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Optimising your recovery

Healthcare in hospital is complex and statistics show that around one in 10 people admitted to hospital will suffer unintended harm due to an error in their treatment or care – called an adverse event. Some adverse events will be minor but some can have serious health consequences, including delayed recovery, significant injury and even death. You can play an important role in optimising your recovery by reducing your risk of suffering an adverse event both in hospital and when you return home.

You can also optimise your recovery with rehabilitation programs that can help you manage your heart condition and maintain your health and wellbeing.

Avoiding falls*

Having a fall can be a major setback when you’re already unwell, causing injury, lack of independence and reduced confidence. Being in hospital and returning home after discharge can significantly increase your risk of a fall because:

  • you’re in a different environment
  • you frequently go from lying down to standing
  • of poor balance
  • of low blood pressure
  • of some medications
  • of physical inactivity
  • of poor eyesight
  • of unsafe footwear such as floppy slippers.

The following steps should be taken to lower your chance of having a fall in hospital:

  • Wear comfortable clothing that isn’t too long or loose, and low-heeled, non-slip shoes that fit you well rather than slippers. Don’t walk without footwear if you have therapeutic stockings on.
  • Take your time when getting up from a sitting position (particularly after emptying your bladder) or lying down, and let staff know if you feel unwell or unsteady on your feet.
  • Bring any walking aids you already have with you to hospital and use them rather than the walls or furniture for balance. If staff recommend that you need assistance or supervision when walking, always ask them for assistance and wait for them to help you.
  • Bring your glasses with you to hospital. If you wear more than one pair, use the correct pair for walking. Be especially careful using bi-focal or multi-focal lenses.
  • Familiarise yourself with your room, its furniture and the bathroom. Advise staff if there is any clutter or spills that may cause you to fall.
  • Drink plenty of fluids.

When you return home, take the same precautions and try to be active every day in as many ways as possible. If you think you may be at increased risk of falling when you return home you can request a professional assessment of your home to identify where the risks are and suggest modifications that will make your home safer.

Things you can do to lower your risk of falling are:

  • keep physically active so that you avoid muscle weakness.
  • walk with your back straight and your eyes up.
  • keep your vision functioning well by getting your eyesight checked every 12 months and when you get new glasses give yourself time to get used to them
  • make sure your home is brightly lit, especially on stairs or steps and install night-lights in case you need to get up frequently during the night to go to the toilet. Alternatively, keep a torch by your bedside or have a bedside light that can be comfortably turned on before you get out of bed.
  • ensure walkways are free of electrical cords, furniture and other clutter. Remove rugs or mats that can slide or secure with double sided tape, Velcro or tacks.
  • check that your home has bathroom and kitchen areas fitted with non-slip surfaces. Use non-slip mats in the bath and shower and by the toilet.
  • wipe up spills as soon as they happen.
  • install handrails by stairs or steps and in bathrooms and toilets.
  • keep frequently used items in storage that are easy to reach to avoid having to use a step ladder or climb onto a chair.
  • be aware of pets when moving around in the house or garden.
  • make sure that outdoor stairs or steps are well lit and have sturdy hand or grab rails. Repair uneven paths, decking or driveways. Keep pathways clear especially if you are carrying bulky items like washing or shopping.
  • to reduce the risk of having a fall, report any hazards in your community such as missing handrails, uneven paths, slippery surfaces or poor lighting. When shopping, take care on tiled floors and report any wet areas to your local council or shopping centre or store managers.

*Adapted from the Australian Council on Safety and Quality in Healthcare’s Falls prevention: Information for Patients and Carers and Best Practice Guidelines for Australian hospitals and Residential Aged Care Facilities (2005).

Avoiding infection

If you have angina – the most common group of symptoms in coronary artery disease – it is important that you avoid getting an infection that can make you generally unwell and worsen your heart condition. You can take steps to minimise your risk of getting an infection including:

  • If you are preparing for surgery DO NOT shave the surgical site unless instructed to do so by your surgeon
  • Before surgery ensure you wash in accordance with the instructions from your healthcare provider
  • If you have an open wound, be careful to get and follow instructions from your health practitioner on treatment and care
  • Avoid close contact with people who have an infectious condition and ask people not to visit you if they are sick. If you are sick, stay away from other patients.
  • Doctors, nurses, dentists and other healthcare professionals come in contact with lots of viruses and bacteria, and it’s essential that they clean their hands properly before they treat you. If you’re concerned, ask your health practitioner if they have washed their hands before they touch you.

When you return home avoid infection by:

  • Cleaning your hands regularly, particularly before touching or eating food. Use warm water and soap and rub your hands vigorously for at least 15 seconds. Alternatively, you can use an alcohol-based gel your local pharmacy or supermarket. This should be done after you’ve used the bathroom, taken out the rubbish, changed a nappy, handled money or played with a pet.
  • Covering your mouth and nose, using a tissue or handkerchief, when you cough or sneeze, and then cleaning your hands.

Avoid medication errors

One of the most common causes of adverse events in hospitals and at home is medication errors. Here are three simple things you can do to try and reduce the risk of harm due to a medication error and optimise your recovery :

  • Keep track of all the medications you take, including complementary and non-prescription medicines. If you’re going to hospital, bring a list of these medicines with you and let hospital staff know about your medicines as soon as possible.
  • When you’re in hospital, tell hospital staff immediately if you have any medication-related concerns – if you feel unwell after taking or being given a medication, if you believe you have been refused any medication, or if your medication is delayed
  • Make sure you know what each of your medications are for, what the side effects or complications are and whether it’s safe for you to take these medications in combination. You should ask your doctor why they have prescribed the medication for you, and you can always ask your pharmacist for any written consumer medicines information, called CMI, that you can refer to when required. For more information on how you can play an active role in ensuring you use your medications safely and for more tips on how to reduce medication-related adverse events, see Maximising your health outcomes – Minimising medication errors.

Cardiac Rehabilitation

Your doctor may recommend cardiac rehabilitation for angina, or after a heart attack or medical procedure. This is a medically-supervised program and may help improve the health and wellbeing of people who suffer from heart problems.

The cardiac rehab team can include doctors, nurses, specialists, physical and occupational therapists, dietitians or nutritionists and psychologists or other mental health specialists.

Rehab generally has two parts:

  • Exercise training. Teaches you how to exercise safely, strengthen muscles and improve stamina. Your exercise plan should be based on your abilities, needs, and interests.
  • Education, counselling, and training. Helps you understand your condition and finds ways to reduce your risk of future problems. The rehab team will help you learn how to cope with the stress of adjusting to your new lifestyle and deal with your fears about the future.

Enhanced External Counterpulsation Therapy

Enhanced external counterpulsation (EECP) therapy can be helpful for some people who have angina. Large cuffs (like the one the doctor puts on your arm when you have your blood pressure taken) are put on your legs. The cuffs are inflated and deflated in sync with your heartbeat.

EECP therapy improves the flow of oxygen-rich blood to the heart muscle and helps relieve angina. Typically, you’ll receive 35 lots of one-hour treatments over approximately seven weeks as part of a rehabilitation program.

Next: Looking to the future

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Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the information. Bupa Australia is not liable for any loss or damage you suffer arising out of the use of or reliance on the information. Except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.

Last published 31 October 2011

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