Date of Award

Spring 5-23-2015

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Joseph Burkard, DNSc, CRNA

Second Advisor

Mary Jo Clark, PhD, RN

Third Advisor

Rebecca Navarrete, MSN, FNP-BC


Project Purpose: The purpose of the project was to implement Human Papillomavirus (HPV) patient education during every well woman exam (WWE) to improve patient knowledge and HPV vaccination rates in military women aged 18-26 years.

Background: The Human Papillomavirus (HPV) has been identified as the biggest risk factor for cervical cancer and, despite the availability of a vaccine; HPV continues to be the most common STI in the U. S. (American Cancer Society, 2013). Approximately 79 million Americans are currently infected with HPV, and 14 million individuals will become infected annually, leading to more than 10,000 cases of cervical cancer each year (Centers for Disease Control and Prevention, 2014). Most cases of HPV are asymptomatic and people are unaware they are infected; thus, patient education and vaccination are key elements to battling the problem. Significant reductions in new HPV infections and reinfection rates are possible with patient education and vaccine recommendation by health care providers.

Project Plan: The health care provider responsible for all women’s health visits in an active duty military treatment facility provided patient education during regularly scheduled annual and/or initial well woman exams. Patients received an educational handout and a verbal recommendation for the HPV vaccine. Immunizations were provided at the close of the visit, if desired. Project effectiveness was evaluated based on changes in HPV immunization rates before and after the project.

Outcomes: The goal of this program was to increase patient knowledge and HPV vaccination rates by providing education and a verbal recommendation for vaccination during regularly scheduled well-woman exams (WWE). The project resulted in a 65% increase in vaccination rates, raising the pre-program vaccination rate of 55% to a post-intervention vaccine percentage of 91%.

Conclusions: The results of this evidence-based practice project demonstrate the importance of patient education and provider recommendation in vaccine acceptance.