Introduction
What you can do to reduce your chances of developing common avoidable conditions or harm.
Inside you will find some information and simple steps you can take to help yourself or someone you care for. If you have any questions please speak to your Nurse or Doctor.
What is a fall?
A fall is when you lose balance unintentionally and it causes you to fall to the floor.
Falls can happen at any age but they are more common as we get older. Some people may be prescribed medications that can increase the risk of them falling. Patients recovering from illness or surgery may be at a higher risk of falling until they feel better.
What should I do if I think I’m at risk?
If you’ve fallen recently, are unsteady on your feet or have a fear of falling. Seek advice from your nurse or Doctor.
Bone Health – Osteoporosis
Have you suffered broken bones before? You may need a bone density scan that will look at the health of your bones or medication to strengthen your bones and prevent further breaks. Speak to your nurse or Doctor.
What can I do to help myself or how can my carer help?
1. Make sure you can see clearly (lighting should be good).
2.Have your eyes tested every two years. If you wear glasses keep them clear of dust and smudges.
3.Check for obstacles or clutter that might trip you up and report any liquid spillages straight away.
4.Clothes should fit well – check trousers and nightdresses are the right length, not too long and dressing gown belts do not dangle.
5.Footwear is low heeled, fastened to the foot and the correct size. If you are in hospital and you do not have slippers, slipper socks that have grips on the sole could be provided to stop you slipping.
6.Take your time when moving especially if you’ve just woken up or are getting up from a sitting position.
7. Exercises can improve your strength, balance and confidence. Chair-based exercises can help if you cannot walk at the moment. If you are worried about walking on your own, ask someone to go with you until you feel confident again.
8.Make sure you have the most appropriate equipment (for example, walking aids and grab rails). Ask your therapist, nurse or Doctor if you are unsure or ask someone to help you until you feel confident again.
If you do have a fall, don’t panic. Call for help and do not try to get up straight away.
What is a pressure ulcer?
A pressure ulcer, sometimes called a pressure sore or bed sore, is an area of damage to the skin and underlying tissue, caused by prolonged pressure to any part of the body.
The first signs that pressure damage may be developing is usually discoloured skin, blisters, swelling or hot/cold patches which may become progressively worse.
People who sit for long periods, have long term conditions or are recovering from an illness or surgery can be more at risk of developing a pressure ulcer.
Muscle tissue is more likely to be affected, so the damage may be under the skin which you cannot see.
An ulcer can develop in as little as a few hours, but can take up to a year to heal.
The surface of skin does not have to be broken for damage to happen underneath.
What can I do to help myself or how can my carer help?
1. Change your position as often as you can, from common pressure areas such as elbows, hips, bottom and heels. For example, when in bed alternate between lying on your back and side and if you can, when sitting, stand for at least one minute every half an hour. If you have pain, ask for pain medication.
2.Sit or lie on clean, dry, crinkle free sheets.
3.Check your skin for signs of pressure damage at least once a day. If skin is darker, redder or more sore than usual, do not continue to lie or sit on that area and tell your carer, nurse or doctor / GP. People with darker skin tones are less likely to have visible reddening of the skin.
4.Use mild and baby soaps (as these are pH balanced), that do not dry out the skin. Dry carefully, without rubbing hard, especially between the toes, groin and under the breasts. Keep your skin moisturised by applying a simple moisturiser. Avoid talcum power. If you have sore areas seek advice.
5.If you suffer from incontinence (where you struggle to control your bladder or bowel movements) it is important to wash your skin with a gentle soap.
6.Please inform your therapist, nurse or doctor if you feel you have a problem with incontinence
What is a blood clot?
Blood clots can happen to anyone but are more likely if you are unwell, less active or dehydrated. Blood becomes more ‘sticky’ and can form a clot. You cannot see it because it is deep within the veins, often in the legs.
This is known as a deep vein thrombosis (DVT). If a piece of the clot breaks away, travels through the bloodstream and lodges in the lung it is known as a pulmonary embolism (PE). This is serious and can be fatal.
What should I do if I think I’m at risk?
If you are known to be at risk of developing a blood clot you may have been:
• prescribed medicines to help prevent a clot forming.
• given special stockings to help the circulation in your calves and legs.
You should take your medicine and wear the stockings as you’ve been directed.
Let your therapist, nurse or doctor know immediately if you have any pain or swelling in your leg or if you suddenly experience a shortness of breath which is not normal for you
What can I do to help myself or how can my carer help?
It is very important to keep the circulation moving in your lower legs.
1.Keep as active as you can.
2.If you are less mobile it’s a good idea to do gentle leg exercises.
3.Try moving your ankles around in a circular motion and moving your toes up and down especially if you are chair bound.
4.If bed bound flex your feet so you can feel your calf muscles stretching every few hours.
5.Smoking can increase the risk of a blood clot. If you do smoke you can get help to stop. Ask a healthcare professional for information.
6.Do not roll down the stockings or fold them over.
7. Make sure you drink enough fluids.
You may be given an injection
• This will be a small needle that will deliver medicine just under your skin.
• The injection can be given in your stomach, thigh or any fatty tissue.
• You will be asked to do this yourself; the nurses will show you or maybe your carer how to do this.
• You may need to continue this at home for a few weeks.
Eating and Drinking
When you are unwell it’s important to get the right nutrition to help with the healing process and your recovery.
This would include eating regularly with 3 meals a day and small snacks in between especially if your appetite is reduced.
Menus are given out to you if you are in hospital. If you require help filling this in ask a member of staff.
If you don’t feel much like eating, milky drinks can be a very helpful way of getting extra energy and protein. You may be given supplement drinks to increase your nutritional intake which can be made with milk or water.
Drinking plenty of fluids will help to keep you hydrated and may help with the absorption of some medicines. Some medicines say to “Take with Food” or “on an empty stomach”.
If you follow a medically prescribed diet be sure to let the ward know as soon as possible so that the right food can be provided.
Sometimes depending on the reason why you are in hospital you may be advised to change your diet or eat a modified diet.
Staff will advise you what may be best for you at the time.
All patients should be screened routinely on admission for risk of malnutrition. If you have lost weight because of illness or are struggling with a poor appetite let your nurse know.
Food hygiene – Your help
When in hospital, food brought in by visitors / relatives is discouraged other than those foods on the following approved list:
• Washed fruit
• Packed confectionary (sweets, chocolate etc)
• Packed biscuits
• Soft Drinks.
Our help
If carers or nursing staff serve your food, they must have washed and dried their hands. In hospital they also need to wear a green plastic apron.
If you are in hospital, all wards have “Protected meal times” – This means that doctors, nurses and visitors are asked not to visit the ward whilst meals are being served and eaten.
Know Your Medicines
If you are admitted into hospital as an inpatient or for a procedure/appointment, please bring all your medications with you; including those you may have purchased over the counter, herbal remedies and vitamin supplements. It is also helpful to bring the most recent copy of your repeat medication list.
If you are an inpatient, you will be visited daily by your Ward Pharmacist. They will use a range of resources to ensure a complete medication list is documented on your admission. This is to ensure that whilst you are in hospital you and your medications will be managed properly.
You may ask your Pharmacist for information regarding your medications, including what they are for, how to take them and common side effects which may occur.
What Can You Do?
• Inform your Pharmacist if you are not taking any of the medications you have been prescribed.
• Tell your Pharmacist, Doctor or Nurse if you are taking any other medications, including over the counter products, herbal remedies, vitamin supplements or internet bought products.
• Bring in all your medications which you are currently taking.
• All medications must be handed to your Nurse for safe storage. These will be kept in your secure bedside locker. Controlled or restricted drugs which are subject to enhanced storage requirements will be stored in the ward controlled drugs cabinet or asked to be sent home with your relatives once we have recorded the appropriate details.
• Never leave medications on your bedside locker or table.
• Only take medications which have been given to you by nursing staff to ensure we have a record of what you have been given.
• Ensure nursing staff confirm your details (name, date of birth and allergy status) before they give you your medications.
• If you have been started on new medication(s), you may ask your Pharmacist for more information about them.
• Always take medications as advised by your healthcare professional.
• If you use needles for any medications, you must dispose of them appropriately in the sharps bins which will be provided to you.
Blood tests
While you are in hospital or at home you may require blood tests. The blood tests will tell the Doctor or nurse a lot of information about how you are and how your body is managing your condition.
When you have a blood test check that the following happens:
1. The Doctor or Nurse will ask you to confirm your name and date of birth.
2.The nurse or Doctor washes their hand thoroughly and applies gloves.
3.Make sure that the Doctor or Nurse writes your name on ALL the blood bottles before they leave.
4.Inform the Doctor or nurse if you have fainted in the past when having blood taken before the test.
5.TELL your Doctor or nurse if you are allergic to plasters or tape used to secure the cotton pad.
6.TELL your Doctor or nurse if you take anticoagulants like warfarin or heparin, watch the site for bleeding after your blood test, you may experience bruising at the site due to the blood thinning medication that you are taking
Investigations
There are many tests and investigation that you may be offered. The investigations you are offered will depend on many reasons including what the Doctor or nurse is trying to exclude.
BEFORE you have your investigation / test
1.Ask the Doctor or nurse what the investigation is for.
2.Make sure you listen and fully understand what they are telling you.
3.If you are not clear ASK AGAIN.
4.BEFORE you have the test, the staff should read out your name, date of birth and sometimes your doctor / GP to check that you are in the correct place and undergoing the test requested by your doctor or nurse.
5.Confirm with the staff what will happen with the results and when you will be given them.
