Review of studies that examine the role of advanced practice registered nurses and physician associates in mass shooting incidents

BACKGROUND: A mass shooting incident (MSI) occurs where four or more people are shot and injured or killed. Mass shooting incidents have increased in frequency since the 1960s with 2,700 injured and 600 individuals killed in 2022. Advanced Practice Registered Nurses (APRNs) and Physician Associates (PAs) are front-line caregivers, who may engage with victims, their families, perpetrators, and potential perpetrators. Advanced Practice Registered Nurses and PAs provide care to these people across care settings. OBJECTIVE: Identify the pertinent literature describing the roles, responsibilities, and skills that APRNs and PAs must possess surrounding MSIs. DATA SOURCE: An integrative review was completed using Covidence. Search engines included Ovid Medline, Ovid Emcare, PsycInfo (Ovid), CINAHL (EBSCO), Scopus (Elsevier), and Cochrane Central Register of Controlled Trials (Wiley). Two team members independently reviewed each citation, and a third member resolved conflicts. CONCLUSIONS: Eleven studies met inclusion criteria. Four phases of the Federal Emergency Management Agency framework (Prevention, Preparedness, Response, Recovery) were represented, and, in some studies, more than one phase was discussed. The review showed strong support for APRN and PA roles in prevention and preparedness of an MSI, and less support surrounding the response and recovery phases of an MSI. Additional research is needed to further define the distinct role that APRNs and PAs can have encompassing MSIs. IMPLICATIONS FOR PRACTICE: Advanced Practice Registered Nurses and PAs possess the skills to intervene in prevention, preparedness, response, and recovery surrounding an MSI. Although some evidence exists to define the role APRNs and PAs can assume, the focus was primarily on prevention with screening for access to firearms and safe storage.