The authoritative reference for the CCC System is the User Manual which is detailed below. We’ve also included a link to the foundational textbook by Dr. Saba on Nursing Informatics. However, numerous studies in the peer reviewed literature have researched applications of the CCC System, please see further below for a bibliography from these resources.
The User Manual for Version 2.5
Saba VK. Clinical Care Classification (CCC) System User’s Guide (Version 2.5). 2nd ed. New York: Springer Publishing Company; 2012.
Available in hard copy from Springer Publisher (link opens in new window). Note: If you register on this site (which is free and only takes a minute), you can also find a free digital copy under Tools\Downloads.
From Springer’s website: “The Clinical Care Classification (CCC) System, a national nursing standard, is a respected resource for documenting patient and nursing care plans for the electronic health record (EHR). It provides a set of standardized, coded patient care terminologies for EHR input in nursing diagnoses and outcomes, as well as in nursing interventions in both acute and ambulatory settings. This new edition of the Users Guide, written by one of the founders of the CCC System, has been modified into an abridged, easy-to-use version to help nurses learn quickly about the CCC System Version 2.5 and expedite their development of CCC-based plans of care. It clearly explains how to use the CCC System, including a description of the CCC model and examples of patient/nursing plans or care templates with their EHR screens and brief explanations.
Key Features:
- Clearly explains how to implement the CCC Version 2.5 terminologies and protocol
- Updates, revises, and re-formats the first edition of the Users Guide for ease-of-use
- In use by 100+ hospitals including the Veterans Affairs system
Recent Peer Reviewed Publications about the CCC System
- Rossetti SC, Dykes PC, Knaplund C, Cho S, Withall J, Lowenthal G, Albers D, Lee RY, Jia H, Bakken S, Kang MJ, Chang FY, Zhou L, Bates DW, Daramola T, Liu F, Schwartz-Dillard J, Tran M, Bokhari SMA, Thate J, Cato KD. Real-time surveillance system for patient deterioration: a pragmatic cluster-randomized controlled trial. Nat Med. 2025 Apr 2. doi: 10.1038/s41591-025-03609-7. Epub ahead of print. PMID: 40175738.
- Visintini E, Chiappinotto S, Palese A, Saiani L. L’uso del linguaggio standardizzato infermieristico nelle cartelle cliniche elettroniche: studio esplorativo su opportunità, limiti e strategie [The use of standardized nursing languages in electronic medical records: an exploratory study on opportunities, limitations, and strategies]. Assist Inferm Ric. 2024 Jan-Mar;43(1):16-25. Italian. doi: 10.1702/4250.42267. PMID: 38572704.
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Dykes PC, Skiba DJ. In memory of Dr. Virginia K. Saba EdD, DS, RN, FAAN, FACMI nursing Informatics pioneer. Int J Med Inform. 2023 Jul;175:105022. doi: 10.1016/j.ijmedinf.2023.105022. Epub 2023 Mar 2. PMID: 36918322.
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Fine S, Chaudhri A, Englebright J, Dan Roberts W. Nursing process, derived from the clinical care classification system components, as an earlier indicator of nursing care during a pandemic. Int J Med Inform. 2023 May;173:104954. doi: 10.1016/j.ijmedinf.2022.104954. Epub 2022 Dec 9. PMID: 36842361.
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Staes C, Yusuf S, Hambly M, Phengphoo S, Guo JW. Safety risks and workflow implications associated with nursing-related free-text communication orders. J Am Med Inform Assoc. 2023 Apr 19;30(5):828-837. doi: 10.1093/jamia/ocad018. PMID: 36805706; PMCID: PMC10114042.
- Yang L, Ji X, Chung P, Cao C, Wu Z. Analysis of the Clinical Care Classification System Used in an Intensive Care Unit of a General Hospital in China. CIN Comput Inform Nurs 2021;39(12):837.
Complete List 2005 through 2025
Please can find these references within our online library (external link). References are searchable and may be exported for use in your own reference manager, or simply to create your own bibliography.
We are always looking for more references to add, if you are aware of a reference we are missing please let us know and we will be happy to include it.
Historical References and Other Sources
- For references from 1991 through 2004 please see this bibliography (PDF)
- The International Advisory Board (IAB) manages a curated bibliography of references (external link). These are ‘primary source articles’ and exclude references about the CCCS in which Dr. Saba, original developer of the CCCS, did not contribute. This list is hosted with the National Center for Biomedical Informatics (NCBI) bibliography tool. For additions, corrections, and suggestions please contact the IAB.