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III. Recommended Critical Care Nursing to assist with manual handling, cleaning and
Workforce Requirements domestic duty staff and other personnel exist to
As a minimum, the critical care unit should maintain allow nursing staff to focus on direct patient care
or strive to achieve the following nursing workforce and associated professional requirements.
requirements: 9. Appropriately skilled and qualified medical staff
are appointed and accessible to the unit for
1. Critically ill patients (clinically determined) decision making and advice at all times. A
require one registered nurse at all times. medical director is appointed to work collab-
2. High-dependency patients (clinically determined) oratively with the head nurse in order to provide
in a critical care unit require no less than one policy/protocol, direction and collaborative
registered nurse for two patients at all times. support.
3. Where necessary, extra registered nurses may 10. Remuneration levels for nursing staff are such
provide additional Assistance, Coordination, that they are competitive with similar professions
Contingency (for late admission, sick staff), Edu- in the country and are scaled in such a way as to
cation, Supervision and Support to a subset of reward and retain qualified, experienced and
patients and nurses in a critical care unit (some- senior critical care nurses.
times referred to as an ACCESS nurse). 11. Appropriate, accessible and functional levels
4. A critical care unit must have a dedicated head of equipment and technology are available
nurse (otherwise called charge nurse or similar) and maintained to meet the demands of the
to manage and lead the unit. This person must expected patient load at any given time, and
have a recognised post-registration critical care nursing staff are adequately trained and skilled
nursing qualification. It is also recommended that in the application of such equipment and
the head nurse/nurse in charge have management technology.
qualifications. 12. Adequate occupational health and safety regula-
5. Each shift must have a designated nurse in charge tions should be in place and enforced to protect
to deputise for the head nurse and to ensure nurses from hazards of manual handling and
direction and supervision of the unit activities occupational exposure.
throughout the shift. This person must have a 13. Organised and structured peer support and
recognised post-registration critical care nursing debriefing procedures are in place to ensure
qualification. nursing staff support and wellbeing following
6. A critical care unit must have a dedicated nurse critical incident exposure.
educator to provide education, training and
quality improvement activities for the unit nursing REFERENCES
staff. This person(s) must have a recognised post-
registration critical care nursing qualification. Australian College of Critical Care Nurses Position Statement on Intensive Care
7. Resources must be allocated to support nursing Nursing Staffing, Available from: www.acccn.com.au
time and costs associated with quality assurance British Association of Critical Care Nursing. Position Statement. Nurse–patient
ratios in critical care. Nursing in Critical Care 2001; 2: 59–63.
activities, nursing and team research initiatives, Williams GF, Clarke T. A consensus driven method to measure the required
education and attendance at seminars and number of intensive care nurses in Australia. Aust Critical Care 2001; 14(3):
conferences. 106–15.
8. Adequate support staff within the critical care International Nursing Council. The global shortage of registered nurses: an over-
view of issues and actions (and accompanying issues, papers). Available from:
area, including: administrative staff, support staff www.icn.ch/global/#3