Aspirin Prescription For Moderate- and High-Risk Obstetric Population in Outpatient Clnic; A Quality Improvement Project.
Conditions: Low Birth Weight, Small for Gestational Age (SGA), Preeclampsia (PE), Prevention &Amp; Control
Sponsor: Cairo University

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Study title: Aspirin Prescription For Moderate- and High-Risk Obstetric Population in Outpatient Clnic; 
A Quality Improvement Project. 
 
Date: 4/11/2024 
 
NCT06694233 
 
 

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CLINICAL AUDIT PROJECT PLAN 
 
Please complete this project plan before starting your project. 
 
1. Short Title of Audit: 
Aspirin Prescription For Moderate- and High-Risk Obstetric Population 
in Outpatient Clnic; A Quality Improvement Project.  
 
2. Details of Audit Lead  
Audit Lead: 
Name: Islam Elkhateb 
Designation: Registrar  
Contact details: 
E-mail: islamtarekhamed@gmail.com 
Phone: 99780408 
 
3. Details of Audit Sponsor:  
 
Name:  
Designation: Consultant  
Audit Sponsor: 
Name: 
Designation: Consultant 
 
Name:  
Designation: Head of department  
 
4. Date plan completed: 
27/10/2024 
 
5. Rationale and Objectives of the Audit: 
Ρrееϲlаmpѕia is a syndrome characterized by the new onset of hуреrtеnѕion plus proteinuria, end-organ 
dysfunction, or both after 20 weeks of gestation. It complicates 3-5% of pregnancies.  
 
Low-dose aspirin reduces the frequency of рrееϲlampsia, as well as related adverse рrеgոaոcy 
outcomes (preterm birth, growth restriction), by 10 to 70 percent when taken by patients аt moderate to 
high risk of the disease. It has an excellent maternal/fetal safety profile, thus it is a reasonable 
preventive strategy for these patients. 
 
A pilot study at our hospital found that not all patients who are candidates for aspirin prescription 
receive it. The aim of this audit cycle is to increase aspirin prescription rates for moderate and high risk 
obstetric population. 
 
 
6. Based on your audit rationale how would you classify this audit? 
This is an external audit   
(e.g. National audit) 
 
This is an internal audit  
(e.g arising from Trust objectives/ risks/ incidents / 
complaints/ NICE guidelines compliance etc) 
This a Division/Service priority  
  
(e.g. part of Divisional or Team Service improvement 
priorities) 
 
This is an individual clinician interest  
(e.g. personal interest, personal development or as 
part of an educational or training programme) 
 
7. What criteria will be audited?  
 
Criterion (suggested proforma) 
Current Target Exception 
Evidence 

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Advise pregnant women at high risk of pre-eclampsia to 
take 75 mg to 150 mg of aspirin daily from 12 weeks until 
the birth of the baby. Women at high risk are those with 
any of the following: 
1. hypertensive disease during a previous pregnancy 
2. chronic kidney disease 
3. autoimmune disease such as 
systemic lupus erythematosus or 
antiphospholipid syndrome 
4. type 1 or type 2 diabetes 
5. chronic hypertension. [2010, amended 2019] 
 
Advise pregnant women with more than 1 moderate risk 
factor for pre-eclampsia to take 75 mg to 150 mg of aspirin 
daily from 12 weeks until the birth of the baby. Factors 
indicating moderate risk are: 
1. nulliparity 
2. age 40 years or older 
3. pregnancy interval of more than 10 years 
4. body mass index (BMI) of 35 kg/m2 or more at first 
visit 
5. family history of pre-eclampsia 
6. multi-fetal pregnancy. [2010, amended 2019] 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
40% 
100% None 
Hypertension 
in pregnancy: 
diagnosis and 
management. 
NICE guideline 
133. Last 
updated 17 
April 2023. 
 
8. How will you implement changes and recommendations? 
 
▪ Labels/ reminders maybe put posted in outpatient department rooms/ clinics.  
▪ Proforma/ labels maybe put in each patient file (like the VTE risk assessment table) 
▪ The topic will be mentioned in the morning meeting.  
▪ The topic maybe covered and illustrated in one of the biweekly scientific meetings.  
▪ An emai/ message maybe sent to all teams on the OBGYN department group.  
 
 
9. Do the audit standards cover the practice of one or more professional groups? 
This is a Multi-disciplinary audit 
 
 
This is an Uni-disciplinary audit 
 
 
 
 
10. What data collection method will be used? 
Concurrent and prospective data collection: Aspirin presciprion rates for high- and moderate- risk 
groups over the month of October were investigated.   
 
After drawing receommendations and implementing changes, Aspirin prescription rates over the next 
six months (November 2024- April 2025) will be monitored and audited.  
 
11. What is your sample size?  

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Interval sampling is the method used for sample size calculation in this audit, in which all cases who will 
present in May 2025 will be included.  
 
 
12. What is your planned project timetable 
Project Activity 
Estimated Completion Date 
Date of completiomn of data collection, inputting, and 
analysis 
31/10/2024 
Proposed date for presentation of results and 
recommendations for the modification of practice 
4/11/2024 
Proposed date for start of implementation of modifications 
5/11/2024 
Proposed date for re-auditing the results 
5/ 2025 
 
 
13. How will service users or carers be involved in this audit? 
Service users are not be involved in this audit since they cannot modify/ control the outcome. 
 
 
Project lead:                                                                                         Project supervisors: 
   
 
 
 
 
 
Department head: