Summary Of Ann Hendrich II Fall Risk Model

Ann Hendrich, a geriatric nurse, designed an assessment tool called the Hendrich II Fall Risk Model. In an article entitled "Predicting Patient Falls; Using the Hendrich II Fall Risk Model in clinical practice", the author discusses this assessment tool and how it can be used to quickly assess a hospitalized patient's risk of falling using eight distinct risk elements. The fall risk assessment tool has been validated using a large case-controlled study in an acute care tertiary facility. Ann Hendrich gives a brief composite example of a situation in which the assessment tool can be implemented and goes on to discuss the reasons why nurses should use this tool in clinical practice. The author also details each specific risk factor, all of which

are intrinsic; confusion or disorientation, depression, dizziness or vertigo, being of male gender, taking medications like benzodiazepines and antiepileptics, performance on the Get-Up-and-Go test, and altered elimination.

The Hartford Institute for Geriatric Nursing video (entitled) demonstrates in a video, the fall risk assessment tool being used at a sub-acute hospital.

The webcast shows a student nurse, a staff nurse, and Ann Hendrich caring for an elderly man with a history of knee and ankle injuries. The student and the nurse begin by asking the man a few questions about sleep, pain, and elimination patterns. The Get-Up-and-Go test is then implemented, before determining that the patient is at high risk for falls. In the webcast, Ann Hendrich explains to viewers that the highest risk factor for falls is unmet elimination

needs.

Because altered elimination is such a key factor in the prediction of patient falls, improving continence in these patients is a nursing priority. There are various methods that are useful in controlling urinary and fecal incontinence; these methods are discussed in an article by Mary Wilde et al entitled "Self-Management of Urinary and Fecal Incontinence: Employing evidence-based strategies can help patients take better control". Along with describing strategies that can be employed by patients themselves to manage incontinence, the authors also discuss the behaviors that need to be adopted by patients in order to do so. These behaviors include describing the problem, carrying out a plan of action to reach objectives, pursuing evidence-based information to construct opinions about treatments and interventions, and self-monitoring. The article outlines several methods to manage incontinence such as avoiding greasy foods, performing Kegel exercises, eating meals at regular intervals, and utilization of the Knack maneuver. The authors use a composite case study to illustrate the significance of self-efficacy in managing incontinence. The authors posit that because self-efficacy leads to increased self-confidence and increased self-perception of ability in incontinent patients, it influencing patients to maintain these habits.

Self-efficacy and self-management play an important role for older adults in terms of fall-prevention strategies, and awareness of risk status.

McInnes et al discusses these themes in the article "Older people's views in relation to risk of falling and need for intervention: a meta-ethnography". Using this meta-ethnographic approach, the authors employed qualitative studies and a systematic literature search to determine which factors aid in the acknowledgement of risk status in older adults. The authors found that people 65 years of age and older could decrease feelings of powerlessness, and provide themselves some semblance of control by utilizing self-management techniques. These techniques include self-assessment of abilities, and embracing opportunities to modify their

surroundings.

Because even slight variations in behavior, cognition, or gait and balance can seriously increase fall risk, nurses have the responsibility and opportunity to implement fall-prevention interventions like the Hendrich II Fall Risk Model. Continuous fall-risk assessments can mean the difference between declining health or increased independence for a patient who is at risk. Asking patients questions about their elimination patterns is paramount, not just for assessing fall risk, but also because it can lead to a meaningful discussion about self-management interventions. When patients engage in a collaborative method of care, the benefits of self-management interventions are enhanced . Nurses encourage these benefits by promoting a patient's knowledge of evidence-based interventions, which can help patients actualize constructive approaches to managing incontinence. How older adults perceive the label of "high-risk" also has serious implications for nursing practice; the literature provides evidence to support the notion that older adults who are labeled as high risk for falls may perceive themselves as less independent. Because of this, it is essential that nursing care permits older adults to wholeheartedly engage in decision-making, and be able to incorporate their personal choices into the plans of care. By doing so, nurses increase a patient's commitment to well-being and thus, enhance their health status.