Interpreting nurses' responses to clinical documentation alerts.

OBJECTIVE: To understand how nurses respond to alerts that detect attempts to enter into electronic health records patient weights that vary significantly from previously recorded weights.
METHODS: Examination of subsequent patient weights to determine if the alerts were true positive (TP) or false positive (FP), and whether nurses overrode alerts, changed their entry or quit without storing a value.
RESULTS: Alerts occurred 2.74%, with 41.9% TP and 58.1% FP. Nurses overrode 30.3% of TP and 97.3% of FP alerts.
CONCLUSIONS: The alert has an acceptable FP rate and does not appear to cause nurses to change entries to satisfy the alert. The alert improves recording of patient weights.