title: Obstacles and opportunities for achieving good care on the surgical ward: nurse and surgeon perspective.
abstract: OBJECTIVE
  The purpose of this qualitative study was to explore and understand from the perspectives of nurses and surgeons the situations and processes that are important in the context of surgical care support or are obstacles to achieving good care.
  
  
  BACKGROUND
  Medical advances and inpatients with multiple illnesses are on the increase. In addition, a high turnover of registered nurses has been identified. This contributes to an increasingly inexperienced nursing staff. Concurrently, studies have shown that patient safety and quality of care are linked to organisational structures and staffing education levels.
  
  
  METHODS
  Eight nurses and six surgeons from three hospitals were interviewed and data were analysed by systematic text condensation.
  
  
  RESULTS
  This identified three themes: shifting focus away from the patients, emphasising good communication, and using the competence of the team.
  
  
  CONCLUSIONS
  This study contributes to a deeper understanding that many interruptions, insufficient communication and unused competence can be a threat to patient safety. Sweden has a high standard but this study elucidates that challenges remain to be resolved.
  
  
  CONCLUSIONS
  The focus on patients can increase by a balance between direct/indirect patient work and administration and by the support of clinicians using their full professional competence.
authors.affiliation: Research & Development Unit in Local Health Care, and Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Yngman-Uhlin
authors.affiliation: Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Emma
authors.initials: E
authors.lastname: Klingvall
authors.affiliation: Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Wilhelmsson
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.|Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Jangland
mesh_terms: D002983:Clinical Competence / Q000592:standards; D006801:Humans; D009726:Nurses / Q000523:psychology*; D010465:Perception; D010561:Personnel Staffing and Scheduling / Q000592:standards; D010563:Personnel Turnover; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D066231:Surgeons / Q000523:psychology*; D013548:Sweden
keywords: good care; nurse; qualitative research; quality of care; surgeon; surgical care