Getting to the Point: Promoting the HPV Vaccine in a Primary Care Clinic

Background:  Implementing a Human Papillomavirus (HPV) vaccination program has the potential to eliminate nearly 70% of all cervical and 18% of Head and Neck cancers in the United States.  However, less than one quarter of service members and their family members have received the vaccine.  In an effort to reach more vaccine eligible women, the Veterans Affairs (VA)/Department of Defense (DoD) Clinical Practice Guideline for the Management of Pregnancy recommends healthcare providers to initiate or continue the HPV vaccine in the inpatient postpartum period (2009).  However, because this guideline is relatively new, few postpartum units have initiated this change to practice.

Purpose: The purpose of this evidence based practice (EBP) proposal is to describe the initiation and evaluation of a postpartum human papillomavirus (HPV) vaccination program within a large military treatment facility.  

Method:  Underpinned by the Rosswurm and Larrabee Model (1999), organization strategies include identifying and engaging key stakeholders, ensuring the vaccine is available on the unit, and assisting the unit leadership to develop a vaccine ordering and administration protocol.  Individual strategies include synthesizing the literature, presenting a formal staff education program regarding HPV, HPV associated cancers, and introduction of the clinical practice guideline in the Ob/Gyn clinic, Postpartum ward, and Immunization clinic settings, and routine updates via posters and short presentations for patients, and hospital leadership and staff. 

Analysis: Upon implementation of a dedicated EBP program for vaccination,  the primary outcome of interest will be the measurement of physcian and midwives habits to prescribe the vaccine  and nursing documentation of patient education regarding vaccination over a three month period.  Analysis will include t-test, chi-square, and generalized estimating equations.

Relevance:  Sexually transmitted infections and cervical cancers are over represented in the MHS as compared to the civilian population.  While the primary purpose of this proposal is to change provider habits and nursing habits, globally this endeavor is attempting to increase the number of women who elect to initiate the HPV vaccine and defeat most cervical cancers among MTF beneficiaries.

Final Report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2018100...