Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Charity Galgani


A. Laurie Vining, DNP, APRN, WHNP-BC

Jennifer Cortopassi, MMS, PA-C



Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased from 0% to 8.45%, and overall Gardasil9 uptake increased from 0.8% to 12.68%, in pre- and post-intervention groups, respectively. A Chi-square test of independence was performed to examine the relationship between intervention groups and Gardasil9 administration. A statistically significant relationship was established between intervention groups and

Gardasil9 administration, with alpha value of .05, χ2(1) = 14.19, p < .001. Persons in the post-intervention group were more likely to be administered a dose of Gardasil9. Implications for practice: Widespread use of the HPV Encouragement Bundle is a cost-effective, inclusive intervention that could be used to improve Gardasil9 vaccine uptake.