Addressing Human Papillomavirus Prevention During Pediatric Acute Sexual Assault Care.
Stephanie Anne Deutsch, Sarah Benyo, Sherlly Xie and 4 others
PMID 30130316WHAT IT FOUND
Adding HPV vaccination discussion to an ED sexual assault pathway increased counseling from 18% to 76% of eligible patients.
Nine patients were vaccinated in the ED. Younger age, male gender, and reliance on caregiver recall for vaccination status were associated with missed opportunities to address HPV.
Key findings
01HPV counseling and vaccination discussion occurred in 76% of intervention group subjects compared to 18% of control group subjects, a statistically significant increase.
02Nine children in the intervention group received HPV vaccination in the ED, whereas none were vaccinated in the control group.
03Failure to deliver HPV-focused care was associated with younger age, male gender, and reliance on verbal report for vaccination status verification.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted at a single institution, limiting generalizability. Data collection was retrospective, relying on documentation accuracy. Sample size for the primary outcome analysis (age-eligible patients) was small (n=105). Broader quality improvement efforts for ED sexual assault care occurred simultaneously, which may have influenced adherence to pathway recommendations independent of the HPV-specific changes. Caregiver reports of vaccination status were not confirmed against state or jurisdictional registries, so accuracy was unknown.
Declared interests
The authors declared no conflicts of interest. One author was supported by the Nemours Foundation. Work was supported by an Institutional Development Award from the National Institute of General Medical Sciences.
The easy way to misread this
Do not assume that pathway implementation guarantees equitable care delivery. The study found that younger and male victims were significantly more likely to have HPV care missed, indicating that provider bias or knowledge gaps about eligibility may persist despite standardized protocols.