Abstract
Extreme risk protection orders (ERPO) seek to temporarily reduce access to firearms for individuals at imminent risk of harming themselves and/or others. Clinicians, including physicians, nurse practitioners, and social workers regularly assess circumstances related to patients’ risk of firearm-related harm in the context of providing routine and acute clinical care. While clinicians cannot independently file ERPOs in most states, they can counsel patients or contact law enforcement about filing ERPOs. This study sought to understand clinicians’ perspectives about integrating ERPO counseling and contacting law enforcement about ERPOs into their clinical workflow. We analyzed responses to open-ended questions from an online survey distributed May-July of 2021 to all licensed physicians (n = 23,051), nurse practitioners (n = 8,049), and social workers (n = 6,910) in Washington state. Of the 4,242 survey participants, 1,126 (26.5%) responded to at least one of ten open-ended questions. Two coders conducted content analysis. Clinicians identified barriers and facilitators to integrating ERPOs into the clinical workflow; these influenced their preferences on who should counsel or contact law enforcement about ERPOs. Barriers included perceptions of professional scope, knowledge gaps, institutional barriers, perceived ERPO effectiveness and constitutionality, concern for safety (clinician and patient), and potential for damaging provider-patient therapeutic relationship. Facilitators to address these barriers included trainings and resources, dedicated time for counseling and remuneration for time spent counseling, education on voluntary removal options, and ability to refer patients to another clinician. Participants who were hesitant to be the primary clinician to counsel patients or contact law enforcement about ERPOs requested the ability to refer patients to a specialist, such as social workers or a designated ERPO specialist. Results highlight the complex perspectives across clinician types regarding the integration of ERPO counseling into the clinical workflow. We highlight areas to be addressed for clinicians to engage with ERPOs.
Funder
National Center for Advancing Translational Sciences
State of Washington
Publisher
Public Library of Science (PLoS)
Reference24 articles.
1. CDC. Provisional Mortality Statistics, 2018 through Last Month Results Form. 2023 [cited 30 Jan 2023]. https://wonder.cdc.gov/controller/datarequest/D176;jsessionid=3042BE226195737B83913A87169E
2. Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009–2017;EJ Kaufman;JAMA Internal Medicine,2021
3. Notes from the Field: Increases in Firearm Homicide and Suicide Rates—United States, 2020–2021;TR Simon;MMWR Morb Mortal Wkly Rep,2022
4. Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study;A Conner;Ann Intern Med,2019
5. Extreme Risk Protection Order: | Bloomberg American Health Initiative. [cited 22 Feb 2023]. https://americanhealth.jhu.edu/implementERPO
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献