The following is a summary of “Formal guidelines from an expert panel: intensive care unit medical staffing, organisation and working hours to improve quality of life at work in France,” published in the January 2025 issue of Critical Care by Terzi et al.
Intensive care units (ICU) are complex settings with high medical costs, and current recommendations for specifying the necessary medical staff are restricted, leading to variability in staffing practices.
Researchers conducted a retrospective study to develop recommendations for staffing needs in ICUs and propose an optimal organization of work hours, aiming to improve workplace QoL.
They formed an organizing committee and expert group convened by the French Intensive Care Society (FICS) and the French National Council of Intensive Care Medicine (CNP MIR, Conseil National Professionel de Médecine Intensive Réanimation). The organizing committee initially defined the questions to address and assigned experts to each topic. These questions were formulated in PICO format (Patients Intervention Comparison Outcome) after an expert meeting. Literature analysis was conducted using the GRADE methodology (Grade of Recommendation Assessment, Development, and Evaluation), assigning evidence levels based on study type and quality. Strong recommendations (GRADE 1 + or 1−) were made for high-level evidence, while moderate to weak evidence led to optional recommendations (GRADE 2 + or 2−).
The results showed literature analysis using the GRADE methodology which led to 22 recommendations across 6 fields. A strong recommendation was made, supported by high-level evidence, prioritizing work organization during permanent care periods, with a maximum of 16 hours of consecutive work allowed, for 21 other recommendations, the evidence level was insufficient for GRADE classification, resulting in expert opinion recommendations. All recommendations and expert opinions were validated with strong agreement.
Investigators concluded that a detailed framework outlining clinical, non-clinical, continuity, and quality aspects was crucial for proposing an optimal medical staff allocation in intensive care and intermediate ICUs to ensure patient safety.
Source:annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01432-4