Date of Award

Spring 2020

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Joyce Cappiello

Second Advisor

Anna Meyer


BACKGROUND: Human trafficking is an under-recognized healthcare issue affecting an

estimated 20 to 40 million individuals globally. Professional nursing organizations, healthcare

regulatory bodies and legislators have declared the need for education and screening practices. A

quality improvement initiative designed to create buy-in from nurse leaders to create and

implement education, screening and a protocol to guide care of human trafficking victims who

may present to inpatient and clinic settings at the organization was developed to bridge gaps in

knowledge and inform evidence-based practice.

METHODS: Literature review informed the development of an education intervention presented

to nurse leaders using multi-modal learning strategies. National Academy of Medicine criteria

for safe, high quality, patient-centered care was used to determine need for the quality

improvement initiative. Victimology paradigm guided development of the content and the

educational initiative was implemented using a framework recommended by subject matter

experts Miller, Chisolm-Straker, Duke and Stoklosa (2019). A brief educational intervention was

deployed in effort to engage a voluntary participant group of 191 nurse leaders with purpose to

create endorsement for policy and practice change.

INTERVENTION: Brief education about human trafficking and the need for education,

screening and a protocol to guide care was deployed to the participant group using multi-modal

strategies. Pre and post assessment surveys were conducted to detect any changes in knowledge

about human trafficking as a healthcare issue and any changes in attitudes related to

implementation of standardized education and screening practices with a protocol to guide care

of victims.



RESULTS: Data was analyzed using two statistical methods for increased understanding of

results. The primary statistical analysis method, a two-tailed student’s t-test assuming unequal

variances found statistical significance for four of the eight survey items. Three knowledge

questions and one attitude question evidenced a statistically significant increase in knowledge

and support related to the quality improvement intervention. Two attitude questions related to

support for education and screening for human trafficking evidenced near statistical significance.

The secondary statistical analysis method, randomized and equal sized samples, yielded no

statistical significance for any of the survey items. Significant differences in response rates to the

pre and post assessment surveys along with homogeneity of the target population may have

impacted the results of data analysis.

CONCLUSIONS: The quality improvement initiative demonstrated some ability to meet all of

identified aims. Statistical significance was noted for a number of survey items, but the primary

focus items, endorsement for education and screening practices for human trafficking, did not

achieve statistical significance. Unanticipated tacit knowledge about human trafficking within

the participant group along with existing attitudes of support for education and screening for

human trafficking may have affected survey results. Despite lack of statistical significance

related to nurse leader buy-in for education and screening practices, overwhelming positive

feedback from the participant group and support for the quality improvement initiative

demonstrated a high degree of clinical significance.