Closer to You (Mais Próximo de ti) – The voice of nurses in the innovation of caring, Portugal

Contributor: Maria José Martins da Costa Días, Chief Nurse, University Hospital Center of Central Lisbon

On 15 May, we celebrated the International Day of Families. This year the theme was Families and New Technologies. We bring you a story from Portugal where nurses are helping to bring families together during COVID-19 by combining caring, compassion and new technologies.

As in many countries, the COVID-19 pandemic brought about a significant change in family access to patients, particularly when the Portuguese National Contingency Plan introduced measures to restrict visits to adult hospitalized patients.

Nurses at the University Hospital Center of Central Lisbon (CHULC) looked for a way to maintain communication and proximity between the patient and their family especially for elderly patients who may have difficulty in using information technologies. Many families were concerned that they could not visit elderly patients and patients became anxious.

The project, Closer to You", (Mais Próximo de Ti), was developed using teleconferencing and other technologies to keep patients and families members in touch, including when the patient is in an emergency ward so that family members can receive daily information by phone about a patient’s status.

Since its inception in April 2020, the project has been supported by the CHULC Board of Directors. Its objectives are to maintain communication and proximity between the hospitalized patient and the family, during the pandemic; to promote the well-being of patients and families by facilitating communication; and to facilitate the articulation of care between the patient, family and the health team and preparation for hospital discharge. The initiative is anchored in a mobile team, mostly nurses, who through email or telephone contact, created especially for the project, receive requests for scheduling of the patient, family or professionals. The team also passes on messages, photos or videos from family and friends to the patient.

The Mais Próximo de Ti mobile team consists of 40 professionals from CHULC. The nurses were fundamental in the creation, realisation and continuity of the initiative. Guidelines and procedures have been drawn up regarding the maintenance of patient and family privacy and data protection for contact, informed consent and for the prevention of healthcare associated infection.

The project was intended to cover at least 20 patients daily at the Hospital Center, but has exceeded that goal with between 35 to 40 patients covered daily. Video calls last an average of 15 minutes and 80% of patients are over 70 years of age. The greatest satisfaction with the project was to keep the families close and informed about the situation of their relatives. The project even enabled one patient to attend her daughter’s wedding via videoconference.

An 86-year old patient said: "The moment of the first video call, I will never forget, because I was three days without talking to my family and I saw my daughter and heard her voice in all the people who entered the infirmary and passed in the hall. When I saw and heard my daughter through the video call, I felt that I had been pulled out of the darkness. It was better than all the medicines I had taken so far".

At the service level, the project made it possible to more effectively prepare for hospital discharge, as well as to alleviate the pain of loss of relatives. Telematics, a work tool that was little explored and seldom used before the pandemic, proved to be essential for the quality of care, bringing families together in these difficult times.