems, 10th revision codes and the patient was seen by a pediatric resident before evaluation by psychiatry. Descriptive statistics were used to analyze results. Ninety-eight patients were evaluated by a pediatric resident for medical assessment before evaluation by a psychiatry team during the study period and were therefore eligible for inclusion. Screening for firearm access was documented by a pediatric resident in 5 of 98 (5.1%) patient encounters. Twenty-five patients (25.5%) had no documented screening for firearm access by any provider during the ED visit, including in 5 cases when patients were discharged home. Pediatric residents rarely document screening for firearm access in patients with known suicidal or homicidal ideation who present to the ED. Additional understanding of the barriers to screening and potential strategies for improving screening and counseling are critical to providing appropriate care for high-risk pediatric patients.
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DOI：
10.1097/00004583-199903000-00010
发表时间：
1999-03-01
影响因子：
13.3
作者：
Kruesi, MJP;Grossman, J;Hirsch, JG
通讯作者：
Hirsch, JG
影响因子：
3.7
作者：
Betz, Marian E.;Barber, Catherine W.;Miller, Mathew
通讯作者：
Miller, Mathew
影响因子：
1.5
作者：
Price, James H.;Thompson, Amy;Teeple, Karen
通讯作者：
Teeple, Karen
影响因子：
2.5
作者：
Dingeldein, Leslie;Sheehan, Karen;Dowd, M. Denise
通讯作者：
Dowd, M. Denise
影响因子：
3.6
作者：
McManus, BL;Kruesi, MJP;Woodward, PJ
通讯作者：
Woodward, PJ