Key messages

• The effective and efficient care of patients in the intensive care unit (ICU) is ensured by the complementary knowledge and skills of physicians and nurses.

• The structured integration of the two professions requires that particular attention is paid to those areas where knowledge and skills overlap (organization quality standards such as protocols).

• It is mandatory that all the relevant characteristics of the ICU should be assessed before plans for staffing are made. Fixed staffing rules should not be imposed as they will often lead to severe mismatch between the provision and the demands of resources at ICU level.

• The classification of ICUs into levels of care related to the requirements of nursing staff is the key to appropriate staffing of each unit.

• Attention to non-clinical aspects of organization and management is essential for the effective functioning of the staff in the ICU.

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