To examine the knowledge, experience and attitudes of nurses working in nursing homes in relation to the administration of antipsychotic medications to individuals diagnosed with behavioural and psychological symptoms of dementia (BPSD).

Questionnaires comprising 17 questions were distributed to 120 nurses working in nursing homes to evaluate their knowledge of and attitudes to the utilisation of antipsychotic medication for BPSD.

Of the 70 nurses who completed the study questionnaire, 68 (97.1%) were confident with their knowledge of managing BPSD symptoms in dementia patients; 49 (70.0%) stated that antipsychotic medications were associated with a noticeable improvement in BPSD symptoms (n = 49, 70.0%) and were mostly commenced at an appropriate stage of the patients illness (n = 47, 67.1%). Music therapy was the most commonly noted (58.6% of nurses) utilised alternative therapy, although only 46% nursing staff reported that there were sufficient alternative therapies available. Qualitative themes of note included the importance of communication between nursing staff, health professionals and family members and an ongoing requirement for training nursing staff regarding antipsychotic prescribing and dispensing in BPSD.

Nurses working in nursing homes demonstrated confidence in their knowledge of treatment strategies in managing BPSD in dementia patients. However, concerns were expressed regarding the limited availability of non-pharmacological interventions.

This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.

Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.

The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.

Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.