The Struggle is Real: Starting and Maintaining a Firearm Safe Storage Program at Your Institution

Isabell Sakamoto, MS, CHES
Lindsay Clukies, MD, FAAP
Sofia Chaudhary, MD
Sandy McKay, MD
Kirsten Bechtel, MD

Best practices from the literature suggest that providing locking and storage devices to parents who are firearm owners is helpful in promoting safe firearm storage, especially during a behavioral health crisis in their child. This may reduce the likelihood of future injury or death from a firearm. However, many children’s hospitals do not have such programs in place. This workshop aims to help participants learn from program managers who have successfully started such programs at their institutions so that barriers and facilitators to program success can be disseminated amongst workshop participants. Additionally, workshop leaders will assist participants in drawing up a preliminary plan to initiate a firearm safety program at their respective institutions.

1. Understand the rationale for programs that provide locking and storage devices to parents who are firearm owners.
2. Develop program goals, values, and mission and identify key messaging to meet the needs of the community/institution.
3. Become familiar with barriers and facilitators to a program initiation within a hospital system (e.g., political, administrative, financial).
4. Determine who your key stakeholders are to initiate and sustain a program.
5. Learn how to engage with legal leadership at your institution.
6. Learn what various distribution mechanisms are available (e.g., community events, patient bedside, outpatient and inpatient settings, Emergency Department, universal hospital screening, at-risk screening).

Opioid Overdose Prevention and Harm Reduction Program

Isabell Sakamoto, MS, CHES
Gloria Vidal, MPH
Christina Delgado, DNP, RN, SANE-A
Chris Buresh, MD
Thomas Agostini, MD
Adriana Herrera, MD

Drug overdose is now a leading cause of injury death among children and young adults in the program region: from 2019 to 2022 the rate of deaths involving opioids nearly doubled among children and young adults. In this region, deaths from drug overdose in people ages 0 to 24 now outpace the number of deaths caused by firearms and motor vehicles - the two leading causes of injury death nationally for this age group. As access to fentanyl increases, harm reduction programming tailored to young people should be implemented to reduce overdose fatalities.

The hospital’s Community Health team developed a strategic program plan with the goal to deliver education and services that appropriately respond to the opioid overdose crisis among young people, reduce stigma around substance use disorder, support access to resources for safe medicine storage and disposal, and ultimately reduce morbidity and mortality. Primary audiences include youth, families, and clinicians. We’ve used the socioecological model to frame delivery of education and services to parents, caregivers, and adults who care for children and teens in the program region.

We’ve piloted an opioid overdose recognition and response education model to deliver to community. Between March and May 2024, approximately 150 community members received education on opioid overdose, and 100 naloxone kits were distributed in the program region through an event. All the people who received naloxone at the event and completed a survey reported that they were at least somewhat likely to carry naloxone within the next month, and 94% reported increased confidence to use naloxone after attending the event.

We’ve also developed and implemented an educational presentation for pediatric medical residents to highlight the urgency of this issue in the pediatric population and to illuminate existing clinical resources and medication treatment options. To date, approximately 31 medical residents have received training to support adolescent opioid awareness and harm reduction, with initial pilot results suggesting increased confidence in providing patient counseling on overdose recognition and naloxone administration.

Currently, this program pilot is funded by the hospital and a limited supply of naloxone was provided by the state department of health.

Program education has been well received by community members and medical residents in the program region. There is momentum to expand the program’s reach through collaboration with clinicians, community health team members, school-based health centers, and community organizations. We plan to use the transtheoretical model and health belief model to further develop program interventions for clinicians and youth audiences.

1. Understand opioid overdose prevention and harm reduction program goals, objectives, and evaluation design for a pediatric hospital.
2. Identify avenues to increase community access to naloxone.
3. Demonstrate ways to collaborate cross-departmentally and with community organizations to develop and implement opioid overdose prevention and harm reduction initiatives.