<![CDATA[Background: Patient transfer from the intensive care unit (ICU) to general wards is a critical transition associated with adverse events (AEs), treatment failure, and mortality. Evidence on optimal transfer management remains fragmented across clinical, nursing, managerial, and patient outcome perspectives. Objective: This systematic review aimed to integrate multidisciplinary evidence on ICU-to-ward transfer management strategies and their effects on patient safety and outcomes. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Five databases were searched for studies published from 2015 to 2026. The protocol was prepared a priori but was not registered in PROSPERO. Quality assessment and risk of bias evaluation used the Newcastle-Ottawa Scale, Cochrane Risk of Bias 2 (RoB 2), AMSTAR 2, and Critical Appraisal Skills Programme (CASP) tools. Results: Twenty studies involving more than 500,000 patients were included. Post-transfer AE incidence ranged from 19–24%, ICU readmission from 8.9–24.1%, and each hour of transfer delay increased mortality odds by 3%. Medication interventions reduced inappropriate medication continuation by 55% (OR 0.45; 95% CI, 0.31–0.63). ABCDEF bundle implementation reduced seven-day mortality (aHR 0.32). Post-intensive care syndrome affected 54–78% of survivors, while machine learning improved readmission prediction (AUC 0.76–0.91). Conclusion: Safe ICU-to-ward transfer requires standardized handover, optimized timing, risk screening, ABCDEF bundle implementation, staff education, and structured follow-up. Integrated protocols can reduce AEs and ICU readmissions while improving care continuity.]]>
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