**Supplement**


#### TTSH-Nutrition Screening Tool


#### IF SCORE IS 4 OR MORE, REFER TO THE DIETITIAN.


Copyright @ Tan Tock Seng Hospital 1 Nutrition and Dietetics Department

**Supplement**

130 Seminars in Dysphagia

TTSH-Nutrition Screening Tool

Refer to instructions overleaf

Total Score

Indicators Scoring

Diagnosis nutritional risk level Moderate 1

Physical appearance Moderately underweight 1

Diet intake adequacy over past Reduced moderately 1 5 days or more Reduced severely 2

Unintentional weight loss over Unsure 1 past 6 months Yes, 0.5 – 3.0kg 2

IF SCORE IS 4 OR MORE, REFER TO THE DIETITIAN.

Name /Sign \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Dietitian contacted \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Copyright @ Tan Tock Seng Hospital 1

Nutrition and Dietetics Department

Ward Bed Unit

Low 0

High 2 Normal 0

Severely underweight 2 Normal 0

Not available -- No 0

Yes, >3.0-7.0kg 3 Yes, >7.0kg 4 Yes, Unsure 2

Patient Details

Instructions:. Score the patients for each criterion by referring to the tables below


Copyright @ Tan Tock Seng Hospital 2 Nutrition and Dietetics Department
