Getting to the Point: Promoting the HPV Vaccine in a Primary Care Clinic
Successful implimentation of a human papillomavirus (HPV) vaccine has the potential to eliminate 70% of all cervical cancers, 18% of head and necks cancers, and 90% of genital warts in the United States. However, although cancers associated with HPV, which include cervical cancer in women and tonsiliar in males, are overrepresented in the military population, few Military Healthcare System beneficiaries eligible for the vaccine (i.e., between the ages of 9 and 26 years of age) have started the HPV series. The purpose of this evidence-based practice (EBP) project was to initiate and evaluate a HPV vaccination program within a military family practice clinic. Guided by the Rosswurm and Larrabee Model (1999), a two prong approach with deliberate organizational and individual strategies was utilized to promote HPV vaccination. Organizational strategies include identifying and engaging key stakeholders and ensuring the vaccine was available in the the clinic. Individual strategies include synthesizing the literature, presenting a formal staff education program regarding HPV and current clinical practice guidelines for adminstration of the vaccine, and providing updates via posters and short presentations, as needed. The primary process indicator for successful implimentation of this project was measuring the change in patient vaccination over a three month period after the implimentation of the formal educationprogram. At the end of the three month period a small increase in the number of HPV immunizations was noted at the clinic (increasing from 59 the month before the interventio to 70 for three months following the intervention), and an increase from 25% to 38% in males receiving the vaccine. Although modest, this increase over the three month period was nearly equal to half of the total number of HPV vaccinations given in the previous year (210 in three months following the intervention, 409 in the previous year). In addition, this EBP effort generated several new research questions for the investigator, gave this clinic and overwhelming desire to develop future nurse-ld EBP programs, and motivated staff to continue to monitor and promote HPV vaccination among men and women.
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