 Significant improvements in our understanding of how to manage pain, agitation and delirium within the intensive care unit have been made in recent years. As a result, international guidelines have become more evidence-based and patient-centred and now provide clear recommendations for best practice management of ICU patients. Although widespread adoption of these guidelines could help patients have less traumatic ICU stays, consistent implementation has been difficult to achieve. To address this issue, ICU nurses from different EU countries recently held a workshop to define barriers to guideline application and propose solutions to overcome them. Insights from the panel suggest that insufficient education and inadequate translation of guidelines into local languages pose significant barriers to implementation. For example, there are widespread disparities in the frequency of assessing pain, agitation and delirium. Although guidelines indicate the critical need for regular assessment, implementation has been variable and sporadic. As a result, many patients are not receiving the interventions they need to achieve the best long-term outcomes. The use of deep sedation is another area in which patients continue to receive outdated treatment. It's now recommended that healthcare providers avoid deep sedation of ICU patients as lighter sedation can improve survival and shorten hospital stays. Despite this, recent studies report widespread variations in sedation-related guideline use at the regional, local and even individual levels. Clearly, more needs to be done to standardize patient care. To aid such efforts, the workshop attendees recommend the translation of international guidelines into local languages and a greater emphasis on the use of multidisciplinary teams, which provide a forum to help bridge gaps between disciplinary priorities. They also argue for a shift in focus from survival to survivorship. With the mortality rate for ICU patients falling to its lowest point in history, healthcare providers have the opportunity to aim attention at improving day-to-day care, which has lasting consequences for patients' physical health and mental function. These recommendations provide a roadmap to help healthcare providers in varied settings understand and implement evidence-based treatment for ICU patients. Through better alignment with international guidelines, it's possible that both survival and quality of life can be improved.