@lizardillo The hospital equipment looks very detailed & accurate. 
I agree that the hospital bed rails could be adjusted.
In my experience, the rails don't tilt outward. They are straight up & down (vertical), or against the bed in the down position. (They pop straight outward a little, then push down against the side of the bed, so even when it's being moved, it doesn't lean out at an angle. It's always perpendicular to the bed.)
I would bring the upper rail in front of the elbow (on the side closest to the viewer, with the handle above), but I don't think you'd need to change the arm. If you feel like it needs it, you could add a pillow under it. (I think it'd be fine either way, so maybe don't bother with a pillow.) (I agree with the comment about the hand facing the other way around, so we would see the palm side & fingertips coming over the bar.)
You also might want to make the rails taller, since it looks like they're only a few inches higher than the edge of the mattress (and maybe longer - I've seen different lengths, though).
If she's supposed to be leaning back against the upper part of the bed, I'd add a pillow behind her head. (Hospital pillows are usually flatter than regular pillows.)
If you want really minute details:
- I see the IV bag hanging behind her, but I don't see the line or insertion point. It looks they'd have to use her hand.

(When it's inserted in the hand, the line is looped around and taped down to prevent the needle from moving or getting tugged on.)
- The hospitals I've been in usually have a solid sheet of linoleum flooring. Not as often, but I've also seen larger tiled linoleum. (Yours looks like maybe 12" tiles, where I've seen maybe 18" tiles. Linoleum tiles have thinner seams than tiled floors, since there's no grout in between the tiles.) Or if it's a newer or remodeled & a nicer hospital, it might have artificial wood flooring.

