SCALE PREDICTIVENESS OF PNEUMONIA RISK IF FED

Patient: ____________________________ Date: _______

FACTORS	Not present	Risk present	Questionable/ borderline
Multiple or progressive disease / one diagnosis
Multiple medications (>5) / <5 medications
NPO (PEG) / Oral
Oral Hygiene: fair-poor / good – excellent
Smoker / non-smoker
Inpatient / outpatient
Physical ability: mobile / sedentary
Reflexive cough: present / absent-delayed
Cognitive status: fair-poor / good – excellent
Management of secretions: minimal / copious
TOTAL

Score

< 7 = Use extreme caution

5-6 = fair – good

<3 = good – excellent