BSN Tracker

Assessment Tool: 3-Ounce Water Swallow Test

Follow the administration steps and observe the patient during and for 1 minute after the swallow. Record any positive indicators. A positive screen requires NPO precautions and urgent Speech-Language Pathology referral. This screen does not rule out silent aspiration.

3-Ounce Water Swallow Test

A standardised bedside dysphagia screening test. The patient drinks 3 oz (90 mL / approximately 6 tablespoons) of water in a continuous swallow without stopping. Presence of any indicator during or within 1 minute after the swallow constitutes a positive (fail) screen. Developed by DePippo, Holas, and Reding (1992). Sensitivity ~70–75% for aspiration detection.

Administration steps

  1. Ensure patient is alert and in an upright sitting position (≥ 60° head of bed).
  2. Confirm no contraindications (e.g., patient is already known to be unsafe for thin liquids).
  3. Give patient 90 mL (3 oz) of plain water in a cup.
  4. Instruct: "Drink all of this water without stopping."
  5. Observe during and for 1 minute after the swallow for the indicators below.
⚠️ Safety note: Do not perform this test if the patient is unconscious, severely cognitively impaired, or already known to be unsafe for thin liquids. A passed 3-oz test does not rule out silent aspiration. SLP evaluation is the gold standard.
Was the test administered?
Observed Indicators (mark all that apply)

If ANY indicator is present, the screen is positive (fail).