Competence development of registered nurses in municipal elderly care in Sweden: A questionnaire survey

Background: Skilled and specialist registered nurses (RNs) are central to evolving elderly care. The past decades' organisational and structural changes have altered RNs' roles and work situations in municipal elderly care in Sweden. This calls for appropriate educational preparation. However, a substantial proportion of RNs in municipal elderly care lack adequate specialist competence. Aim: The focus of this study was to describe RNs' perceptions of needs and possibilities for competence development in municipal elderly care and compare the perceptions of RNs' who work solely in dementia care (DC) with those who work in general elder care (GC) where older persons have diverse diagnoses. Design: A non-experimental, descriptive and comparative design was used. Settings: Sixty special housing with subunits in a large city in the middle of Sweden. Participants: Participating RNs were a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC and 118 (55.4%) in GC. Method: A structured questionnaire that was specifically designed for this study and focused on needs and possibilities for competence development in nursing. Results: The RNs were on average not lacking or were hardly lacking knowledge in examined domains. However, RNs in GC lacked knowledge of dementia, falls, and fall injures to a greater extent than RNs in DC. RNs in DC perceived greater possibilities for competence development at work. Most RNs requested a better organisation for competence development, especially in GC. The majority of RNs had no supervision. The use of RNs' competence was high, although they used their highest competence about half of the working hours. The employers' financial contribution to RNs' continuing education was poor. Conclusion: A better organisation and greater possibilities for RNs' competence development is needed. The employers need to make a greater contribution financially to RNs' continuing education. It is essential to provide RNs with supervision. (C) 2006 Elsevier Ltd. All rights reserved.