Problem: In a tertiary, Level 1-designated trauma center pediatric emergency department, a random one-month review revealed only 1 of 134 patients (0.7%) were screened for Child Sex Trafficking (CST) using a validated screening tool. Purpose: Implementation of the Short Screen for Child Sex Trafficking (SSCST) aims to identify patients at high risk for CST to provide safe disposition planning for true victims of CST and community referrals for false- positive patients. Methods: Approximately 120 staff members, including medical providers, nurses, and social workers, were trained to use the SSCST screening tool. Medical providers stratified patients as “high-risk” or “low risk”, with high-risk patients undergoing further evaluation to confirm CST status. Upon initial implementation, multidisciplinary team members expressed the need for an additional validated tool to assess high-risk patients without relying on patient self-disclosure of CST. Thus, the protocol was amended to providing outpatient sexual health clinic referrals to all SSCST-eligible patients, regardless of risk stratification. This nursing-led intervention involved 60 nurses with a distribution goal of 50%. Data collection occurred over 15 weeks via surveys. Results: During the pre-implementation period, a weekly average of 23 eligible patients presented with a 0% resource distribution rate. After initial SSCST implementation in week 4, the referral distribution rate increased 20%. The amended protocol was implemented from week 5-15, during which an average of 35 eligible patients presented weekly with fluctuations in referral distribution rates between 0-10%, falling short of the 50% goal despite a 70% RN education review rate. Conclusions: Outcomes from the amended protocol demonstrate several systemic barriers to distribution consistent with current literature. Limited distribution rates were reported due to time constraints, prioritization of higher acuity patients, high patient volumes, discharges completed by Advanced Practice Providers, and difficulty identifying eligible patients. No correlation was observed between referral rates, RN education completion, or volume of eligible patients. Without formal SSCST screening, referral demand increased as all eligible patients received referrals regardless of CST risk level. Future formal screening using the SSCST tool could better identify high-risk patients, enabling a more targeted resource distribution practice and patient outcomes.