The Swedish healthcare system is organized in a way that all nurses despite formal competence and experience have the same responsibilities. A newly graduated nurse has the same work-load and responsibility in patient care as the experienced nurse. newly graduated nurses need supervision by clinical experts in the process of developing skills, but also to reduce risks that exists when their authority is above their skills and level of experience. The aim was to identify existing organizational models were the nurses´work has been formalized according to their level of competence and experince in order to improve patient safety and patient satisfaction. A search with a systematic approach in CINAHL, The Cochrane Library and MedLine was performed. A total of 397 studies were identified and 31 articles were screened in full text. Finally three articles , which are insufficient with regards to issue recommendations, presented common factors as models that focus on experienced nurses´competence and the organization of patient care. The research regarding models of organization that secure nursing competence in patient care, how it is utilized and, it´s effect on patient care is insufficient. there is a need for extensive research examining this relation at ward level.

En nyligen examnerad sjuksköterska har samma arbetsmängd och ansvar som en sjuksköterska med hög kompetens och lång erfarenhet. Suftet var att identifiera organisationsmodeller som tar hänsyn till sjuksköterskors kompetensnivå och erfarenhet i den patientnära omvårdnaden. CINAHL, Cochrane och MedLine söktes systematiskt och 397 studier identifierades, av dessa screenades 31 fulltextdokument. Slutligen återstod tre artikler, vilket är otillräckligt för att dra några slutsatser om fungerande modeller. Det finns stort behov av fortsatt forskning.