Six months after the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) published the DIVI Recommendations on the structure, personal, and organization of intensive care units the journal Frontiers in Medicine published a translated English version open access. "We are proud to be able to present the German perspective on intensive care medicine to an international audience of specialists now," says Professor Christian Waydhas, member of the DIVI Presidium and coordinator of the paper. “We aim to provide guidance and recommendations for the requirements of (infra)structure, personal, and organization of intensive care units.”

The authors were guided not only by economic and social conditions, but also by new international scientific findings, standards, and recommendations. In addition, interprofessional and interdisciplinary cooperation was essential in the preparation of the guideline: nurses, therapists and doctors worked together on the recommendation for two years.

Guidance and recommendations for the requirements of intensive care units

The recommendations cover the fields of a 3-staged level of intensive care units, a 3-staged level of care with respect to severity of illness, qualitative and quantitative requirements of physicians and nurses as well as staffing with physiotherapists, pharmacists, psychologists, palliative medicine, and other specialists, all adapted to the 3 levels of ICUs. Furthermore, proposals concerning the equipment and the construction of ICUs are supplied.

During the pandemic years, the focus of many colleagues was on the treatment of COVID patients. "Now the time has come to discuss worldwide how the quality of patient care in intensive care and emergency medicine wards can be significantly improved through structure, staffing and building design," Waydhas says.

Background

The DIVI published its first structural recommendations back in 2010. More than twelve years later, the general framework in the public health sector, the economic conditions and medical advancements have significantly changed in the health care system and especially in intensive care and emergency medicine have changed significantly. Staff shortages and the provision of intensive care beds are currently at the forefront of an intense debate.

Photograph: Professor Christian Waydhas (Medienzentrum UK Essen)