{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:00:19Z","timestamp":1790816419529,"version":"4.1.0"},"reference-count":18,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>No standardized process for determining intensive care unit discharge readiness is available. Intensive care unit readmission is associated with adverse patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether implementation of an intensive care unit discharge protocol based on the National Early Warning Score impacts intensive care unit readmission rates, intensive care unit length of stay, and rapid response team activations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This quality improvement initiative was implemented in the medical intensive care unit at a 671-bed urban, academic medical center. De-identified electronic medical record data (vital signs, length of intensive care unit stay, and readmission risk factors) were obtained before and during the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two hundred ten patients during the preintervention phase and 211 patients during the intervention phase met inclusion criteria. A nonsignificant 1.5% reduction in intensive care unit readmission rate was found (P = .54). Mean National Early Warning Score at intensive care unit discharge for patients who required readmission was significantly higher in the preintervention group (P = .004), and significantly more patients in the preintervention group were discharged with a National Early Warning Score indicating high risk (P = .04). Length of stay and rapid response team activations did not significantly differ between groups. All readmitted patients had readmission risk factors, most commonly respiratory reasons and vital sign abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An intensive care unit discharge protocol provides standardization to the discharge process and promotes collaboration between nurses and physicians. Future research on a National Early Warning Score\u2013driven intensive care unit discharge protocol is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2026340","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:02:40Z","timestamp":1790812960000},"page":"e1-e8","source":"Crossref","is-referenced-by-count":0,"title":["Standardizing Intensive Care Unit Discharge Through Use of the National Early Warning Score"],"prefix":"10.4037","volume":"46","author":[{"given":"Abigail","family":"Weilbacher","sequence":"first","affiliation":[{"name":"Abigail Weilbacher is a doctor of nursing practice student, Mennonite College of Nursing, Illinois State University, Normal, Illinois, and the assistant unit director of the medical intensive care unit at Rush University Medical Center, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn A.","family":"Prasun","sequence":"additional","affiliation":[{"name":"Marilyn A. Prasun is the Carle BroMenn endowed professor at Mennonite College of Nursing, Illinois State University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Cook","sequence":"additional","affiliation":[{"name":"Heather Cook is the manager of the critical care outreach team and vascular access team at Rush University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"1","key":"2026093020023566100_b1-04600e1","doi-asserted-by":"publisher","first-page":"e13782","DOI":"10.2196\/13782","article-title":"Impact of intensive care unit readmissions on patient outcomes and the evaluation of the National Early Warning Score to prevent readmissions","volume":"3","author":"Mcneill","year":"2020","journal-title":"JMIR Perioper Med"},{"issue":"45","key":"2026093020023566100_b2-04600e1","doi-asserted-by":"publisher","DOI":"10.1186\/s43168-025-00402-5","article-title":"Risk factors and associated outcomes of respiratory ICU readmission","volume":"19","author":"Hasswa","year":"2025","journal-title":"Egypt J Bronchology"},{"issue":"6","key":"2026093020023566100_b3-04600e1","doi-asserted-by":"publisher","first-page":"e62840","DOI":"10.7759\/cureus.62840","article-title":"Determinants of readmission in the intensive care unit: a prospective observational study","volume":"16","author":"Kumar","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"2026093020023566100_b4-04600e1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13037-024-00391-2","article-title":"The Rothman Index predicts unplanned readmissions to intensive care associated with increased mortality and hospital length of stay: a propensity-matched cohort study","volume":"18","author":"Stahel","year":"2024","journal-title":"Patient Saf Surg"},{"issue":"4","key":"2026093020023566100_b5-04600e1","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.aucc.2016.10.003","article-title":"Scoping review: the use of early warning systems for the identification of in-hospital patients at risk of deterioration","volume":"30","author":"Le Lagadec","year":"2017","journal-title":"Aust Crit Care"},{"issue":"4","key":"2026093020023566100_b6-04600e1","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1002\/nop2.821","article-title":"Nurses\u2019 experiences and perceptions of two early warning score systems to identify patient deterioration \u2013 a focus group study","volume":"8","author":"Langkjaer","year":"2021","journal-title":"Nurs Open"},{"key":"2026093020023566100_b7-04600e1","unstructured":"Royal College of Physicians\n          . 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