Assessing Screening Process at Wesley Women’s Clinic to Improve HPV Vaccination [15M]

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Abstract

INTRODUCTION:

The lifetime cumulative risk of developing a human papilloma virus (HPV) infection is at least 80%. HPV infection has been shown to cause cervical cell abnormalities that serve as precursors to dysplasia and cancerous changes. This project aimed to evaluate the HPV vaccination screening process at Wesley Women’s Clinic (WWC) in order to increase the number of patients who are offered the HPV vaccine.

METHODS:

We retrospectively reviewed well-woman visits and postpartum visits at WWC for women ages 20-26 from January through February 2017. Only non-immune patients (have not received any HPV vaccination) were included. Cases were assessed to determine whether clinicians discussed the HPV immunization, recommended the HPV vaccination, and whether it was administered.

RESULTS:

Of 48 patients reviewed, 36 were included. The majority of the patients (52.8%, n=19) were seen for a postpartum visit, and mean age was 22.9±2.14 years old (range: 20-26). Eight (22.2%) patients had the HPV vaccination discussed at their appointment. Six (16.7%) patients were offered vaccination. Two (5.6%) patients declined the vaccine before the physician offered vaccination. Four (11.1%) patients received a HPV vaccination dose. When vaccination was discussed, it was not administered to 50% (4/8) of patients due to inability to afford the vaccine and patient refusal.

CONCLUSION:

HPV vaccination is poor due to lack of physician discussion at routine health maintenance visits and patient refusal. Steps to improve HPV vaccination rates include modifying the electronic medical record to include a vaccination history on the postpartum visit template, and creating a well-woman exam visit template.

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