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

Background: Human trafficking (HT) is "the recruitment, transportation, transfer, harboring or receipt of people through force, fraud or deception, with the aim of exploiting them for profit" and affects approximately 17,000 individuals annually in the United States. The project site was in an adult emergency department (AED) in a large urban academic medical center, where routine HT screening did not occur. Objective: The purpose of this project was to implement a validated HT screening tool in an AED to identify victims and connect them to community resources. Methods: Staff nurses were educated on the Rapid Appraisal for Trafficking (RAFT) tool. Eligible patients presenting to the AED were screened for HT using the RAFT tool. 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. Results: Of 11,925 patient encounters, 195 patients were screened using the RAFT tool (1.6%). Among these, 139 screened negative, 10 screened positive, and 46 met the exclusion criteria. Resource acceptance varied among RAFT-positive patients: 80% (8/10) declined all resources, 10% (1/10) accepted only the community resource list, and 10% (1/10) accepted all available resources. Staff participation was limited to 36.5% (23/63) of nurses. Survey results (n = 23) showed strong support for the intervention, with 91.3% finding screening feasible to implement and 87% considering it necessary, while 95.6% rated the tool as easy to use. Conclusions and Implications for Nursing: Routine HT screening in the emergency department can increase the recognition of those experiencing HT for resource provision, including staff education, referral services, and reevaluation measures for an underserved population.