Table 2.

Confirming the Study Findings

ICU	Phase 1 Analysis	Phase 3 Analysis	Summary Opinions of Findings
Predictive for Death
HR	X	X	Participants agreed with this finding. In particular, they are noticing when changes in the patient are more acute, and they are more at risk. Some participants also expressed that they take vitals (e.g., blood pressure or heart rate) more frequently when somebody is on pressors.
BT	X	X	Some participants agreed with the nursing practice of measuring temperature more frequently so that clinicians can get continuous data. Others asked why body temperature was considered a significant feature for predicting mortality in the ICU while respiratory rate, blood pressure, and oxygen level were not. Some participants commented on body temperatures were manually measured, while other data were coming from mechanical ventilators, which may explain the aspects of clinical practice for patient deterioration in the ICU.
Withheld meds	X	X	Some agreed with the findings since withholding a medication generally means the patient is too sick to receive it. A few participants argued with this finding, though, saying if patients are sicker, then they would receive more medications, such as a bolus or antibiotics.
Predictive for Survival
PRN administration	X	-	Some were unsure why an increase in PRN medications given was found to be associated with survival to discharge in both the ICU and ACU. Others wondered which types of medications were considered “PRN” compared to standard, planned orders. Some participants stated that if more analgesic was given for temperature or pain, it would be associated with survival. A few participants expressed that nurses often titrate medications for at-risk patients instead of giving PRN medications. Furthermore, some participants did not understand our interpretation of a PRN-given, while others questioned our methods of analysis and inclusion of PRN-given data in the analytic model.

ACU	Phase 1 Analysis	Phase 3 Analysis	Summary Opinions of Findings
Predictive for Death
SpO₂	X	X	Participants agreed with the ACU-related findings. Specifically, some agreed that increases in blood pressure and oxygen saturation entries are signs of increased concern for patients in the ACU. “If you’re checking SpO₂ and blood pressures more often, you’re more worried about the patient. If you’re commenting about the SpO₂, that’s bad.”
BP	X	X	Participants agreed with the ACU-related findings. Specifically, some agreed that increases in blood pressure and oxygen saturation entries are signs of increased concern for patients in the ACU.
BT	X	-	Only a few participants stated that if patients were septic, body temperature would be frequently monitored. Others disagree with this, saying taking temperature would not be a focus when concerned about a patient.
Predictive for Survival
RR	X	-	A fraction of the clinicians were uncertain that increases in respiratory rate entries were significant in predicting patient survival in the ACU. They noted that respiratory rate is a unique vital sign, and a value within the normal range for respiratory rate was an estimated value, not a measured value, is entered in the EHR by nurses and nursing assistants. One participant felt that within the context of our study, the value of respiratory rate, and not its frequency, was a more suitable proxy for nursing concern.
PRN administration	X	X	They also agreed with the association of increases in PRN medications given with being discharged alive from the ACU. These clinicians stated that for a provider to treat a patient with a PRN medication, such as pain medications, a patient must have a stable enough mental status to complain about a symptom. Additionally, pain is associated with many complications, such as agitation and tachycardia, especially in the ACU. Thus, PRNs given are a good sign of treating pain to lead to better outcomes.

X: Significant, Non-significant, HR: heart rate, BT: body temperature, Withheld meds: withheld medication administrations, PRN: Pro re nata medication administration, SpO₂: oxygen saturation, BP: blood pressure, RR: respiratory rateICU: Intensive Care Unit, ACU: Acute Care Unit