Table 3.

Barriers to implementing and practicing family engagement in the cardiac intensive care unit

Healthcare system-related
Policies and Leadership
COVID-related visitor restrictive policies (n=15)
Lack of leadership; leadership content with status quo (n=2)
Lack of support by hospital administration (n=1)
Culture
Unit culture does not favor engagement in acute care situations (i.e., resuscitation, invasive procedures; n=1)
Resources
Resource limitations (i.e., staff shortages, lack of available of integrative therapies, 24/7 chaplain; n=5)
Financial constraints (n=2)
Other challenges
Lack of formalized protocols (n=2)
Infection control (n=1)
Security issues (n=1)
Healthcare provider related
Time limitations (n=4)
Physician/nurse interest is variable; lack of buy-in from the group (n=3)
Lack of knowledge of physician about the importance and practice of family engagement (n=2)
Coordination of multidisciplinary team availability (n=1)
Family-related
Family availability (i.e., unable to reach, family not available at convenient time; n=4)
Family distance to the unit (n=3)
Problematic family dynamics and unclear roles among family members (i.e., intrafamily conflict; n=3)
Family health literacy (n=1)
Insufficient trust in physicians-in-training during rounds (n=1)

The number of survey respondents reporting the barrier to engagement is listed next to each item. The total number of responses may add up to more than 39 as some respondents listed more than 1 barrier.