Hendrich-II-Fall-Risk-Model - How To 2.5 HOURS try this...

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50 AJN November 2007 Vol. 107, No. 11 http://www.nursingcenter.com How To How To try this try this By Ann Hendrich, MSN, RN, FAAN Continuing Education 2 . 5 HOURS Ed Eckstein Predicting Patient Falls Using the Hendrich II Fall Risk Model in clinical practice.
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[email protected] AJN November 2007 Vol. 107, No. 11 51 A lvin Stewart was a healthy, indepen- dent 65-year-old when he was hospi- talized for partial lung resection for a nonmalignant tumor. (This case is a composite based on my experience.) Now, three days after surgery, his recovery has been complicated by inadequate pain control and chron- ic urinary retention and urgency, exacerbated by the general anesthesia. When asked to rise from the side of the bed or a chair, he has to push up with both hands. As he takes the first few steps he looks un- steady, walking with a noticeable sway, and he fre- quently grabs objects for support. Mr. Stewart is mildly disoriented from oxycodone (OxyContin and others), and he says that it causes him to feel dizzy and “forget exactly where I am.” The nurse discusses toileting assistance with him, and he expresses a strong desire to “go it alone and remain independent.” She believes this desire for independence may prevent him from asking for or waiting for help when he needs it. The nurse had scanned Mr. Stewart’s room for factors that might increase his risk of falling, but she knows that if his risk is high, additional interventions will be needed to reduce it. To ascertain his level of risk, the nurse uses the Hendrich II Fall Risk Model. WHY USE THE HENDRICH II FALL RISK MODEL? Developed by nurses to assess a patient’s risk of falling in the acute care setting, the Hendrich II Fall Risk Model provides a means of predicting which patients are at risk for falling. It is designed to be administered quickly and focuses on eight indepen- dent risk factors identified in 2003 by me and my col- leagues 1 : • confusion, disorientation, impulsivity • symptomatic depression • altered elimination • dizziness, vertigo • male sex • administration of antiepileptics (or dosage changes or cessation) • administration of benzodiazepines • poor performance in the “Get-Up-and-Go” test of rising from a seated position Each of the independent risk factors is assigned a specific score. If a factor isn’t present, the patient receives a score of 0. The researchers derived the scores from the odds ratios identified in the 2003 study. 1 To make scoring simple, the odds ratios, which represented the likelihood of falling as a result of a particular risk factor, were converted to whole numbers, then to risk points. As a result, read it watch it try it Web Video Watch a video demonstrating the use and interpretation of the Hendrich II Fall Risk Model at http://links.lww.com/A111 .
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