# Tool for Nursing Acuity Measurement - Swedish version (NAM-S) for somatic in-patient care: development, validity, and reliability

## TL;DR

This paper introduces a validated nursing acuity measurement tool, NAM-S, for adult somatic in-patient care in Sweden.

## Contribution

The study presents a newly developed and validated nursing acuity tool tailored for Swedish adult somatic in-patient care.

## Key findings

- The NAM-S tool demonstrated acceptable validity and inter-rater reliability.
- The tool distinguishes between advanced and basic nursing tasks.
- Further research is needed to refine and assess the practical use of NAM-S.

## Abstract

Nursing acuity measurements refer to the assessments of the intensity of nursing care required by a patient, helping to determine appropriate levels of nursing resources and staffing requirements. The aim of this paper is to describe the development and validation of a tool for measuring nursing acuity within adult somatic in-patient care settings, distinguishing between advanced nursing tasks and basic nursing tasks.

The nursing acuity tool was developed through an iterative process in the context of a Swedish healthcare region. The methodological process involved a literature search, exploration of non-validated tools used within Swedish healthcare, and nursing staff discussions to reach a conceptual tool. This tool underwent pilot testing across five wards, as well as testing for content- and construct validity, and inter-rater reliability.

After an iterative process of development and testing, we reached a final version of a tool, subsequently named the Swedish Nursing Acuity Measurement (NAM-S). The results demonstrated acceptable validity and inter-rater reliability.

Our study provided support that the NAM-S can be used for assessing nursing acuity within adult somatic in-patient care. To refine the model, further examinations of its usefulness and experiences of the practical use of NAM-S are warranted.

The online version contains supplementary material available at 10.1186/s12913-026-14036-w.