Elements of a care pathway for human trafficking victims in emergency departments: A mapping review

Human trafficking, a form of modern slavery, is a global health problem. Human trafficking victims may need health care while they are being exploited, and traffickers often take victims to emergency departments (EDs) if their injuries and illness prevent them from working. Healthcare professionals in EDs could help combat human trafficking; however, 85% of human trafficking victims in EDs remain unidentified. Implementing a standardized care pathway to improve the identification and care of human trafficking victims may improve the identification of these victims and allow victims to become survivors.

This mapping review aimed to identify the elements that should be included in a care pathway facilitating the recognition of and response to human trafficking victims in EDs.

Five electronic databases generated 159 articles and 628 gray literature records, of which 23 primary research reports and five reports from gray literature were included. The following electronic databases were searched: EBSCOhost, Scopus, Web of Science, ProQuest, and PubMed. ProQuest Central and gray literature were records OR Magazines OR Newspapers OR Blogs, Podcasts, AND Websites OR Working Papers OR Conference Papers & Proceedings. The inclusion criteria for the population were adults (≥18 years), human trafficking victims, and sex trafficking victims. The concept, pathway and algorithm, and context of the ED were used. Records were blinded when assessing eligibility. The demographics of the included records were descriptively analyzed. The reports and gray literature were deductively coded and charted. The data extraction tool was based on the emergency nursing framework and was developed before data extraction. Inductive analysis was used to create subthemes, namely, approach to victims, characteristics, red flags, identifying questions, opportunities to be recognized, strategies, approach upon recognition, potential danger, and resources.

A holistic care pathway embedded in a person-centered trauma-informed approach was conceptualized. The strategies are based on The Blue Heart and The Blue Campaign 4Ps, including prevention, protection, prosecuting, and partnerships. An evidence-informed approach that is culturally congruent and gender sensitive should be adopted. Healthcare professionals will be able to identify and assess victims, avoid retraumatization, and initiate interprofessional partnerships to provide coordinated care.

Human trafficking victims may escape detection in EDs. This mapping review identified elements to be included in a care pathway for recognizing and responding to victims of human trafficking. The care pathway should be built on person-centered and trauma-informed care and include prevention, protection, prosecution, and partnership-building strategies. Moreover, an interprofessional team approach is needed to identify, assess, and care for such victims. Future studies should develop a standardized care pathway for healthcare professionals to recognize and respond to human trafficking victims in emergency departments.