104028-6
Hendrich II fall risk model [Hendrich II]
Active
104029-4 Confusion, disorientation, and impulsivity
Form Coding Instructions
Patient may be disoriented to time, place, and/or person. Patient is unable to retain or receive instructions or displays impaired safety or personal judgment: a cluster of global, transient changes and disturbances in attention, cognition, psychomotor activity, level of consciousness, and/or sleep/wake cycles, impulsive behavior, hallucinations, agitation, unrealistic, inappropriate, or unusual behavior
Source: AHI of IndianaFully-Specified Name
- Component
- Confusion, disorientation or impulsivity
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Confusion, disorientation or impulsivity
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.78 (NAM)
- Change Reason
- Release 2.78: COMPONENT: And edited to OR to match the scale expression; SHORTNAME: And edited to OR to match the scale expression;
- Order vs. Observation
- Observation
Normative Answer List LL6517-8
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Confusion, disorientation, impulsivity not observed | 0 | LA33936-8 | |
| Confusion, disorientation, impulsivity observed | 4 | LA33937-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104030-2 Symptomatic depression
Form Coding Instructions
ICD-10 equals depression and/or appears depressed, hopeless, in a melancholic mood, is not interacting appropriately, and/or is tearful, withdrawn, displays a flat affect or seeming lack of interest, states he/she is depressed. A general loss of interest in life events. If the depression is managed with drugs and/or therapies, they do NOT score additional points when the depression is in therapeutic control
Source: AHI of IndianaFully-Specified Name
- Component
- Symptomatic depression
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Change Reason
- Release 2.79: ORDER_OBS: Triggered by coll w SCT: component that the description is property like as in Color, Appearance, Osmolality have changed to Component: Observation, and Property: Color, or Appearance, or Osmolality, so forth…;
- Order vs. Observation
- Observation
Normative Answer List LL6518-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Symptomatic depression not observed | 0 | LA33938-4 | |
| Symptomatic depression observed | 2 | LA33939-2 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104031-0 Altered elimination
Form Coding Instructions
Incontinence, nocturia, frequency, urgency or stress incontinence, diarrhea, or related to use of cathartics, any toileting self-care deficit, e.g., physical impairment. This does NOT include a Foley or indwelling catheter UNLESS it causes symptoms referenced above while in use with the patient
Source: AHI of IndianaFully-Specified Name
- Component
- Altered elimination
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Order vs. Observation
- Both
Normative Answer List LL6519-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Altered elimination not observed | 0 | LA33940-0 | |
| Altered elimination observed | 1 | LA33941-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104032-8 Dizziness, vertigo
Form Coding Instructions
Medical diagnosis of vertigo or reports a sensation of spinning. Sway path may be present when the patient stands (circular motion upon arising)
Source: AHI of IndianaFully-Specified Name
- Component
- Dizziness, vertigo
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.78 (MAJ)
- Order vs. Observation
- Both
Normative Answer List LL6520-2
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Dizziness, vertigo not observed | 0 | LA33943-4 | |
| Dizziness, vertigo observed | 1 | LA33944-2 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104033-6 Born male and/or self-identify as male
Form Coding Instructions
Born male and/or self-identify as male
Source: AHI of IndianaFully-Specified Name
- Component
- Gender [born male or identifies as male]
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Gender [born male or identifies as male]
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Order vs. Observation
- Both
Normative Answer List LL6521-0
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Gender (male) not observed | 0 | LA33945-9 | |
| Gender (male) observed | 1 | LA33946-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104034-4 Any administered antiepileptics [Anticonvulsants]
Form Coding Instructions
Carbamazepine, Divalproex Sodium, Ethotoin, Ethosuximide, Felbamate, Fosphenytoin, Gabapentin, Lacosamide, Lamotrigine, Levetiracetam, Methsuximide, Oxcarbazepine, Phenobarbital, Phenytoin, Pregabalin, Primidone, Topiramate, Trimethadione, Valproic Acid, Zonisamide
Source: AHI of IndianaFully-Specified Name
- Component
- Any administered antiepileptics [Anticonvulsants]
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Any administered antiepileptics Anticonvulsants
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Change Reason
- Release 2.79: COMPONENT: Remove the brackets;
- Order vs. Observation
- Both
Normative Answer List LL6528-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Any administered antiepileptics_anticonvulsants not observed | 0 | LA33947-5 | |
| Any administered antiepileptics_anticonvulsants observed | 2 | LA33948-3 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104035-1 Any administered [Benzodiazepines]
Form Coding Instructions
Alprazolam, Chlordiazepoxide, Clobazam, Clonazepam, Clorazepate, Diazepam, Estazolam, Eszopiclone, Flurazepam, Halazepam3 , Lorazepam, Midazolam, Oxazepam, Quazepam, Ramelteon, Temazepam, Triazolam, Zaleplon, Zolpidem
Source: AHI of IndianaFully-Specified Name
- Component
- Any administered [Benzodiazepines]
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Any administered Benzodiazepines
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Order vs. Observation
- Both
Normative Answer List LL6529-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Any administered Benzodiazepines not observed | 0 | LA33949-1 | |
| Any administered Benzodiazepines observed | 1 | LA33950-9 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104036-9 Get up and go test
Form Coding Instructions
With person sitting in a chair (preferred) or on the side of the bed, place palm of hands flat on thighs and ask them to stand without assistance. Be sure to watch for sway path or signs of dizziness or vertigo upon standing. Watch them take a few steps as they walk or as you stand by them to walk and turnaround with a few more steps. Score the patient according to the Get-Up-and-Go Test guidelines
Source: AHI of IndianaFully-Specified Name
- Component
- Get-up-and-go test: rising from a chair
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Get-up-and-go test: rising from a chair
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Order vs. Observation
- Both
Normative Answer List LL6531-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Ability to rise in a single movement_no loss of balance with steps | 0 | LA33951-7 | |
| Pushes up, successful in one attempt | 1 | LA33952-5 | |
| Multiple attempts, but successful | 3 | LA33953-3 | |
| Unable to rise without assistance during test | 4 | LA33954-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104037-7 Hendrich II total score
Fully-Specified Name
- Component
- Total score
- Property
- Score
- Time
- Pt
- System
- ^Patient
- Scale
- Qn
- Method
- Hendrich II
Long Common Name
Total score Hendrich II
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (MIN)
- Change Reason
- Release 2.79: SURVEY_QUEST_TEXT: Added the requested survey question text;
- Order vs. Observation
- Both
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.
104038-5 Hendrich II fall risk assessment interpretation
Form Context
A score of 5 or greater is considered high risk
Source: AHI of IndianaFully-Specified Name
- Component
- Hendrich II fall risk assessment interpretation
- Property
- Imp
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- Hendrich II
Long Common Name
Hendrich II fall risk assessment interpretation Hendrich II
Basic Attributes
- Class
- CLIN.RISK
- Type
- Clinical
- First Released
- Version 2.77
- Last Updated
- Version 2.79 (NAM)
- Change Reason
- Release 2.79: COMPONENT: Adding interpratation to the assessment;
- Order vs. Observation
- Observation
Normative Answer List LL6533-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| High risk_5 or greater | 5 or greater | LA33957-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
Copyright
- Organization
- AHI of Indiana
- Copyright
- © 2012 AHI of Indiana.
- Terms of Use
- Used with permission.