Failure to recognize early signs of deterioration can result in unplanned and unnecessary admissions to an intensive care unit (ICU) for acutely ill patients convalescing in the hospital. Clinical deterioration is likely to occur up to 8 hours before decisions to initiate a transfer to an ICU. However, failure to recognize a patient’s clinical deterioration accounts for 40% of the unplanned and avoidable transfers to an ICU.

Early warning scores (EWSs), systematic methods for early detection of a patient’s risk for clinical deterioration, are often derived from physiological parameters and nursing assessments to prompt nursing action. The adoption of electronic medical records by health care systems has provided an opportunity for the integration of EWSs as a clinical decision support tool to minimize unplanned transfers and avoid ICU transfers. However, one of the significant limitations of EWSs integrated into electronic medical records...

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