About half of adults admitted to intensive care units (ICUs) are patients whose condition has deteriorated while on a medical-surgical unit. Patients’ early warning scores (EWSs) are based on physiological measures and were developed as a decision tool to help bedside nurses identify and take action when a patient decompensates.

Fetzer and colleagues created an EWS bundle of interventions, including alerting an experienced ICU nurse, to improve communication and patient outcomes related to patient deterioration. After testing the bundle, they found the following:

  • The number of medical-surgical transfers to the ICU decreased.

  • The percentage of patients admitted to the ICU after a rapid response team (RRT) call decreased.

  • RRT calls increased in general but decreased for patients with an EWS greater than 4 (indicating clinical deterioration), suggesting earlier identification and intervention occurred with deteriorating patients.

Findings suggest that use of an electronically...

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