Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-16-2025

Graduate Advisor

Charity Galgani, DNP, APRN, WHNP-BC

Co-Advisor

Laurie Vining, DNP, WHNP-BC, RNC-MNN

Committee

Jill Neeman, MSN, RNC-MNN

Abstract

Problem: Human papillomavirus (HPV) is the most common sexually acquired infection in the world (DeCherney et al., 2018). Even a single dose of the HPV vaccine can provide up to 97% protection against HPV 16 and 18, which are the strains that cause 70% of all cervical cancers (Barnabas et al., 2022). Missouri ranks 35th in the country for HPV vaccination (Office of Disease Prevention and Health Promotion, 2020).

Methods: This quality improvement project implemented an HPV toolkit consisting of: 1) staff nurse education in the form of a written presentation 2) patient and provider education in the form of printed out ACOG info sheets 3) offering HPV vaccine doses to eligible patients 4) utilizing the Medication Administration Record (MAR) to obtain information on vaccine barriers and 5) reminders to staff to address vaccination status with patients.

Results: The HPV toolkit proved statistically insignificant (a = .05, OR = 2.25, p = .449). Due to the timing of IRB approval, hospital physicians began offering the HPV vaccine to eligible patients prior to implementation of the remaining interventions. 90% of eligible pre-implementation participants received the HPV vaccine compared to 81% of eligible post-implementation participants. These results are far above the national average of 39.9% vaccination rate among 18–26-year-olds and surpasses the goal of 80% vaccination rate by 2030 (CDC, 2020). The toolkit was effective across demographic variables.

Implications for practice: Implementing an HPV toolkit in the inpatient postpartum period can increase HPV vaccination uptake. Using the MAR to identify eligible patients, offering the HPV vaccine, and provider and patient education are all interventions that can increase vaccination rates. It may be beneficial to tailor interventions to mitigate postpartum patient overwhelm so the toolkit can be even more effective.

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