Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Irene Gilliland


Allison Schebler - Poulos


The purpose of this quality improvement project was to increase human papillomavirus vaccination series initiation rates among indigent women, ages 19-26, at a clinic in South Texas. The human papillomavirus is a sexually transmitted infection that has been associated with multiple types of cancers. Each year, approximately 6.2 million cases of the human papillomavirus infection are diagnosed; as many as 75% of all new infections occur among females 18-26 years of age. The human papillomavirus vaccination has a high efficacy in regards to cancer prevention, preventing as many as 76% of cancers with only one dose. The project included educating clinic staff about human papillomavirus vaccination guidelines, finding a funding source for the human papillomavirus vaccine and developing a protocol for aligning the providers with current guidelines and screening patients to identify vaccine eligible women. The population served at this clinic was primarily Hispanic (84%), 22 years of age, used no contraceptive methods (62%), was single (92%), with a high school diploma (56.9%). Before initiation of the project, random chart audits of 50 human papillomavirus vaccination eligible women indicated that only one out of 50 received the human papillomavirus vaccination. During the project cycle, 21 of the 50 human papillomavirus vaccination eligible women received at least 1 dose of the vaccination, indicating clinical and statistical significance. The interventions implemented were effective in improving adherence to guidelines and improved vaccination rates by 40%. Stakeholder commitment to the project ensures sustainability.