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Costing Nursing Care: Using the Clinical Care Classification System to Value Nursing Intervention in an Acute-Care Setting


CIN: Computers, Informatics, Nursing: August 2011 - Volume 29 - Issue 8 - p 455-460
doi: 10.1097/NCN.0b013e3181fcbe55
Feature Article

The purpose of this study was to combine an established methodology for coding nursing interventions and action types using the Clinical Care Classification System with a reliable formula (relative value units) to cost nursing services. Using a flat per-diem rate to cost nursing care greatly understates the actual costs and fails to address the high levels of variability within and across units. We observed nurses performing commonly executed nursing interventions and recorded these into an electronic database with corresponding Clinical Care Classification System codes. The duration of these observations was used to calculate intervention costs using relative value unit calculation formulas. The costs of the five most commonly executed interventions were nursing care coordination/manage-refer ($2.43), nursing status report/assess-monitor ($4.22), medication treatment/perform-direct ($6.33), physical examination/assess-monitor ($3.20), and universal precautions/perform-direct ($1.96). Future studies across a variety of nursing specialties and units are needed to validate the relative value unit for Clinical Care Classification System action types developed for use with the Clinical Care Classification System nursing interventions as a method to cost nursing care.

Author Affiliations: Clinical Simulation and Technology, School of Nursing, University of Alabama at Birmingham (Dr Moss); and Clinical Care Classification (CCC), SabaCare, Inc, Alexandria, VA (Dr Saba).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Jacqueline Moss, PhD, RN, NB 356 1530 3rd Ave S, Birmingham, AL 35294 (

© 2011 Lippincott Williams & Wilkins, Inc.