The following article is part of coverage from the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020). Due to the global COVID-19 pandemic, the Association made the necessary decision to cancel the meeting originally scheduled for March 25 to 28, 2020, in Long Beach, CA. While live events will not proceed as planned, readers can click here to catch up on the latest research intended to be presented at the meeting.
Implementation of a human papillomavirus (HPV) vaccine tool-kit is an effective way to increase vaccination rates among adolescents, according to results of a poster presented virtually at the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2020).
The 4 Pillars Practice Transformation Program is an evidence-based tool kit that has been shown to increase HPV vaccination rates across settings, noted lead author Rachel E. Hodge, MSHS, BSN, RN, from the University of Maryland School of Nursing. Staff education was conducted and patient education materials were posted throughout the primary care clinic where the kit was implemented. The Pillars were implemented over a 10-week period:
- Pillar 1 (Convenience and Easy Access): All encounters of patients aged 11 to 18 years were used as an opportunity to vaccinate
- Pillar 2 (Patient Communication): providers issued a recommendation from the Centers for Disease Control and Prevention for the HPV vaccine using the Same-Way Same-Day strategy
- Pillar 3 (Enchanted Vaccination Systems): Immunization status was assessed as part of vital signs and Vaccine Information Statements were given to all eligible patients parents
- Pillar 4 (Motivation): Progress toward improving HPV vaccination rates was tracked and posted in the staff break room of the clinic
Prior to the program, the HPV vaccination rate was 68%. Of the patients presenting for 11-year-old well child checks, 100% were vaccinated (n=32). The final rate of vaccination was 76.6%, representing an 8.6% increase in vaccinations. All of the eligible patients were given vaccine information statements, and immunization status was assessed as part of vital signs for 100% of patient encounters. No real difference in gender was discovered in the final HPV vaccination rate; among boys (n=521), there was a 78% final rate while girls (n=574) had a 76% final rate.
A total of 15 patients who previously refused vaccination were vaccinated following implementation of the 4 Pillars Practice Transformation Program, noted Ms Hodge.
Recommended areas of improvement, according to the authors, include clear documentation of reason for vaccine refusal to better focus education efforts and advocacy for the HPV vaccine to be mandatory as half of refusals in this project were due to deferral until school entry mandates it.
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Hodge RE, Hoffman A. Increasing humanpapilloma virus vaccination rates among adolescents in primary care. Presented virtually at: NAPNAP 2020; June 4-5, 2020. Abstract F12.