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Measuring Direct Nursing Cost Per Patient in the Acute Care Setting

Jenkins, Peggy PhD, RN; Welton, John PhD, RN

Journal of Nursing Administration: May 2014 - Volume 44 - Issue 5 - p 257–262
doi: 10.1097/NNA.0000000000000064

OBJECTIVE: The objective of the study was to measure the variability of direct nursing cost for similar patients and to examine the characteristics of nurses assigned to different types of patients.

BACKGROUND: There is no standard method for measuring direct nursing cost by patient.

METHODS: Deidentified data were collected from 3 databases for patients admitted from January 2010 through December 2012 on 1 medical/surgical unit in a large Magnet® hospital. Direct nursing care time and costs were calculated from the nurse-patient assignment.

RESULTS: Variability in nursing intensity (0.36-13 hours) and cost per patient day ($132-$1,455) was significant for similar patients. Higher cost nurses were not assigned sicker patients (F 3, 3029 = 87.09, P < .001, R 2 = 0.124). Mean (SD) nursing direct cost per day was $96.48 ($55.73).

CONCLUSIONS: Standard measurement of nursing cost per patient could be benchmarked across hospitals and inform nursing administration care delivery decisions.

Supplemental Digital Content is available in the text.

Author Affiliations: Senior Director (Dr Jenkins), VHA, Inc, Irving, Texas; Professor, Director of PhD Program and Senior Scientist (Dr Welton), University of Colorado College of Nursing, Aurora.

The authors declare no conflicts of interest.

Correspondence: Dr Jenkins, 9506 E 4th Ave, Denver, CO 80230 (

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