{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:54:37Z","timestamp":1791442477226,"version":"4.3.3"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The transition from the intensive care unit (ICU) to a general ward is a period of heightened vulnerability, yet the precise timing and modifiable predictors of adverse events remain poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine the incidence, timing and types of adverse events following ICU\u2010to\u2010ward transfer, evaluate the predictive accuracy of four early\u2010warning scores and identify independent risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A prospective cohort study of 207 adult patients transferred from ICUs to general wards at a tertiary university hospital over 20\u2009months (March 2024\u2013October 2025) was enrolled. Four early warning scores (PACS, MEWS, SWIFT, LACE) were calculated daily for 5\u2009days post\u2010transfer. Multivariable logistic regression was used to identify independent risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The total number Adverse events occurred in 52 patients (25.1%), most commonly ICU readmission (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946, 22.2%) and healthcare\u2010associated infections (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929, 14.0%). Critically, 88% of events occurred within the first 48\u2009h (day 1: 56.0%; day 2: 32.0%). SWIFT demonstrated the highest predictive accuracy at transfer (AUC 0.856). Mechanical ventilation was the strongest independent risk factor (OR 10.11), followed by prolonged ICU stay (OR 6.40), respiratory diagnosis (OR 4.99), &gt;\u20093 invasive devices (OR 4.41) and comorbidities (OR 3.64). These five factors collectively explained 88.5% of adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adverse events affect one in four patients after ICU\u2010to\u2010ward transfer, with the vast majority occurring within the first 48\u2009h. A simple set of readily identifiable risk factors can guide nursing surveillance and targeted interventions during this critical window.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Bedside nurses should prioritize enhanced monitoring for patients with a history of mechanical ventilation, prolonged ICU stay, multiple invasive devices and significant comorbidities during the first 48\u2009h post\u2010transfer. Daily use of early\u2010warning scores can inform monitoring frequency and rapid response activation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70700","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:15:36Z","timestamp":1791436536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The First 48\u2009Hours: Incidence, Timing and Predictors of Adverse Events After\n                    <scp>ICU<\/scp>\n                    \u2010To\u2010Ward Transfer: A Prospective Cohort Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-9789","authenticated-orcid":false,"given":"Ghada Shalaby Khalaf","family":"Mahran","sequence":"first","affiliation":[{"name":"Department of Critical Care and Emergency, Faculty of Nursing Philadelphia University  Amman Jordan"},{"name":"Faculty of Nursing Assiut University  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1023-2425","authenticated-orcid":false,"given":"Heba","family":"Gebril","sequence":"additional","affiliation":[{"name":"Medical Surgical Nursing, Faculty of Nursing Alexandria University  Alexandria Egypt"},{"name":"College of Nursing Shaqra University  Shaqra Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan A.","family":"Odeh","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Northern Border University  Arar Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2969-7619","authenticated-orcid":false,"given":"Mostafa Muhammad Ahmed","family":"Ali","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Nursing Department, Faculty of Nursing Assiut University  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Ramadan","family":"Abdalfadeel","sequence":"additional","affiliation":[{"name":"Primary Nursing Department, Faculty of Nursing Al\u2010Ahliyya Amman University  Amman Jordan"},{"name":"Nursing Administration Department, Faculty of Nursing Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-2062","authenticated-orcid":false,"given":"Muamar O.","family":"Aldalaeen","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Northern Border University  Arar Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000001341"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-021-02696-y"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.7475\/kjan.2025.37.1.36"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12091"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.14744\/ejp.2022.4001"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0B013E318164E3B0"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066620981902"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-020-01609-w"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc12747"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.12885"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000042955"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2022.103378"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4867-0"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.1923"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201611-851OC"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2020.02.003"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004327"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.4266\/acc.2022.01375"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/94.10.521"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000000266"},{"key":"e_1_2_14_25_1","unstructured":"S. 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