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Identifying Human Trafficking: Implementing a Screening Tool in an Adult Emergency Department

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2024-05
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DNP Project
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Problem & Purpose: Human trafficking (HT) is defined as “the recruitment, transportation, transfer, harboring or receipt of people through force, fraud or deception, with the aim of exploiting them for profit” (United Nations Office on Drugs and Crime, 2022) and includes both labor and sex trafficking. HT affects approximately 16,000 individuals annually in the United States. HT survivors reported interacting with the healthcare system during their time in trafficking. The project site is a 54-bed adult emergency department (AED), in a large urban academic medical center, serving patients 22 years of age and older, where routine HT screening does not occur. The purpose of this project is to implement a validated HT screening tool in an AED to identify victims and connect them to community resources. Methods: In the Fall of 2023, all patients presenting to the AED were screened for HT using the four-item, Rapid Appraisal for Human Trafficking (RAFT) tool by staff nurses. If the patient answered in the affirmative to any of the RAFT items, they were offered a community resource list and an evaluation by social work. Clinically stable patients who consented to screening were eligible for participation. Results: 195 patients were screened using the RAFT tool. 46 patients met exclusion criteria due to screening refusal, altered mental status, or clinical intoxication. 139 patients screened negative on the RAFT tool requiring no further intervention. 10 patients screened RAFT positive, 8 of whom declined all resources, 1 received a community resource list but declined to speak to SW about their HT experience, and 1 received a community resources list, a SW evaluation, and a psychiatric evaluation. Conclusions: Routine HT screening is a feasible intervention in the ED and can increase the recognition of those experiencing HT for resource provision. Successful screening does require systems in place including education, referral services and re-evaluation measures.

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