Perceptions of nurses in nursing homes on the usage of benzodiazepines

Aim. This paper reports the findings of a qualitative study on how nurses perceive their own role in the use of benzodiazepines in nursing homes and to identify the factors that have an impact on the nurses' role in the use of benzodiazepines. Background. The use of benzodiazepines in nursing homes is of particular concern, as nursing-home residents receive considerably more benzodiazepines than non-institutionalised older persons. Evidence of their long-term effectiveness is lacking. Nurses are important partners in the decision-making process of starting and discontinuation of benzodiazepines. Design. Qualitative descriptive. Method. Three focus group interviews and 10 additional semi-structured interviews were used with 33 registered nurses. The interviews were thematically analysed. Findings. Nurses' main concern is to work towards the comfort of the patient. Benzodiazepines are an easy option with not too many side effects and administration of benzodiazepines is experienced as a routine action. When prescribed they will almost automatically lead to chronic usage as there is no evaluation of their effect. There are three aspects that have an impact on nurse's perceptions of their role in benzodiazepine usage: their own individual attitude and perceptions, their knowledge and organisational factors. Conclusion. Nurses do not see benzodiazepines as a problem drug and once a prescription is initiated it will almost automatically lead to chronic usage. Nurses should work towards a pro-active promotion of addressing sleeping problems and they can play a key role in non-pharmacological interventions. Relevance to clinical practice. Nurses can play a key role in suggesting non-pharmacological alternatives. Education to provide more insight into the problems of insomnia and anxiety may positively influence their attitudes and behaviour. All caregivers in nursing homes should be informed about the relevance of this issue.