Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-16-2025

Graduate Advisor

Charity Galgani

Co-Advisor

Laurie Vining

Committee

Jill Neeman

Abstract

Problem: Despite strong recommendations from the Centers for Disease Control and

Prevention (CDC, 2021) for HPV vaccination in individuals aged 9 to 26, postpartum women

are often overlooked as a target population. Every year in the U.S., oncogenic human

papillomavirus (HPV) infection causes approximately 330,000 cases of precancerous cervical

dysplasia and 12,000 cases of cervical cancer, the most common female cancer attributable to

HPV (Wang et al., 2024). Many providers miss the opportunity to offer the vaccine during the

postpartum hospital stay and the six-week visit—when patients are insured, motivated, and

more accessible.

Methods: This quality improvement (QI) project used a descriptive, observational design to

evaluate the effect of a postpartum HPV vaccination toolkit on vaccine uptake. The study was

conducted at a nonprofit hospital in the Midwest, focusing on postpartum six-week checkup

visits. A total of 60 postpartum women, aged 18 to 26 years, were included, who were eligible

for HPV vaccination based on CDC guidelines. Data collected during the time of this quality

improvement project included the number of patients receiving HPV vaccine before

implementing the toolkit, and after implementation.

Results: Following the implementation of the HPV vaccination toolkit, vaccine acceptance

among postpartum women improved notably. The proportion of postpartum women who

accepted the HPV vaccine increased from 82.1% to 93.7% following the intervention,

suggesting a positive association between toolkit use and vaccine uptake. Distribution of vaccine administration was consistent over the study period, indicating steady implementation.

Implications for practice: Following the implementation of a HPV vaccination toolkit on an

inpatient postpartum clinic, vaccine acceptance among eligible postpartum women

significantly improved. Prior to the intervention, 82.1% of postpartum patients (n = 28)

accepted the HPV vaccine. After the toolkit was implemented, 93.7% of patients (n = 32)

accepted the vaccine, demonstrating an 11.6% absolute increase in uptake.

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