实施一种针对在急诊就诊的青少年的儿童性贩卖筛查工具 - 一项质量改进倡议。
Implementation of a screening tool for child sex trafficking among youth presenting to the emergency department - A quality improvement initiative.
机构信息
Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, United States of America.
Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, United States of America.
出版信息
Child Abuse Negl. 2022 Mar;125:105506. doi: 10.1016/j.chiabu.2022.105506. Epub 2022 Jan 25.
BACKGROUND
Identification of sex-trafficked youth in the emergency department (ED) is difficult and routine screening is uncommon.
OBJECTIVES
Our Quality Improvement (QI) Project aimed to increase ED screening and identification of high-risk youth using the Short Screen for Child Sex Trafficking (SSCST).
PARTICIPANTS
Youth (11 through 17 years) seeking care at two metropolitan EDs with a high-risk chief complaint triggering a best practice alert (BPA).
METHODS
A BPA prompted administration of the SSCST and referral of screen 'positive' youth for comprehensive evaluation for child sex trafficking by the forensic nurse examiner (FNE). Targeted QI interventions defined three study periods (SP). Outcomes measures included screening 50% of high-risk youth with 50% of those youth referred for FNE evaluation.
RESULTS
Over three study periods, 5454/13,956 (39.1%) youth triggered a BPA for high-risk chief complaint; 4354 (78.6%) received the SSCST screen; 1336 (76.0%) of screen-positive youth were referred for FNE evaluation. Outcomes measures were exceeded during all three study periods. SSCST modifications to increase specificity led to a significant decrease in the percentage of positive screens (42.8% SP1 vs 29.4% SP3). Financial programmatic support and further staff training led to an increase in FNE evaluations (86.4 SP3 vs 5.7% of referred youth SP1). Identification of trafficked patients increased from 1.3% of screen-positive youth to 11.3% (SP1 vs SP3; p < 0.0001).
CONCLUSIONS
Routine screening for child sex trafficking can be implemented in the ED setting and increases the identification of at-risk youth.
背景
在急诊科（ED）识别性交易的青少年很困难，常规筛查并不常见。
目的
我们的质量改进（QI）项目旨在通过短儿童性交易筛查工具（SSCST）增加 ED 筛查和识别高危青少年的数量。
参与者
在两家大都市 ED 寻求医疗的青少年（11 至 17 岁），他们的主要诉求存在高危因素，触发最佳实践警报（BPA）。
方法
BPA 提示对 SSCST 进行管理，并将筛查阳性的青少年转介给法医护士检查官（FNE）进行儿童性交易的全面评估。有针对性的 QI 干预措施定义了三个研究阶段（SP）。结果衡量标准包括对 50%有高危主诉的青少年进行筛查，其中 50%的青少年转介给 FNE 评估。
结果
在三个研究阶段中，有 5454/13956（39.1%）名青少年因高危主诉触发 BPA；4354（78.6%）名青少年接受了 SSCST 筛查；1336（76.0%）名筛查阳性的青少年被转介给 FNE 评估。在所有三个研究阶段都超过了结果衡量标准。为了提高特异性，对 SSCST 进行了修改，这导致阳性筛查的比例显著下降（SP1 的 42.8%与 SP3 的 29.4%）。财政计划支持和进一步的员工培训导致 FNE 评估增加（SP3 的 86.4%与 SP1 的转介青少年的 5.7%）。从筛查阳性的青少年中识别出的被贩卖的患者从 1.3%增加到 11.3%（SP1 与 SP3；p<0.0001）。
结论
在 ED 环境中可以实施儿童性交易常规筛查，增加高危青少年的识别率。
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