Increasing the HPV Vaccination Rate in a Family Practice: A quality improvement project

Abstract

<p>The purpose of this DNP project was to identify barriers in a family practice setting to recommending the HPV vaccine and to use this information to develop a practice protocol to enhance the delivery of the vaccine series. The goal of the quality improvement project was to increase HPV vaccination rates for patients in this setting. The Stetler Model for Research Utilization was used as a framework to guide each step in the project. </p> <p>The Project Director/DNP student gave an educational presentation for the providers that addressed strategies for improving HPV vaccination rates and reducing barriers to recommending the vaccine. A pre/post-education survey was used to evaluate changes in provider perceived confidence in and barriers to recommending the vaccine. The information from the surveys identified barriers in practice to recommending the HPV vaccine and guided the development of a practice protocol to enhance the delivery of the vaccine series. The protocol included steps for identification of patients needing the vaccine, patient/parent education, provision of the vaccine, and follow-up to ensure completion of the vaccine series.</p> <p>Data from the pre and post-education surveys were analyzed to determine if perceived barriers decreased and confidence improved. Data from chart audits were completed on the HPV vaccination rate prior to and five months after protocol implementation to determine if the HPV vaccination rate increased. Pre-education survey data showed that providers had higher than expected confidence and lower perceived barriers with recommending the HPV vaccine and discussing HPV and HPV vaccine with patients prior to the presentation; nonetheless, post-education survey data showed a positive change regarding several confidence related items. There was initially only a slight decrease in perception of barriers demonstrated with the post-education survey data; however, 5 months after implementation of the protocol assessment showed that perceived barriers continued to decrease over time. A total of 1,052 charts were reviewed pre-protocol intervention (n = 565) and post-protocol implementation (n = 487). There was a 10% overall increase in HPV vaccination rates. Limitations of the project included a small sample size and short-time frame. In conclusion, provider education to increase confidence and decrease barriers to recommending the HPV vaccine and developing an HPV vaccination protocol can lead to an increase in vaccination rates. Additionally, it may take using the protocol over a period of time to overcome some perceived barriers.</p>