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Background Terminal agitation is common towards the end of life and is treated as a palliative care emergency. It has implications for family bereavement, with relatives of patients who have had terminal agitation, reporting high levels of distress. Within our specialist palliative care unit, the team identified incidences of sub-optimal management of terminal agitation over a period of months. We identified that this was multifactorial, with recent significant staff turnover and nursing staff with less specialist experience resulting in unfamiliarity in management of terminal agitation.Aims To survey attitudes and confidence towards managing terminal agitation. To develop and deliver a tailored education programme to improve confidence in the identification, management and escalation of terminal agitation; particularly out of hours.Method We conducted a staff survey on familiarity with symptoms of terminal agitation, drugs used and experience of supporting patients and relatives. This was followed by an education programme consisting of ‘bite sized’ sessions for the nursing team, healthcare assistants and resident doctors. The sessions were delivered to small groups and scheduled opportunistically at pre-existing handover time. We also reviewed unit guidance around management of terminal agitation, designing a flow chart as a quick reference guide and educational tool.Results Initially around half of all responders reported they felt ‘somewhat confident’ with managing terminal agitation, with newer members of the team reporting lower levels of confidence. Responders identified some challenges of managing terminal agitation relating to variations in prescriptions of anticipatory medicines as well as selecting most appropriate medicine.Conclusion The follow up survey is in progress but supports effectiveness of the sessions, which can be easily scheduled into the busy day. We are implementing a similar format tailored to our other inpatient unit and also exploring virtual and pre-recorded education sessions to support newly starting nursing staff.