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Adult nursing
Nurses’ intuitive worrying predicts physiological changes in patients’ vital signs
  1. Kate Frazer
  1. School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
  1. Correspondence to Dr Kate Frazer, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin 4, Ireland; kathleen.frazer{at}

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Commentary on: Romero-Brufau S, Gaines K, Nicolas CT, et al. The fifth vital sign? Nurse worry predicts inpatient deterioration within 24 hours. JAMIA Open 2019.

Implications for practice and research

  • Worry factor scores may assist nurses with assessment and prediction of patient deterioration in hospitals.

  • Further research is needed to determine the weight of the worry factor variable in conjunction with other elements of early warning score systems.


The introduction of early warning scores and rapid responses is associated with improvements in patient outcomes such as cardiopulmonary arrests in general wards, unplanned intensive care unit (ICU) admissions and mortality.1 Internationally, systems enhancing patient safety and reducing risk of adverse events are part of quality measures embedded in organisations.1–3 Douw et al’s systematic review finds nurses’ judgement and intuition in assessing patient signs and symptoms are skills developed over time leading …

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  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.