Uptake of the Human Papillomavirus Vaccine
Uptake of the Human Papillomavirus Vaccine
This quality assurance (QA) project used a descriptive design. The project was undertaken in a small private urban pediatric practice to examine the percentage of eligible girls who had uptake of the HPV vaccine and completed the three-dose series during the year of 2007. The practice includes one full-time board-certified pediatrician and two part-time board-certified pediatric nurse practitioners and has an active patient population of 2766. Ages of patients range from newborn through age 21 years. Demographics of the study population are shown in Table 1.
The practice policy was to offer the HPV vaccine during all office visits for eligible girls, including both well-child care (WCC) and episodic visits (gynecologic and non-gynecologic appointments). Eligibility for the HPV vaccine was determined to be age 12 years or older. Exclusion criteria included known pregnancy (the CDC does not require pregnancy testing prior to the administration of the vaccine), moderate or severe illness, or hypersensitivity to yeast or any component of the vaccine. The HPV vaccine can be given to female clients who are lactating, are immuno-compromised, have minor acute illness, have had genital warts or an equivocal or abnormal PAP test, or have tested positive for HPV via the Hybrid Capture II High Risk test (CDC, 2009a). The pediatrician and nurse practitioners utilized typical office vaccination practices, including the provision of brief verbal education during which current recommendations for the HPV vaccine were provided followed by provision of a standardized CDC Vaccine Information Sheet on the HPV vaccine to parents (CDC, 2009a). If parents declined the HPV vaccine for their daughters, a notation was made in the chart and the HPV vaccine was to be offered again at the next office visit. If parents agreed to uptake of the HPV vaccine, the first dose was given to their daughters and the parents were encouraged to schedule an appointment for administration of the next dose prior to leaving the office. No reminders were used to follow up on the second or third doses if they had not been scheduled, and no follow-up telephone calls or postcards were sent for second or third doses that were missed.
Methods of data collection included both computer query and chart review. A Web-based data management system is used in the office for electronic scheduling and billing. A query of this database identified the number of active patients who were eligible (N = 518) and the number who received the vaccine within two age cohorts: 12 to 17 years and 18 to 21 years. The unit of analysis for this project was the patient, and all patients were accounted for once they were in the data set as described in the following section. Data were collected on completion of the first, second, and third doses via a chart review by the nurse practitioner.
Descriptive statistics were used to summarize the HPV vaccine uptake and dose completion rates. A χ analysis was used to examine the difference in proportions of HPV vaccine uptake between younger and older age groups in the practice.
Methods
Description of the Practice
This quality assurance (QA) project used a descriptive design. The project was undertaken in a small private urban pediatric practice to examine the percentage of eligible girls who had uptake of the HPV vaccine and completed the three-dose series during the year of 2007. The practice includes one full-time board-certified pediatrician and two part-time board-certified pediatric nurse practitioners and has an active patient population of 2766. Ages of patients range from newborn through age 21 years. Demographics of the study population are shown in Table 1.
Participants
The practice policy was to offer the HPV vaccine during all office visits for eligible girls, including both well-child care (WCC) and episodic visits (gynecologic and non-gynecologic appointments). Eligibility for the HPV vaccine was determined to be age 12 years or older. Exclusion criteria included known pregnancy (the CDC does not require pregnancy testing prior to the administration of the vaccine), moderate or severe illness, or hypersensitivity to yeast or any component of the vaccine. The HPV vaccine can be given to female clients who are lactating, are immuno-compromised, have minor acute illness, have had genital warts or an equivocal or abnormal PAP test, or have tested positive for HPV via the Hybrid Capture II High Risk test (CDC, 2009a). The pediatrician and nurse practitioners utilized typical office vaccination practices, including the provision of brief verbal education during which current recommendations for the HPV vaccine were provided followed by provision of a standardized CDC Vaccine Information Sheet on the HPV vaccine to parents (CDC, 2009a). If parents declined the HPV vaccine for their daughters, a notation was made in the chart and the HPV vaccine was to be offered again at the next office visit. If parents agreed to uptake of the HPV vaccine, the first dose was given to their daughters and the parents were encouraged to schedule an appointment for administration of the next dose prior to leaving the office. No reminders were used to follow up on the second or third doses if they had not been scheduled, and no follow-up telephone calls or postcards were sent for second or third doses that were missed.
Data Collection
Methods of data collection included both computer query and chart review. A Web-based data management system is used in the office for electronic scheduling and billing. A query of this database identified the number of active patients who were eligible (N = 518) and the number who received the vaccine within two age cohorts: 12 to 17 years and 18 to 21 years. The unit of analysis for this project was the patient, and all patients were accounted for once they were in the data set as described in the following section. Data were collected on completion of the first, second, and third doses via a chart review by the nurse practitioner.
Data Analysis
Descriptive statistics were used to summarize the HPV vaccine uptake and dose completion rates. A χ analysis was used to examine the difference in proportions of HPV vaccine uptake between younger and older age groups in the practice.
Source...