Lock It Up: A Safe Gun and Medication Storage Program for Safer Homes and Communities

Ashley Mahnke, MBA, CHES, CPST-I
Latoya Stamper, MSW, CPST
Mackenzie Rose, CHES, CPST

Rising unintentional firearm injuries, ingestions, and suicides in our community have prompted a long-standing hospital-based home safety program to evolve and address these concerns. Enhancing our focus on general home safety, the program now includes safe gun and medication storage solutions to prevent injuries. Each year, the hospital's emergency department and mental health services care for a high rate of children and teens presenting with unintentional firearm injuries and suicide ideation. The purpose of this program is to enhance education and provide safe storage devices to these patient’s families, reducing access to lethal means. Proper storage of firearms and medications is a critical strategy in preventing unintentional injury, suicides, and death.

Beginning in 2022, the program initiated the distribution of gun locks (trigger and cable locks) and medication lock bags through collaborations with social work and mental behavioral health teams. In 2024, a multidisciplinary workgroup was formed to integrate these efforts for a cohesive approach to firearm and medication safety. Program optimization involved: 1) identifying families of at-risk patients in the emergency department and trauma center for participation; 2) integrating documentation into the electronic health record with updated flowsheets and a bilingual liability agreement; 3) developing a data report to track product distribution; 4) creating and implementing a digital gun safety teaching sheet; 5) expanding the range of available safe storage products (lockboxes with key and biometric lockboxes) sourced from approved vendors and managed through a centralized warehouse; and 6) launching a two-part staff training program, including evidence-based Counseling on Access to Lethal Means (CALM) training. In 2025, the team plans to create a standardized screening practice integrated into the hospital's social determinants of health assessment to further identify eligible families. Data analysis for this program evaluation included descriptive statistics on product distribution.

In 2024, 70 safety products were distributed to families across 10 counties, including 45 lock boxes, 2 cable locks, 2 trigger locks, and 21 medication lock bags. Ingestions and suicide were the leading complaint with 64% being female. So far in 2025, 46 safety products have been given to 32 children, and 43 staff participated in the CALM training. Program educators noted positive feedback from families receiving education and safety products.

Initial data indicates a significant need for continued expansion of this safe gun and medication storage program across the health system. The program's development highlights the value of clinical integration and multidisciplinary collaboration. This has been well-received by staff, leadership, and families. Future efforts will focus on quality improvement and further program expansion.

1. Participants will understand the key components of a successful safe storage program and be able to implement a similar program.
2. Participants will learn how to integrate a safety program into the electronic health record to facilitate system-wide implementation.
3. Participants will learn about clinical integration in establishing a safe storage program.