• Dawn Carpenter, Alexander Menard, Johnny Isenberger, Gregg A Stevens, and Lisa LaRock.
• Dawn Carpenter is an acute care nurse practitioner in the surgical intensive care unit and trauma service line at Guthrie Health Care System, Sayre, Pennsylvania, and an associate professor at Tan Chingfen Graduate School of Nursing, University of Massachusetts (UMass) Chan Medical School, Worcester, Massachusetts.
• Crit Care Nurse. 2024 Oct 1; 44 (5): 203120-31.

BackgroundFrom 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased. The role of acute and critical care nurses during shootings is not well defined in the literature.ObjectiveTo identify roles of acute and critical care nurses during mass shooting incidents and provide best-practice recommendations for shooting incidents within a hospital.MethodsThe methods of Whittemore, Knafl, and Torraco informed this integrative review. Ovid MEDLINE, CINAHL, and Scopus databases were searched for publications related to acute and critical care nurses, mass shooting incidents, and hospital setting.ResultsOf 13 589 articles retrieved, 27 were included; 63% were narrative reviews. The highest level of evidence was an expert consensus panel; next highest was a quasi-experimental study that simulated experiences to test mass casualty incident response. Third highest was a qualitative study that analyzed nurses' experiences during a mass casualty experience.DiscussionThe evidence revealed 3 themes: prevention and preparedness, response to incident, and recovery phase. Education and training for acute and critical care nurses about mass shooting incidents are central to defining nurses' roles and best practices for these incidents. Nurses must know Stop the Bleed techniques and run-hide-fight protocols. Additionally, acute and critical care nurses need representation on hospital committees to develop and implement policies and procedures.ConclusionsHospitals are not immune to mass shooting incidents. Acute and critical care nurses require education including simulations and drills on mass shooting incidents to ensure safety of nurses and patients.©2024 American Association of Critical-Care Nurses.

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