Volume 65, November 2022, 101228AbstractBackground

Human trafficking is a form of modern slavery, exploiting people across all cultures and ethnic groups. Human trafficking victims (HTV) are at increased risk for neglect, physical, and psychological harm.

Local Problem

Approximately 68% of HTV report seeking medical treatments in the emergency department at some point during their captivity. Many emergency department nurses today are however not well prepared to identify potential HTV in day to day practice.

Methods

The purpose of this quality improvement (QI) project was to improve emergency room nurses’ self-efficacy in victim identification through education and implementation of a screening tool. Self-efficacy in victim identification was measured through a pre- and post- implementation survey.

Interventions

The intervention for this QI project included education delivered asynchronously online and in person across all shifts as well as a victim screening assessment. The screening assessment was imbedded in the pre-existing safety assessment of the electronic medical record.

Results

Using the mean response of pre- and post- implementation surveys, a paired t-test analysis allowed comparison indicating a significant improvement to self-reported levels of self-efficacy in nursing staff.

Conclusion

A statistically significant change in mean practice self-efficacy scores reinforced the importance of education and screening in victim identification.

Section snippetsBackground and problem statement

The identified problem serving as the foundation for this QI project pertains to human trafficking victims and the challenges associated with their identification during encounters within the healthcare system. Human trafficking is the 21st century version of slavery that occurs when the trafficker exploits an individual with force, fraud, or coercion to make them perform commercial sex or labor [1]. Of the almost 50,000 victims identified worldwide, 50 % were victims of sexual exploitation

Literature search

A search was conducted of databases inclusive of CINAHL, MEDLINE, and the Cochrane Library for literature with inclusion criteria as articles written in English, published between 2014 and 2020, publications from peer reviewed journals, and publications relating patient demographics of any age and gender. Exclusion criteria included literature published prior to 2014, written in a language other than English, and publications from resources other than peer reviewed academic journals. For all

QI project aim

The purpose of this DNP practice change project was to improve emergency room nurse self-efficacy in the identification of victims of human trafficking across the lifespan, subsequently supporting the successful identification of human trafficking victims. The completion of this project was accomplished through the implementation of human trafficking specific education and a patient assessment screening tool which by the end of the ten-week implementation period resulted in improved

Clinical question

The searchable question for this project was developed using the PICOT format and is as follows: In nurses working in the emergency department (P), how does the implementation of standardized screening form and human trafficking education (I) compared to no screening tool or education (C) effect the self-efficacy of emergency department nurses in the identification of victims of human trafficking (O) over a 10-week period (T)?

Methods

A QI project design provides a proven and established process for change management in healthcare organizations. Through the implementation of human trafficking specific education and screening, the benefits during the 10-week implementation period were anticipated to include improved knowledge of victim characteristics and risk factors, improved knowledge of related to vulnerable populations, and perceived benefits in using a victims screening tool.

The setting for this project was a general

Results

Resulting data did meet parametric assumptions allowing for statistical analysis to be completed using the paired t-test to show the mean difference for each item. The average self-reported self-efficacy improved following the implementation of education and human trafficking screening tool. There was a significant difference in the pre-implementation mean (M = 2.26, SD = 0.216) and the post-implementation mean (M = 3.417, SD = 0.133) conditions; t (5) = 9.3380, p = 0.0002.

The individual pre-

Discussion

Based on the results, evidence exists that the educational initiative resulted in improved nurse self-efficacy as it relates to identification of human trafficking victims using the tool introduced. The clinical question for this practice change was answered by distributing to participants a six item self-efficacy survey before and after implementation. In response to the survey, participating nurses were able to assess their own self-efficacy as it related to identification of human

Strengths and limitations of the project

The major strength of this project is the buy-in expressed by stakeholders and participants in the value of the project aim of identifying and potentially rescuing victims of human trafficking. Additional strength can be seen in the practice change itself which presented minor change and minimal burden to the nursing staff’s pre-implementation workflow. Observed strengths can also be seen in the data collection methods for this project. The data collection occurred via a short six-item survey

Conclusion

The purpose of this QI practice change project was to improve emergency room nurse self-efficacy in the identification of victims of human trafficking, subsequently supporting the successful identification of human trafficking victims. The completion of this project was accomplished through the implementation of human trafficking specific education and patient assessment screening tool which by the end of the ten-week implementation period resulted in improved self-reported levels of

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References (13)

There are more references available in the full text version of this article.

View full text

© 2022 Elsevier Ltd. All rights reserved.