Dietetics lacks a validated tool that captures inpatient nutrition acuity beyond malnutrition. Through an iterative process, a nutrition acuity scoring tool (NAS) was created. It was based on nutrition diagnoses seen with inpatients and their need for medical nutrition therapy (MNT) in order to avoid the onset or deterioration of a diagnosis. The tool underwent face validity testing at 12 hospitals but required further validation.

To measure the content validity of the NAS as a metric for inpatient nutrition acuity.

A modified Delphi approach as an online survey was used to examine the NAS content validity. Canadian dietitians with experience using and teaching nutrition care process terminology (NCPT) ranked each NAS item on a Likert scale for clarity (very clear to very unclear) and appropriateness (very appropriate to very inappropriate). The a priori content validity index threshold at the item (iCVI) and scale level (sCVI) was 0.78 and 0.9, respectively. Items not meeting the iCVI threshold in round 1 were modified for round 2. RESULTS: Participants (N=13) were from 5 provinces, averaged 14.2 years of work experience (SD 8.2), had used NCPT terminology for 5 years (SD 1.6), worked full time (76.9%, n=10), were from a teaching hospital (84.6%, n=11) and had provided NCPT instruction (84.6%, n=11). Consensus was achieved on all items after two Delphi rounds. The sCVI for Delphi round 1 and 2 was 0.93 and 0.96, respectively.

The NAS was found to be content valid with a sample of Canadian dietitians. This tool would benefit from reliability testing.

Inpatient acuity and complexity is rising. A metric that classifies nutrition acuity helps dietitians describe their patient population and is an essential step for triaging inpatients to receive dietitian services.