Firearm-related injuries are a leading cause of injury and death in children and adolescents. Nurses and pediatricians have long voiced concerns about gun safety and children. In policy statements published in 1992, 2000, 2012, and reaffirmed in 2016, the American Academy of Pediatrics (AAP) advised "the absence of guns from children's homes and communities is the most reliable and effective measure to prevent firearm related injuries in children and adolescents" (AAP, 2012).

Webster, Wilson, Duggan, and Pakula (1992) explored parental beliefs about gun injury prevention for children by surveying 215 parents in three pediatric practices in Maryland. Household gun ownership ranged from 27% in suburban areas to 53% in rural areas. Gun owners believed children would know the difference between toy and real guns and could be trusted with a loaded gun at a much younger age than nongun owners. Most participants agreed that they would follow their pediatrician's advice about safe gun storage but fewer than 20% of mothers and 10% of fathers agreed that they would remove guns from their homes. Other studies have confirmed parental gun owner misperceptions of children's developmental capabilities and behavioral tendencies toward guns. In 2005, Howard, one of the first nurses to research gun safety and children, surveyed 82 parents on firearm safety, firearm storage, and firearm training for children. Of the 22% of participants who owned a gun, 85% did not practice safe gun storage despite believing that this was important. Her research confirmed parental unrealistic perceptions with most gun owners believing that if children are taught about gun safety they will be safe from injury (Howard, 2005).

In November 2018, several studies on firearms and children were presented at the AAP national conference. Patel (2018) studied differences in the intent of firearm-related injury as compared with injuries caused by assault or self-harm by evaluating injuries reported in 111,839 emergency room visits nationwide. They found that younger children were more likely to sustain nonintentional-related injuries, almost 90% of those injured were male (average age of 18), and 38% of injuries occurred in public housing. Doh (2018) surveyed 297 pairs of parents/caregivers and their children about guns. Most parents believed that their children could distinguish between toy and real guns; however, only 41% of children (ages 7-17 years) could do so correctly. When asked if they thought their child could obtain a gun within 24 hours, only 5% of parents agreed, yet 14% of children with guns in their homes and 4% without believed that they could easily obtain a gun within a day. Chao and Taylor (2018) reported on state gun legislation and found that twice as many pediatric gun-related deaths occurred in states with the most lenient gun legislation.

Recently, in response to mass shooting incidents, many other professional associations have joined the AAP (2018) in developing policies supporting pediatric gun-related injury prevention, including the American Academy of Nursing, the American Association of Colleges of Nursing, and the Emergency Nurses Association. The AAP (2016) position statement on safe gun storage provides some of the most helpful strategies for pediatric providers. These include: trigger locks, lock boxes, personalized safety mechanisms, and high trigger pressures. Nurses are integral to researching and preventing pediatric firearm injuries and deaths. The AAP site designed to help pediatricians advocate for gun safety is a useful resource for nurses: https://www.aap.org/en-us/advocacy-and-policy/Pages/How-Pediatricians-Can-Advoca. Consider using your influence as a nurse to work with the community and your patient population to promote firearm safety.

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