“Reading between the lines” of flow sheet data: nurses' optional documentation associated with cardiac arrest outcomes

Historically, short “comments” on paper-based flow sheets conveyed the patient's overall clinical state. We analyzed the content and documentation patterns of electronic health record flow sheets for 201 cardiac arrest patients. Free-text comments were associated with the abnormality of clinical measurements (p < .05). The documentation of 3 or more comments for acute care patients was associated with a greater likelihood of dying by discharge (p < .01). Documentation of intensive care unit vital signs greater than the minimum hourly requirement was associated with increased survival of a cardiac arrest (p < .05). Further analysis of such patterns may be useful for the measurement of nursing knowledge and surveillance activities, interdisciplinary communication tools, and clinical decision making.