en ● International Health مقاله اصيل پژوهشي Orginal Article <div style="text-align: justify;"><strong>Background</strong>: The early warning score (EWS), developed by the royal college of physicians, is a bedside tool based on the measurement of patients&rsquo; vital signs to enable early detection of physiological deterioration within 24 hours. It assigns numerical scores to parameters, including respiratory rate, oxygen saturation, body temperature, systolic blood pressure, heart rate, and level of consciousness.&nbsp;<br> <strong>Methods</strong>: A quasi-experimental design was used to conduct this study in the Emergency Department at Main Hospital, Assiut University, Egypt. A purposive sample of 120 patients was enrolled and randomly assigned in a 1:1 ratio to a study group receiving EWS-based care (n=60) and a control group receiving routine care (n=60) using simple coin flip randomization. Data collected over six months (January&ndash;June 2025). Three tools were used: Tool I: patient assessment, tool II: EWS implementation, and tool III: patient outcomes.<br> <strong>Results</strong>: Patients in both groups were predominantly male (45.0% in the study group and 60.0% in the control group), with comparable mean age (46.48&plusmn;8.38 vs 45.93&plusmn;11.51 years). The study group experienced a substantial reduction in unplanned intensive care unit (ICU) admissions (23.3% vs 68.3%, P<0.001) and significantly lower rates of emergency surgery, urinary tract infection, and neurological complications (P<0.01). However, the mean hospital stay was longer in the study group than the control group (6.72&plusmn;2.31 vs 4.25&plusmn;1.23 days; P<0.001).<br> <strong>Conclusion</strong>: Although the study was limited to a single acute care setting, findings suggest that structured physiological monitoring enhances early recognition of deterioration.</div> Acute care, Early warning score (EWS), Outcomes 391 400 http://jrh.gmu.ac.ir/browse.php?a_code=A-10-2857-1&slc_lang=en&sid=1 Ekhlas Tag Allden Ahmed EkhlasElkhteeb@gmail.com 100319475328460047535 0009-0001-5148-8523 Yes Department of Critical Care and Emergency Nursing, Assiut Universty Hospital, Assiut, Egypt. Mona Aly Mohamed Mona@aun.edu.eg 100319475328460047536 0009-0006-9051-0216 No Department of Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Asyut, Egypt. Hanan Mahmoud Ahmed Drhanan_abalrus@aun.edu.eg 100319475328460047537 0009-0006-7639-6541 No Department of Endocrinology, Faculty of Medicine, Assiut University, Asyut, Egypt.