{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:04:50Z","timestamp":1790323490931,"version":"4.1.0"},"reference-count":34,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100002082","name":"Health New Zealand Te Whatu Ora","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002082","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intensive and Critical Care Nursing"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.iccn.2026.104481","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:04:58Z","timestamp":1782518698000},"page":"104481","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["The use of the modified Dutch worry criteria, combined with vital signs and early warning scores, to improve nurses' recognition and escalation of ward deteriorating patients: A prospective cross-sectional observation multi-method study"],"prefix":"10.1016","volume":"97","author":[{"given":"Alison M.","family":"Pirret","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwadwo","family":"Ofori-Anyinam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"De-Viell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Goodin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9","key":"10.1016\/j.iccn.2026.104481_bb0005","doi-asserted-by":"crossref","first-page":"5234","DOI":"10.1111\/jan.16260","article-title":"Early warning tools and clinician \u2018agency\u2019 for strengthening safety culture: an integrative review","volume":"81","author":"Ferguson","year":"2025","journal-title":"J Adv Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0010","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/jan.14619","article-title":"Do early warning track and trigger tools improve patient outcomes? A systematic synthesis without meta-analysis","volume":"77","author":"Credland","year":"2020","journal-title":"J Adv Nurs"},{"issue":"8","key":"10.1016\/j.iccn.2026.104481_bb0015","doi-asserted-by":"crossref","first-page":"4871","DOI":"10.1111\/jan.16656","article-title":"Critical points of Rrsk in registered nurses\u2019 use of a National Early Warning Score\u2014Perceptions and challenges","volume":"81","author":"Nadaf","year":"2025","journal-title":"J Adv Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0020","first-page":"1","article-title":"Early warning scores for detecting deterioration in adult hospital patients\u202f: systematic review and critical appraisal of methodology. BMJ","volume":"369","author":"Gerry","year":"2020","journal-title":"Br Med J"},{"issue":"9","key":"10.1016\/j.iccn.2026.104481_bb0025","doi-asserted-by":"crossref","DOI":"10.2196\/28209","article-title":"Predicting patient deterioration: a review of tools in the digital hospital setting","volume":"23","author":"Mann","year":"2021","journal-title":"J Med Internet Res"},{"issue":"1","key":"10.1016\/j.iccn.2026.104481_bb0030","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-024-02531-6","article-title":"Indicators of clinical deterioration in adult general ward patients from nurses\u2019 perspectives: a mixed-methods systematic review","volume":"23","author":"Chung","year":"2024","journal-title":"BMC Nursing"},{"issue":"2","key":"10.1016\/j.iccn.2026.104481_bb0035","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0300-9572(02)00100-4","article-title":"The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team","volume":"54","author":"Hodgetts","year":"2002","journal-title":"Resuscitation"},{"issue":"1","key":"10.1016\/j.iccn.2026.104481_bb0040","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-015-0950-5","article-title":"Nurses\u2019 worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review","volume":"19","author":"Douw","year":"2015","journal-title":"Crit Care"},{"issue":"1","key":"10.1016\/j.iccn.2026.104481_bb0045","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-024-02645-x","article-title":"Nurse worry as a trigger for rapid response team activation improving outcomes: a retrospective cohort study in non-critical units","volume":"24","author":"Gentil","year":"2025","journal-title":"BMC Nursing"},{"key":"10.1016\/j.iccn.2026.104481_bb0050","first-page":"62","article-title":"The impact of a modified New Zealand early warning score (M\u2013NZEWS) and NZEWS on ward patients triggering a medical emergency team activation: a mixed methods sequential design","author":"Pirret","year":"2021","journal-title":"Intensive Critical Care Nursing"},{"key":"10.1016\/j.iccn.2026.104481_bb0055","first-page":"68","article-title":"Removing modifications to the New Zealand early warning score- does ethnicity matter? A multimethod research design","author":"Pirret","year":"2022","journal-title":"Intensive Crit Care Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0060","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/j.1365-2648.2005.03615.x","article-title":"Packaging: a grounded theory of how to report physiological deterioration effectively","volume":"52","author":"Andrews","year":"2005","journal-title":"J Adv Nursing: Wiley"},{"key":"10.1016\/j.iccn.2026.104481_bb0065","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.aucc.2013.11.001","article-title":"Nurses\u2019 perceptions of accessing a medical emergency team: a qualitative study","volume":"27","author":"Massey","year":"2014","journal-title":"Aust Crit Care"},{"key":"10.1016\/j.iccn.2026.104481_bb0070","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.aucc.2009.07.001","article-title":"\u2018Patients of concern\u2019 to nurses in acute care settings: a descriptive study","volume":"22","author":"Cioffi","year":"2009","journal-title":"Aust Crit Care"},{"key":"10.1016\/j.iccn.2026.104481_bb0075","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ijnurstu.2016.04.006","article-title":"Nurses\u2019 \u2018worry\u2019 as predictor of deteriorating surgical ward patients: a prospective cohort study of the Dutch-early-nurse-worry-Indicator-score","volume":"59","author":"Douw","year":"2016","journal-title":"Int J Nurs Stud"},{"issue":"4","key":"10.1016\/j.iccn.2026.104481_bb0080","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1097\/NNA.0b013e3182118528","article-title":"Assessing individual frontline nurse critical thinking","volume":"41","author":"Berkow","year":"2011","journal-title":"J Nurs Adm"},{"key":"10.1016\/j.iccn.2026.104481_bb0085","series-title":"Legitimising ward nurses\u2019 worry to improve management of deteriorating patients: A pilot quality improvement project","author":"Pirret","year":"2020"},{"key":"10.1016\/j.iccn.2026.104481_bb0090","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/nop2.1105","article-title":"Signs and symptoms, apart from vital signs, that trigger nurses\u2019 concerns about deteriorating conditions in hospitalized paediatric patients: a scoping review","volume":"9","author":"Jensen","year":"2021","journal-title":"Nurs Open"},{"key":"10.1016\/j.iccn.2026.104481_bb0095","first-page":"40","article-title":"Using the NEWS2 and ABCDE assessment to identify early signs of clinical deterioration","author":"Nicholas","year":"2024","journal-title":"Nursing Standard: RCNi"},{"key":"10.1016\/j.iccn.2026.104481_bb0100","series-title":"Quantitative psychological research: The complete student's companion","author":"Clark-Carter","year":"2018"},{"key":"10.1016\/j.iccn.2026.104481_bb0105","doi-asserted-by":"crossref","DOI":"10.1016\/j.iccn.2025.104145","article-title":"Beyond the score: rethinking early warning scores and rapid response systems in complex clinical environments","volume":"90","author":"Bruyneel","year":"2025","journal-title":"Intensive Crit Care Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0110","doi-asserted-by":"crossref","DOI":"10.1016\/j.iccn.2024.103628","article-title":"Combining the nurse intuition patient deterioration scale with the National Early Warning Score provides more net benefit in predicting serious adverse events: a prospective cohort study in medical, surgical, and geriatric wards","volume":"83","author":"Haegdorens","year":"2024","journal-title":"Intensive Crit Care Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0115","article-title":"\u2018White lies and safety nets\u2019: the perceptions of nurses on the use of early warning systems and the development of higher-order thinking skills","author":"Massey","year":"2024","journal-title":"Aust Crit Care"},{"issue":"1","key":"10.1016\/j.iccn.2026.104481_bb0120","article-title":"Ward-based staff perspectives on their preparedness to recognize patient Ddterioration: an interpretive description study","volume":"33","author":"Mikhail","year":"2025","journal-title":"J Nurs Res"},{"key":"10.1016\/j.iccn.2026.104481_bb0125","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.aucc.2023.06.004","article-title":"Exploring the nurses\u2019 experiences in recognising and managing clinical deterioration in emergency patients: a qualitative study","volume":"37","author":"Qingqing","year":"2024","journal-title":"Aust Crit Care"},{"key":"10.1016\/j.iccn.2026.104481_bb0130","first-page":"163","article-title":"Acknowledging: a classic grounded theory explaining how nurses\u2019 employ clinical judgement when complying with early warning system protocols","author":"Connor","year":"2025","journal-title":"Int J Nurs Stud"},{"issue":"6","key":"10.1016\/j.iccn.2026.104481_bb0135","doi-asserted-by":"crossref","first-page":"509","DOI":"10.7861\/clinmed.2022-0435","article-title":"Using NEWS2: an essential component of reliable clinical assessment","volume":"22","author":"Welch","year":"2022","journal-title":"Clin Med"},{"issue":"5","key":"10.1016\/j.iccn.2026.104481_bb0140","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13051359","article-title":"Exploiting the features of clinical judgment to improve assessment of disease severity in the emergency department: an Acutelines study","volume":"13","author":"Visser","year":"2024","journal-title":"J Clin Med"},{"issue":"2","key":"10.1016\/j.iccn.2026.104481_bb0145","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/jan.15547","article-title":"How nurses use national early warning score and individual early warning score to support their patient risk assessment practice: a fieldwork study","volume":"79","author":"Langkjaer","year":"2023","journal-title":"J Adv Nurs"},{"key":"10.1016\/j.iccn.2026.104481_bb0150","doi-asserted-by":"crossref","first-page":"e497","DOI":"10.1016\/S2589-7500(22)00067-X","article-title":"Clinical assessment as a part of an early warning score\u2014a Danish cluster-randomised, multicentre study of an individual early warning score","volume":"4","author":"Nielsen","year":"2022","journal-title":"Lancet Digital Health"},{"issue":"9","key":"10.1016\/j.iccn.2026.104481_bb0155","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/nop2.70032","article-title":"Internationally qualified nurses\u2019 perspectives on transitioning specialty skills within Australia: a content analysis","volume":"11","author":"Kurup","year":"2024","journal-title":"Nurs Open"},{"key":"10.1016\/j.iccn.2026.104481_bb0160","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnsa.2022.100083","article-title":"Global migration and factors that support acculturation and retention of international nurses: a systematic review","volume":"4","author":"Pressley","year":"2022","journal-title":"Int J Nursing Studies Adv"},{"key":"10.1016\/j.iccn.2026.104481_bb0165","series-title":"Language barriers between nurses and patients: a scoping review. Patient education and counselling","author":"Gerchow","year":"2021"},{"key":"10.1016\/j.iccn.2026.104481_bb0170","first-page":"6","article-title":"Transitioning experiences of internationally educated nurses in host countries: a narrative systematic review","author":"Rajpoot","year":"2024","journal-title":"Int J Nursing Studies Adv"}],"container-title":["Intensive and Critical Care Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339726001497?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339726001497?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:36:09Z","timestamp":1790321769000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0964339726001497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":34,"alternative-id":["S0964339726001497"],"URL":"https:\/\/doi.org\/10.1016\/j.iccn.2026.104481","relation":{},"ISSN":["0964-3397"],"issn-type":[{"value":"0964-3397","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The use of the modified Dutch worry criteria, combined with vital signs and early warning scores, to improve nurses' recognition and escalation of ward deteriorating patients: A prospective cross-sectional observation multi-method study","name":"articletitle","label":"Article Title"},{"value":"Intensive and Critical Care Nursing","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.iccn.2026.104481","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104481"}}