The aim of the journal is to promote excellence, inform practice and encourage debate in the care of the critically ill patient by specialist nurses and healthcare professionals. It provides an international forum for the dissemination and exchange of research findings, experience and ideas. We also welcome manuscripts from other members of the multidisciplinary team providing the content is relevant to critical care nursing.

Intensive and Critical Care Nursing: the international journal of practice and research has, as the sub-title indicates, an international audience. Therefore the manuscript should be placed in a global context e.g. if local demographic statistics are used these should be compared with international trends/statistics. In the literature review and discussion similarities and differences in approach and evidence should be described at an international level. In the same vein it is also important that the context in which a research study took place is described fully so that readers may compare and judge the relevance of the findings to their own environment. The use of parochial English should be avoided. At submission stage, authors of reviews and original research articles are required to provide three to four bullet points outlining the manuscript implications for clinical practice.

The Editors of the journal welcome contributions for publication from the following categories: Letters to the Editor and Editorials, Reviews and Original Research articles, Commentaries, Clinical Practice articles (Case Studies) with educational value.

ONLINE SUBMISSION

Submission to this journal proceeds totally online. Use the following guidelines to prepare your article via http://ees.elsevier.com/iccn/ and you will be guided stepwise through the creation and uploading of the various files. The system automatically converts source files to a single Adobe Acrobat PDF version of the article, which is used in the peer-review process. Please note that even though manuscript source files are converted to PDF at submission for the review process, these source files are needed for further processing after acceptance. All correspondence, including notification of the Editor's decision and requests for revision, takes place by e-mail and via the Author's homepage.

The following files are required to be uploaded separately during the submission process so authors are requested to save these as individual files on their PC prior to the submission process ready for upload:

Title page with author details
Manuscript without author details
Implications for Practice bullet points (for original research and review articles only)

The Guidelines are separated into the following sections:

A Pre-submission Considerations
B Types of Contributions
C Preparation of the Manuscript
D Post Acceptance

(A) PRE-SUBMISSION CONSIDERATIONS

Submission Declaration
Submission of an article implies that the work described has not been published previously (except in the form of an abstract or as part of a published lecture or academic thesis), that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, without the written consent of the copyright-holder.

Conflict of interest
At the end of the text, under a subheading "Conflict of interest statement" all authors must disclose any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. See also http://www.elsevier.com/conflictsofinterest.

Ethical approval
All studies must be conducted to a high ethical standard and must adhere to local regulations and standards for gaining scrutiny and approval.

The work described in the article must have been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans http://www.wma.net/en/30publications/10policies/b3/; EC Directive 86/609/EEC for animal experiments http://ec.europa.eu/environment/chemicals/lab_animals/legislation_en.htm. This must be stated at an appropriate point in the article.

For information on Ethics in Publishing and Ethical guidelines for journal publication see http://www.elsevier.com/authorethics and http://www.elsevier.com/ethicalguidelines.

Patient anonymity. Studies on patients or volunteers require ethics committee approval and informed consent which should be documented in the manuscript.

Patients have a right to privacy. Therefore identifying information, including patients' images, names, initials, or hospital numbers, should not be included in videos, recordings, written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and you have obtained written informed consent for publication in print and electronic form from the patient (or parent, guardian or next of kin where applicable). If such consent is made subject to any conditions, Elsevier must be made aware of all such conditions. Evidence of written consent must be provided to Elsevier on request.

Even where consent has been given, identifying details should be omitted if they are not essential. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance that alterations do not distort scientific meaning and editors should so note.

If such consent has not been obtained, personal details of patients included in any part of the paper and in any supplementary materials (including all illustrations and videos) must be removed before submission.

Contributors and Acknowledgements
All authors should have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted. In the covering letter to the editorial office, we ask you make a true statement that all authors meet the criteria for authorship, have approved the final article and that all those entitled to authorship are listed as authors.

Acknowledgements
All contributors who meet some but not all of the criteria for authors as defined above should be listed in an acknowledgements section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Authors should disclose whether they had any writing assistance and identify the entity that paid for this assistance.

Changes to authorship
This policy concerns the addition, deletion, or rearrangement of author names in the authorship of accepted manuscripts:

Before the accepted manuscript is published in an online issue: Requests to add or remove an author, or to rearrange the author names, must be sent to the Journal Manager from the corresponding author of the accepted manuscript and must include: (a) the reason the name should be added or removed, or the author names rearranged and (b) written confirmation (e-mail, fax, letter) from all authors that they agree with the addition, removal or rearrangement. In the case of addition or removal of authors, this includes confirmation from the author being added or removed. Requests that are not sent by the corresponding author will be forwarded by the Journal Manager to the corresponding author, who must follow the procedure as described above. Note that: (1) Journal Managers will inform the Journal Editors of any such requests and (2) publication of the accepted manuscript in an online issue is suspended until authorship has been agreed.

After the accepted manuscript is published in an online issue: Any requests to add, delete, or rearrange author names in an article published in an online issue will follow the same policies as noted above and result in a corrigendum.

Role of the funding source
All sources of funding should be declared at the end of the text. Authors should declare the role of study sponsors, if any, in the study design, in the collection, analysis and interpretation of data; in writing of the manuscript; and in the decision to submit the manuscript for publication. If the study sponsors had no such involvement, the authors should so state. Please see http://www.elsevier.com/funding

Funding Body Agreements and Policies
Elsevier has established agreements and developed policies to allow authors whose articles appear in journals published by Elsevier, to comply with potential manuscript archiving requirements as specified as conditions of their grant awards. To learn more about existing agreements and policies please visit http://www.elsevier.com/fundingbodies

Review Process
The decision to publish a paper is based on an editorial assessment and peer review. Initially all papers are assessed by an editorial committee consisting of 2 or more members of the editorial team. The prime purpose is to decide whether to send a paper for peer review and to give a rapid decision on those that are not.

Manuscripts going forward to the review process are reviewed by members of an international expert panel. All such papers will undergo a double blind peer review by two or more reviewers. All papers are subject to peer review and we take every reasonable step to ensure author identity is concealed during the review process. The Editors reserve the right to the final decision regarding acceptance.

English Language Service
Please write your text in good English. Authors who require information about language editing and copyediting services pre- and post-submission please visit http://www.elsevier.com/languagepolishing or our customer support site at http://epsupport.elsevier.com for more information. Please note Elsevier neither endorses nor takes responsibility for any products, goods or services offered by outside vendors through our services or in any advertising. For more information please refer to our Terms and Conditions: http://www.elsevier.com/termsandconditions

(B) TYPES OF CONTRIBUTIONS - word limits exclude tables, figures and references.

Letters to the Editor (500-1,000 words)
The Editorial Board welcomes critical responses to any aspect of the journal. In particular, letters that point out deficiencies and that add to, or further clarify points made in a recently published work, are welcomed. Not all letters will be published, the editorial decision is final. The Editorial Board reserves the right to offer authors of papers the right of rebuttal, which may be published alongside the letter.

Editorials (1,000-2,000 words)
Authors who have ideas for editorials which address issues of substantive concern to the discipline, particularly those of a controversial nature or linked directly to forthcoming content in the journal, should contact the Editor in Chief - iccn@elsevier.com

Research papers Articles (2,000- 3000 words for quantitative research studies and up to 5000 words for manuscripts which present qualitative data).

These should be reports of new findings related to critical care nursing that are supported by research evidence. These should be original, previously unpublished works. Research papers should adhere to recognised standards for reporting

Review papers (up to 3,000 words)
Critical or systematic reviews that seek to summarise or draw conclusions from the established literature on a topic relevant to critical care nursing including:
- systematic reviews, which address focussed practice questions;
- literature reviews, which provide a thorough analysis of the literature on a broad topic;
- policy reviews, i.e. reviews of published literature and policy documents which inform nursing practice, the organisation of nursing services, or the education and preparation of nurses specifically relating to the critical care and related environment.

Case Studies (1,000-2,000 words)
Usually document the management of one patient, with an emphasis on presentations that are unusual, rare or where there was an unexpected response to treatment (e.g. an unexpected side effect or adverse reaction). Authors may also wish to present a case series where multiple occurrences of a similar phenomenon are documented.

(C) PREPARATION OF THE MANUSCRIPT

Submitted papers should be relevant to an international audience and authors should not assume knowledge of national practices, policies, law, etc. Since the journal is distributed all over the world, and as English is a second language for many readers, authors are requested to write in plain English and use terminology which is internationally acceptable.

Abbreviations - Avoid the use of abbreviations unless they are likely to be widely recognised. In particular you should avoid abbreviating key concepts in your paper where readers might not already be familiar with the abbreviation. Any abbreviations which the authors intend to use should be written out in full and followed by the letters in brackets the first time they appear, thereafter only the letters without brackets should be used.

Statistics - Standard methods of presenting statistical material should be used. Where methods used are not widely recognised explanation and full reference to widely accessible sources must be given.

Authors are required to submit manuscripts according to the requirements set out below. Please note that papers not formatted in this manner will be returned to the author for amendment before entering into the editorial and peer review process. In particular please take care to follow the instructions for the formatting of references.

Your article should be typed on A4 paper, double-spaced with margins of at least 3cm. Number all pages consecutively beginning with the title page.

To facilitate anonymity, the author's names and any reference to their addresses should only appear on the title page. Please check your typescript carefully before you send it off, both for correct content and typographic errors. It is not possible to change the content of accepted typescripts during production.

Informed consent - Where applicable authors should confirm that informed consent was obtained from human subjects and that ethical clearance was obtained from the appropriate authority.

Permissions - Permission to reproduce previously published material must be obtained in writing from the copyright holder (usually the publisher) and acknowledged in the manuscript.

Format
Papers should be set out as follows, with each section beginning on a separate sheet. Depending on the paper type this should include the title page, abstract, key words, "Clinical Implications", text, references, tables, figure legends, figures, appendices.

Title page
• The title page should give the title in capital letters. The title should be in the format Topic / question: design/type of paper and identify the population / care setting studied (e.g. Natural history of dental plaque accumulation in mechanically ventilated adults: A descriptive correlational study).
• The authors' names should then be stated (as they are to appear).
• For each author you should give one first name, the surname and any initials as well as address(es) - clearly indicating who is the corresponding author and detailing their institutional affiliation; name, address, telephone, fax and e-mail
• You should give a maximum of four degrees/ qualifications for each author and the current relevant appointment only.
• Authors' addresses should appear on the title page below the authors' names and appointments.

Abstract
Abstracts should be a maximum of 200 words and should not include abbreviations. The abstract should summarise the content and should be provided on a separate sheet following the title page. If a research study is the subject of the manuscript then it should follow the following format: Objectives, Research Methodology/Design, Setting, Main Outcome Measures, Results, Conclusion.

Keywords
The purpose of these is to increase the likely accessibility of your paper to potential readers searching the literature. Provide between four and ten key words in alphabetical order, which accurately identify the paper's subject, purpose, method and focus. Use the Medical Subject Headings (MeSH®) thesaurus or Cumulative Index to Nursing and Allied Health (CINAHL) headings where possible (see http://www.nlm.nih.gov/mesh/meshhome.html).

Headings
The content of your paper should determine the headings which you use. Research and Clinical papers should follow the usual layout, for example Introduction, Methods (Research Questions and /or Objectives; Setting; Ethical Approval; Participants; Data Collection; Data Analysis), Results, Discussion, Conclusion. If your paper takes another form you should use the appropriate headings, but do bear in mind that headings should facilitate reading and understanding. Normally only two kinds of headings; major headings should be indicated by underlined capital letters in the centre of the page. Minor headings should be underlined, have lower-case letters (beginning with a capital) and begin at the left hand margin.

Implications for Clinical Practice
At submission stage, authors of reviews and original research articles are required to provide three to four bullet points outlining the manuscript implications for clinical practice. You will be requested to upload these as a separate word file during the submission process.

Tables, Illustrations and Figures
Tables and figures should be included in a separate file. All tables and figures should be clearly labelled.

File formats - General points

• Make sure you use uniform lettering and sizing of your original artwork.
• Save text in illustrations as "graphics" or enclose the font.
• Only use the following fonts in your illustrations: Arial, Courier, Times, Symbol.
• Number the illustrations according to their sequence in the text.
• Use a logical naming convention for your artwork files.
• Provide captions to illustrations separately.
• Produce images near to the desired size of the printed version.
• Submit each figure as a separate file.

A detailed guide on electronic artwork is available on our website: http://www.elsevier.com/artworkinstructions

Formats
Regardless of the application used, when your electronic artwork is finalised, please "save as" or convert the images to one of the following formats (note the resolution requirements for line drawings, halftones, and line/halftone combinations given below):

• EPS: Vector drawings. Embed the font or save the text as "graphics".
• TIFF: color or grayscale photographs (halftones): always use a minimum of 300 dpi.
• TIFF: Bitmapped line drawings: use a minimum of 1000 dpi.
• TIFF: Combinations bitmapped line/half-tone (color or grayscale): a minimum of 500 dpi is required.
• DOC, XLS or PPT: If your electronic artwork is created in any of these Microsoft Office applications please supply "as is".

Please do not:
• Supply embedded graphics in your wordprocessor (spreadsheet, presentation) document.
• Supply files that are optimised for screen use (like GIF, BMP, PICT, WPG); the resolution is too low.
• Supply files that are too low in resolution.
• Submit graphics that are disproportionately large for the content.

Preparation of supplementary data. Elsevier now accepts electronic supplementary material (e-components) to support and enhance your scientific research. Supplementary files offer the Author additional possibilities to publish supporting applications, movies, animation sequences, high-resolution images, background datasets, sound clips and more. Supplementary files supplied will be published online alongside the electronic version of your article in Elsevier Web products, including ScienceDirect: http://www.sciencedirect.com. In order to ensure that your submitted material is directly usable, please ensure that data is provided in one of our recommended file formats. Authors should submit the material in electronic format together with the article and supply a concise and descriptive caption for each file. For more detailed instructions please visit our artwork instruction pages at: http://www.elsevier.com/authors.

Illustrations and tables that have appeared elsewhere must be accompanied by written permission to reproduce them from the original publishers. This is necessary even if you are an author of the borrowed material. Borrowed material should be acknowledged in the captions in the exact wording required by the copyright holder. If not specified, use this style: 'Reproduced by kind permission of . . . (publishers) from . . . (reference).' Identifiable clinical photographs must be accompanied by written permission from the patient.

References
The accuracy of references is the responsibility of the author. The journal uses the 'name and year: Vancouver' Reference style.

No more than three references should be used to support a single idea. Avoid citation of personal communications or unpublished material. Citations to material in press (i.e accepted for publication) is acceptable. Citation of material currently under consideration elsewhere (e.g. "under review" or "submitted") is not. Please ensure that every reference cited in the text is also present in the reference list (and vice versa).

Reference management software
This journal has a standard template available in the reference management package EndNote (http://www.endnote.com/support/enstyles.asp). Using plug-ins to wordprocessing packages, authors only need to select the appropriate journal template when preparing their article and the list of references and citations to these will be formatted according to the journal style which is described below.

In text citations: All citations in the text should refer to:
• Single author: the author's name (without initials, unless there is ambiguity) and the year of publication;
• Two authors: both authors' names and the year of publication;
• Three or more authors; first author's name followed by 'et al.' and the year of publication.

Citations may be made directly (or parenthetically). Groups of references should be listed first alphabetically, then chronologically.

Examples: "...is based on individual situation" (Dean, 2008). "McKinney and Melby (2002) highlight the complex..."

Bibliographic List: References should be arranged first alphabetically and then further sorted chronologically if necessary. More than one reference from the same author(s) in the same year must be identified by the letters "a", "b", "c", etc., placed after the year of publication.

Examples:

Reference to a journal publication:

Alspach G. Handing off critically ill patients to family care-givers. What are your best practices? Critical Care Nurse 2009: 29(3):12-22

Reference to a book:

Gwinnutt C. Clinical anaesthesia. 2nd ed. Oxford: Blackwell Publishing; 2006.

Reference to a chapter in an edited book:

Whittin P, Edbrooke D. Evaluation of critical care outreach: are the resources for outreach justified? In: Cutler LR, Robson WP, editors. Critical care outreach. West Sussex, England: John Wiley and Sons; 2006. P. 269-80.

Note shortened form for last page number. e.g., 51-9, and that for more than 6 authors the first 6 should be listed followed by 'et al'. For further details you are referred to "Uniform Requirements for Manuscripts submitted to Biomedical Journals" (J Am Med Assoc 1997;277:927-34), see also http://www.nejm.org/general/text/requirement/1.htm

Journal abbreviations source
Journal names should be abbreviated according to:
Index Medicus journal abbreviations: http://www.nlm.nih.gov/tsd/serials/lji.html;
List of title word abbreviations: http://www.issn.org/2-22661-LTWA-online.php;

Web references
As a minimum, the full URL should be given. Any further information, if known (DOI, author names, dates, reference to a source publication, etc.), should also be given. Web references should be included in the reference list.

PERMISSIONS TO REPRODUCE BORROWED MATERIAL
Written permission to reproduce borrowed material (illustrations, tables and identifiable clinical photographs) must be obtained from the original publishers and authors, and submitted with the typescript. Borrowed material should be acknowledged in the captions in this style: Reproduced by kind permission of ... (publishers) ... from ...(reference) .

(D) POST ACCEPTANCE

Proofs
One set of page proofs (as PDF files) will be sent by e-mail to the corresponding author (if we do not have an e-mail address then paper proofs will be sent by post) or, a link will be provided in the e-mail so that authors can download the files themselves. Elsevier now provides authors with PDF proofs which can be annotated; for this you will need to download Adobe Reader version 7 (or higher) available free from http://www.adobe.com/products/acrobat/readstep2.html. Instructions on how to annotate PDF files will accompany the proofs (also given online). The exact system requirements are given at the Adobe site: http://www.adobe.com/products/acrobat/acrrsystemreqs.html#70win.

If you do not wish to use the PDF annotations function, you may list the corrections (including replies to the Query Form) and return them to Elsevier in an e-mail. Please list your corrections quoting line number. If, for any reason, this is not possible, then mark the corrections and any other comments (including replies to the Query Form) on a printout of your proof and return by fax, or scan the pages and e-mail, or by post. Please use this proof only for checking the typesetting, editing, completeness and correctness of the text, tables and figures. Significant changes to the article as accepted for publication will only be considered at this stage with permission from the Editor. We will do everything possible to get your article published quickly and accurately. Therefore, it is important to ensure that all of your corrections are sent back to us in one communication: please check carefully before replying, as inclusion of any subsequent corrections cannot be guaranteed. Proofreading is solely your responsibility. Note that Elsevier may proceed with the publication of your article if no response is received.

Open Access

This journal offers authors two choices to publish their research;
1. Open Access
• Articles are freely available to both subscribers and the wider public with permitted reuse
• An Open Access publication fee is payable by authors or their research funder

2. Subscription
• Articles are made available to subscribers as well as developing countries and patient groups through our access programs (http://www.elsevier.com/access)
• No Open Access publication fee

All articles published Open Access will be immediately and permanently free for everyone to read and download. Permitted reuse is defined by your choice of one of the following Creative Commons user licenses:

Creative Commons Attribution-Non Commercial-ShareAlike (CC BY-NC-SA): for non-commercial purposes, lets others distribute and copy the article, to create extracts, abstracts and other revised versions, adaptations or derivative works of or from an article (such as a translation), to include in a collective work (such as an anthology), to text and data mine the article, as long as they credit the author(s), do not represent the author as endorsing their adaptation of the article, do not modify the article in such a way as to damage the author’s honor or reputation, and license their new adaptations or creations under identical terms (CC BY NC SA).

Creative Commons Attribution-NonCommercial-NoDerivs (CC-BY-NC-ND): for non-commercial purposes, lets others distribute and copy the article, and to include in a collective work (such as an anthology), as long as they credit the author(s) and provided they do not alter or modify the article.

Creative Commons Attribution (CC-BY): available only for authors funded by organizations with which Elsevier has established an agreement. For a full list please see http://www.elsevier.com/fundingbodies

Elsevier has established agreements with funding bodies. This ensures authors can comply with funding body Open Access requirements, including specific user licenses, such as CC-BY. Some authors may also be reimbursed for associated publication fees. http://www.elsevier.com/fundingbodies

To provide Open Access, this journal has a publication fee which needs to be met by the authors or their research funders for each article published Open Access. Your publication choice will have no effect on the peer review process or acceptance of submitted articles. The Open Access publication fee for this journal is 2500 USD, excluding taxes.

Learn more about Elsevier’s pricing policy http://www.elsevier.com/openaccesspricing

Offprints
The corresponding author, at no cost, will be provided with a PDF file of the article via e-mail. The PDF file is a watermarked version of the published article and includes a cover sheet with the journal cover image and a disclaimer outlining the terms and conditions of use. Additional paper offprints can be ordered by the authors. An order form with prices will be sent to the corresponding author.

Copyright
Upon acceptance of an article, authors will be asked to complete a 'Journal Publishing Agreement' (for more information on this and copyright see http://www.elsevier.com/copyright). Acceptance of the agreement will ensure the widest possible dissemination of information. An e-mail will be sent to the corresponding author confirming receipt of the manuscript together with a 'Journal Publishing Agreement' form or a link to the online version of this agreement.

Subscribers may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution and for all other derivative works, including compilations and translations (please consult http://www.elsevier.com/permissions). If excerpts from other copyrighted works are included, the author(s) must obtain written permission from the copyright owners and credit the source(s) in the article. Elsevier has preprinted forms for use by authors in these cases: please consult http://www.elsevier.com/permissions.

SUBMISSION CHECKLIST

It is hoped that this list will be useful during the final checking of an article prior to sending it to the journal's Editor for review. Please consult this Guide for Authors and a recent issue of the journal for further details of any item.

Ensure that the following items are present:

• One Author designated as corresponding Author:
• E-mail address
• Full postal address
• Telephone and fax numbers
• All necessary fields have been uploaded
• Keywords
• All tables (including title, description, footnotes)
• Authors of reviews and original research articles are required to provide three to four bullet points outlining the manuscript implications for clinical practice

Further considerations
• Manuscript has been "spellchecked".
• References are in the correct format for this journal.
• All references mentioned in the Reference list are cited in the text, and vice versa.