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Background: 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. Aim: To identify existing organizational models were the nurses’ work has been formalized according to their level of competence and experience in order to improve patient safety and patient satisfaction. Method: A search with a systematic approach in CINAHL, The Cochrane Library and MedLine. A total of 397 studies were identified and 31 articles were screened in full text. Result: Finally three articles, which are insufficient with regards to issue recommendations, presented common factors as models that focus on experienced nurses´ competence and the organisation of patient care. Conclusion: 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.

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