We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Mr64b Wachs Dysphagia Screening Tool. Mr64b Wachs Dysphagia Screening Tool

Get Mr64b Wachs Dysphagia Screening Tool. Mr64b Wachs Dysphagia Screening Tool

Hospital / Health ServiceDysphagia Screening Tool Royal Brisbane Women's Hospital (BWH)SurnameUMRN / Misgiven NameDOBGender Post CodeAddressWard: Telephone Doctor: Screening Procedure for Patients.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the MR64B WACHS Dysphagia Screening Tool online

The MR64B WACHS Dysphagia Screening Tool is designed to assess individuals for dysphagia and aspiration risk. This guide provides step-by-step instructions on how to accurately complete the form to ensure proper screening and management of swallowing difficulties.

Follow the steps to effectively complete the Dysphagia Screening Tool.

  1. Click ‘Get Form’ button to download and access the MR64B WACHS Dysphagia Screening Tool.
  2. Begin by filling in the patient’s personal information at the top of the form, including surname, given name, unique medical record number (UMRN/MRN), date of birth (DOB), gender, postal code, address, ward, telephone number, and doctor’s name.
  3. Move to Phase 1, where you will assess the patient’s history. Review the list of conditions and indicate ‘Yes’ or ‘No’ for each question. If any boxes are marked ‘Yes’, proceed to Phase 2. If all boxes are marked ‘No’, complete the Swallowing Management Plan as the patient will have a modified or general diet.
  4. In Phase 2, conduct an interview with the patient, family, or carer. Record their responses to the questions regarding swallowing difficulties, cough episodes, and food modifications. Indicate ‘Yes’ or ‘No’ for each response.
  5. If the responses indicate a potential issue, administer the Water Test only if all dysphagia indicators were marked ‘No’. Document the patient’s reaction to swallowing water.
  6. Based on the results from both phases, determine the patient’s status regarding dysphagia. If there are indicators or failed Water Test, refer the patient to a speech pathologist and follow the necessary nutrition and hydration protocols. Document all findings in the medical record.
  7. Complete the Swallowing Management Plan if dysphagia is identified, including recommendations for being nil by mouth (NBM), IV fluids, or NG feeds.
  8. Finalize the form by entering your print name, designation, signature, date, and time in the designated fields. Ensure all sections are completed before saving the changes, downloading, printing, or sharing the form.

Complete your dysphagia screening online today to ensure the health and safety of your patients.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related links form

Sager Brown Know Before You Go Peace Poster Kit Order Form - Lions Clubs International - Lionsclubs Twic Card Cost Regional Transportation District Employment Application - RTD

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The VFSS (Videofluoroscopic Swallowing Study) is the standard assessment for dysphagia. The VFSS is commonly conducted in hospitals by radiology and SLP.

Abstract. Videofluoroscopic swallow studies (VFSS) are often considered the 'gold standard' technique to assess dysphagia.

Water swallow test (WST) is commonly applied for dysphagia screening [11]. A validation study of WST documented a sensitivity of 96.5%, a specificity of 48.7%, and a false positive rate of 51.3% [12].

The EAT-10 is a valid outcome measure for dysphagia therapy. The National Foundation of Swallowing Disorders has provided an online version. The M.D. Anderson Dysphagia Index (MDADI) is a valid, reliable questionnaire for people with head and neck cancer.

During the exam, the SLP will carefully evaluate your teeth, lips, jaws, tongue, cheeks and soft palate. You may need to perform movements like smacking your lips together or sticking out your jaw, and you might be asked to make sounds such as coughing or clearing your throat.

Dysphagia screening: “Swallowing screening is a pass/fail procedure to identify individuals who require a comprehensive assessment of swallowing function or a referral for other professional and/or medical services.” ( American Speech-Language-Hearing Association, 2004)5.

Dysphagia assessments may involve the use of the Fibreoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopic Swallowing Study (VFSS) or diagnostic ultrasound.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get MR64B WACHS Dysphagia Screening Tool. MR64B WACHS Dysphagia Screening Tool
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232