PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

Sample Answer for PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052 Included After Question

Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

 

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

 

To Prepare:

 

Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.

Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.

Consider the best method of disseminating the results of your presentation to an audience.

The Assignment: (Evidence-Based Project)

 

Part 4: Recommending an Evidence-Based Practice Change

 

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

 

Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)

Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.

Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.

Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.

Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.

Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.

Add a lessons learned section that includes the following:

A summary of the critical appraisal of the peer-reviewed articles you previously submitted

An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

By Day 7 of Week 10

Submit Part 4 of your Evidence-Based Project.

 

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

 

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

 

Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

 

Note: You will access this article from the Walden Library databases.

 

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

 

Note: You will access this article from the Walden Library databases.

 

Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

 

Note: You will access this article from the Walden Library databases.

 

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

 

Note: You will access this article from the Walden Library databases.

 

The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/

 

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

 

Name: NURS_6052_Module06_Week10_Assignment_Rubric

Grid View

List View

Excellent Good Fair Poor

Part 4: Disseminating Results

 

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:

 

· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.

· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

81 (81%) – 90 (90%)

The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.

 

The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.

 

The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.

 

The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.

72 (72%) – 80 (80%)

The narrated presentation adequately summarizes the evidence-based project. The narrated presentation is professional in nature and adequately addresses the components of the evidence-based project.

The narrated presentation accurately explains how to disseminate the results of the project to an audience; some specific examples may be provided.

The narrated presentation accurately provides a justification for the selection of this dissemination strategy and may be supported by specific examples.

 

The narrated presentation provides an accurate synthesis of at least one outside resource related to the dissemination strategy explained. The narrated presentation integrates at least one outside resource and two or three course-specific resources that may support the presentation.

63 (63%) – 71 (71%)

The narrated presentation vaguely, inaccurately, or incompletely summarizes the evidence-based project. The narrated presentation may be professional in nature and somewhat addresses the components of the evidence-based project.

The narrated presentation inaccurately or vaguely explains how to disseminate the results of the project to an audience; inaccurate or vague examples may be provided.

 

The narrated presentation inaccurately or vaguely provides a justification for the selection of this dissemination strategy and may be supported by inaccurate or vague examples.

The narrated presentation provides a vague or inaccurate synthesis of outside resources reviewed related to the dissemination strategy explained. The response minimally integrates resources that may support the presentation.

0 (0%) – 62 (62%)

The narrated presentation vaguely and inaccurately summarizes the evidence-based project or is missing. The narrated presentation is not professional in nature and inaccurately and incompletely addresses the components of the evidence-based project or is missing.

The narrated presentation vaguely and inaccurately explains how to disseminate the results of the project to an audience, no examples are provided, or it is missing.

The narrated presentation vaguely and inaccurately provides a justification for the selection of this dissemination strategy, no examples are provided, or it is missing.

The narrated presentation provides a vague and inaccurate synthesis of outside resources reviewed related to the dissemination strategy explained or is missing. The presentation fails to integrate any resources to support the presentation.

Written Expression and Formatting—Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

 

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

 

Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.

 

Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

 

No purpose statement, introduction, or conclusion was provided.

Written Expression and Formatting—English Writing Standards:

 

Correct grammar, mechanics, and proper punctuation.

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

4 (4%) – 4 (4%)

Contains a few (one or two) grammar, spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (three or four) grammar, spelling, and punctuation errors.

0 (0%) – 3 (3%)

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Total Points: 100

Name: NURS_6052_Module06_Week10_Assignment_Rubric

A Sample Answer For the Assignment: PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

Title: PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

I work with a tertiary hospital. The hospital has been providing its services for the last 50 years. The hospital provides a wide range of services to its populations. The services include inpatient, outpatient, surgeries, maternity, and psychiatric care services. The organization has an effective culture that promotes excellence. The culture of the organization is characterized by teamwork in the provision of patient care. The leadership and management encourages open communication to ensure that the needs of the healthcare providers are prioritized in patient care. The organization also utilizes transformation leadership styles to ensure that employees develop the competencies that they need in addressing the actual and potential needs of their populations. There is also the provision of rewards and incentives to motivate the employees engage in activities that contribute to the optimum care outcomes in the organization. Based on the above, the organization is ready to implement change that addresses the issue of the increasing prevalence of CLABSI .

The current problem in the organization is the high prevalence of CLABSI in patients admitted in the acute care settings. CLABSI  rates have been rising over the past translating into low quality and safety of patient care. The high rate of CLABSI  could be attributed to the low level of awareness among the healthcare providers on the interventions used in the prevention of CLABSI (Scheier et al., 2021). The low level of awareness and skills imply that evidence-based interventions may not be utilized in providing the needed patient care. CLABSI  is associated with a number of adverse outcomes. The adverse outcomes include the increased risk of complications, increased care costs, hospital stay, and reduced quality of life. Evidence-based interventions exist for CLABSI (Reynolds et al., 2021). Therefore, the problem can be addressed to ensure high quality, safe and efficient care in the organization.

The scope of the proposed issue is the prevention of CLABSI  in acute care patients. The aim is to reduce the prevalence of CLABSI among hospitalized patients. The healthcare providers will be involved in the implementation of the change. It is expected that the implementation of the change will reduce the negative effects of CLABSI  and promote safety, quality and efficiency in patient care. The stakeholders will include nurses, physicians, managers and nurse leaders. Nurses will be involved in the implementation of the change. They will administer the chlorhexidine baths to reduce CLABSI (Zerr et al., 2021). Physicians and nurses will work together to implement the intervention. Managers and nurse leaders will coordinate the implementation process of the change. They will ensure that the implementation is done according to the developed plan. They will also oversee the use of the resources in the implementation of the change.

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Implementation of change is associated with a number of risks. The first risk is resistance to change. There is an increased risk of the healthcare providers and other stakeholders declining to embrace the change. The resistance could be attributed to lack of knowledge or inadequate preparedness for the change. The other risk is the lack of support from the hospital. A lack of support will result in poor implementation due to scarcity in resources (Greenhalgh, 2017). The other risk is misuse of resources. Ineffective or poor implementation of change may lead to resource wastage. Lastly, it increases the risk of adverse patient outcomes. Poor implementation of the change may lead to patient harm due to safety issues with the adopted interventions (Chletsos & Saiti, 2020). Therefore, interventions should be implemented to enhance the adoption process of the change.

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The proposed evidence-based idea is the use of chlorhexidine bathing to reduce the risk and rate of CLABSI  in acute care settings. The existing evidence shows that chlorhexidine is effective in reducing and destroying disease causing bacteria on the skin. The reduction implies that the risk of patients CLABSI  is reduced significantly. There is also the improvement in the safety and quality of care that patients receive. The use of chlorhexidine in preventing CLABSI is feasible because it does not require the extensive use of organizational resources and skills (Zerr et al., 2021). The proposed intervention can produce sustainable outcomes, hence, the need for its adoption in the organization.

PART 4 RECOMMENDING AN EVIDENCE-BASED PRACTICE CHANGE NURS 6052

The plans for knowledge transfer will be varied. One of them will be the promotion of the active involvement of the stakeholders in the change initiatives. Active stakeholder involvement will ensure that the stakeholders have developed the needed competencies for the implementation and sustainability of the change. The second strategy will be the promotion of open communication. Open communication will be used to foster trust and honesty among the stakeholders. Open communication will also enable the stakeholders to express their needs and ideas related to the change. The third strategy will be training. Training will be offered to the stakeholders to minimize resistance to change. Lastly, regular assessments will be offered to ensure that the stakeholders receive frequent feedback on their abilities, challenges and opportunities for achieving outcomes in the implementation of the intervention (Greenhalgh, 2017).

Several dissemination plans will be used in the project. The first one will be the presentation of the results to the healthcare providers in the organization. Dissemination to the healthcare providers will create awareness among them and increase their understanding of the need for the change in promoting optimum outcomes of care. The second dissemination plan is publishing the results of the intervention in reputable journals of nursing and healthcare. Publishing will create an extensive reach and awareness of the other healthcare providers about the ways of promoting quality, safety and efficiency in patient care. The other strategy will be presenting the results in scientific conferences. This will create awareness and facilitate discussions about the ways in which the intervention can be improved further. The last dissemination approach will be implementing the use of the intervention across the organization (Wensing et al., 2020). This will ensure the uniform implementation of the change for improved outcomes in the organization.

One of the measurable outcomes that will be associated with the proposed change is the reduction of the rate of CLABSI in the hospital. The reduction will be attributable to the use of chlorhexidine baths to eliminate disease causing bacteria on the skin. The other measurable outcome is the reduction in the hospital stay and costs by patients admitted in the acute care settings. The reduction will be attributed to the effectiveness of the intervention. The other outcome is the incorporation of the intervention into clinical policies of safety and quality. The incorporation will ensure sustained and consistent use of chlorhexidine baths in reducing CLABSI .

I learned a number of lessons from the critical appraisal of evidence and completing the evaluation table. One of the lessons learned is that CLABSI is a critical health concern in acute care settings. The risks of patients developing CLABSI  are high. I also learned that CLABSI  is associated with negative outcomes to patients and healthcare systems. They include increasing costs of care, complications, poor quality of life, and increased utilization of resources. I also learned that CLABSI  are preventable. Healthcare providers have the essential role of exploring evidence-based interventions that can be used to prevent and reduce the risk of CLABSI . The experience also showed that the use of chlorhexidine baths is highly feasible in preventing and reducing CLABSI . Therefore, the implementation of the proposed change should aim at utilizing best practices to ensure the realization of optimum outcomes in the process.

REFERENCES

uChletsos, M., & Saiti, A. (2020). Strategic Management and Economics in Health Care. Springer Nature.

uGreenhalgh, T. (2017). How to Implement Evidence-Based Healthcare. John Wiley & Sons.

uReynolds, S. S., Woltz, P., Keating, E., Neff, J., Elliott, J., Hatch, D., Yang, Q., & Granger, B. B. (2021). Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): A stepped wedge cluster randomized trial. Implementation Science, 16(1), 45. https://doi.org/10.1186/s13012-021-01112-4

Health organizations operate with the aim of optimizing outcomes such as safety, quality, and efficiency in addressing the needs of their organizations. Often, health organizations operate in highly dynamic and challenging environments. They experience issues such as competition from other organizations, changing consumer needs and preferences, and emerging health problems. These challenges imply that health organizations must embrace change to respond to their current and emerging needs in their markets. Change initiatives provide organizations competitive edge over others involved in the same market niche. Healthcare providers, including nurses play a crucial role in the implementation of change initiatives that address organizational needs. They select evidence-based practice interventions to ensure efficiency in the adopted strategies and realization of optimum safety and quality outcomes in service delivery. Therefore, this presentation examines an organizational issue and proposed change to address it.

The organization I work with is a tertiary hospital. The hospital leads in the region in the provision of specialized and general care to its diverse populations. The hospital has a culture that supports change. First, healthcare providers utilize teamwork in the provision of patient care services. Teamwork aims at ensuring collectivism in the realization of the organizational outcome. The organization also strives to support safety culture. This is achieved by the adoption of evidence-based interventions in the implementation of organizational strategies. Evidence-based strategies optimize outcomes such as safety, quality, and efficiency. There is also the use of open communication among different stakeholders. Open communication ensures the prioritization of the stakeholder needs, views, and concerns. Open communication has strengthened openness and trust among the organizational employees, hence, enhanced teamwork in the provision of patient care. The organization also recognizes the vital role that rewarding performance plays in contributing to employee productivity. As a result, it undertakes biannual performance appraisals and uses them to reward employees and motivate them to explore additional ways of achieving the desired outcomes. These aspects of the organizational culture make it ready to embrace change.

The selected nursing problem in my organization is nursing shortage. The hospital currently experiences an acute shortage of nurses, which has affected the provision of patient care services to the patients. Several circumstances surround the issue of nurses shortage in the hospital. One of them is high rate of nurses’ turnover. The rate of nurses leaving their jobs intentionally has risen significantly over the past years. The rise is attributed to organizational issues such as high workload because of the few nurses, burnout, and occupational stressors associated with the challenge of balancing professional and family life demands. The other factor is unhealthy workplaces. This can be seen from violence targeted at nurses by other nurses and other healthcare providers. Most nurses report experiencing either physical or verbal violence from others, which affect their psychological and physical health, hence, their intention to leave their jobs. The other factor is the low number of nursing students being trained among the American universities. This is attributed to the shortage of faculty staff to train a high number of nurses to address the current shortage. Lastly, more than one million nurses will be retiring in the next decade. This implies that the problem of nursing shortage will persist if no intervention is embraced (Yahya Muabbar & Zayyan Alsharqi, 2020). The affected stakeholders by the problem include nurses and patients. Nurses suffer from high workload while patients are affected by low quality nursing care being given to them. The risks of implementing change include resistance to change from the adopters, inadequate support from health organizations, and disruption of the existing systems and processes by change.

The proposed idea to address the issue of nurses shortage in the hospital is empowering them. The hospital should implement nurse-centered interventions that address their actual and potential needs. The interventions should align with the needs and expectations of the nurses. One of the empowerment strategies that the hospital should consider is rewarding their performance. The hospital should ensure that the remuneration for the nurses aligns with the role and contributions of nurses to its success. The hospital should also implement reward schemes regularly to motivate nurses to engage in additional ways to meet the needs of their patients and theirs too. The other strategy is ensuring health and safe working environment (Challinor et al., 2020). The hospital should ensure the adoption of strict policies that condone behaviors such as violence targeted at nurses. In addition, workplace stressors such as high workload should be addressed to prevent more nurses from leaving their jobs in the hospital. The other empowerment strategy is ensuring flexibility in the nurses’ schedules. The leadership and management should ensure that nurses have flexible schedules that help them to balance between work and family demands. There should also be programs such as counseling for nurses to help them be resilient and develop effective coping skills for managing the workplace demands. These empowerment strategies should be incorporated into the organization’s culture to ensure sustainable change (Farid et al., 2020; Gensimore et al., 2020; Lester et al., 2020; Seren Intepeler et al., 2019).

The plan for knowledge transfer will comprise several interventions. One of them will be training nurses about the selected empowerment strategies. For example, nurses will be enrolled into training sessions where they will be informed about their role in creating safe work environments and advocating for sustainable change. Training will equip them with the competencies they need to drive excellence in nursing practice and protection of nurses’ needs and interests. The second strategy is creating discussion forums for nurses. The forums will enables them to share their issues and potential strategies that should be adopted in the organization. The third strategy for knowledge transfer will be involving nurses in assessing, planning, implementing, and evaluating the selected empowerment strategies. Their involvement will ensure the adoption of interventions that align with nurses’ expectations, hence, their sustainability (Dang et al., 2021). Lastly, best strategies will be incorporated into the organization’s culture. The incorporation will ensure the organization supports evidence-based strategies that contribute to nurses’ retention in the organization.Three dissemination strategies will be adopted. The first one is publishing an article about the results of empowering nurses on the hospital’s nursing staffing levels. Publishing an article will be an effective approach to reaching a large nursing audience. It will also be used in other organization as an evidence-based intervention to address nurses’ shortages. The second dissemination strategy will be presenting results in nursing conferences. The conferences will provide opportunities to share knowledge with other nurses on the effectiveness of the intervention and how to improve it further. The last strategy will be developing new guidelines in the hospital to guide employee management (Dang et al., 2021). The empowerment strategies that prove effective will be incorporated into human resource policies, hence, sustainability in the use of best practices in the hospital.

Several outcomes will be used to assess the effectiveness of nurses’ empowerment in addressing the issue of nursing shortage in the organization. One of them will be the rate of nurses’ turnover. The rates will be compared before the intervention and after it to determine its impact on nursing workforce. The other measure will be nurses’ level of job satisfaction. Surveys, interviews and questionnaires will be administered to determine the satisfaction of nurses with the adopted empowerment interventions. An increase in their level of satisfaction will translate into the success of the intervention. Information about nurses’ intent to leave their jobs will also be obtained before and after the empowerment interventions. A reduction in their intention to leave their jobs will translate into project success. The costs incurred by the organization in hiring, training, and retaining nurses will also be compared before and after empowerment interventions to obtain a true picture of its impacts (Blouin & Podjasek, 2019; Cao et al., 2019).

I learned several things from conducting the evaluation table using the peer-reviewed articles. One of them is the importance of evidence-based data in nursing practice. I learned that nurses should make their decisions based on the best available evidence. The use of evidence-based data ensures optimum outcomes such as safety, quality, and efficiency. The other lesson learnt is the need for nurses to be competent in article critique. This will help them to determine the level of evidence in each article and relevance to their practice. I also learnt that evidence-based data is important in improving patient and nursing outcomes. This could be seen from the enhanced outcomes in the articles included in the review. Organizations influence the use of evidence-based data in their process. Therefore, they should ensure that their culture supports new practices to enhance performance and care outcomes in addressing the needs of different populations.

References

Blouin, A. S., & Podjasek, K. (2019). The Continuing Saga of Nurse Staffing: Historical and Emerging Challenges. JONA: The Journal of Nursing Administration, 49(4), 221. https://doi.org/10.1097/NNA.0000000000000741

Cao, Y., Liu, J., Liu, K., Yang, M., & Liu, Y. (2019). The mediating role of organizational commitment between calling and work engagement of nurses: A cross-sectional study. International Journal of Nursing Sciences, 6(3), 309–314. https://doi.org/10.1016/j.ijnss.2019.05.004

Challinor, J. M., Alqudimat, M. R., Teixeira, T. O. A., & Oldenmenger, W. H. (2020). Oncology nursing workforce: Challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564–e574. https://doi.org/10.1016/S1470-2045(20)30605-7

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition. Sigma Theta Tau.

Farid, M., Purdy, N., & Neumann, W. P. (2020). Using system dynamics modelling to show the effect of nurse workload on nurses’ health and quality of care. Ergonomics, 63(8), 952–964. https://doi.org/10.1080/00140139.2019.1690674

Gensimore, M. M., Maduro, R. S., Morgan, M. K., McGee, G. W., & Zimbro, K. S. (2020). The Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work Characteristics, and Resilience: A Moderated Mediation Model. JONA: The Journal of Nursing Administration, 50(10), 546. https://doi.org/10.1097/NNA.0000000000000932

Lester, P. E., Dharmarajan, T. S., & Weinstein, E. (2020). The Looming Geriatrician Shortage: Ramifications and Solutions. Journal of Aging and Health, 32(9), 1052–1062. https://doi.org/10.1177/0898264319879325

Seren Intepeler, S., Esrefgil, G., Yilmazmis, F., Bengu, N., Gunes Dinc, N., Ileri, S., Ataman, Z., & Dirik, H. F. (2019). Role of job satisfaction and work environment on the organizational commitment of nurses: A cross-sectional study. Contemporary Nurse, 55(4–5), 380–390. https://doi.org/10.1080/10376178.2019.1673668

Yahya Muabbar, H., & Zayyan Alsharqi, O. (2020). The Impact of Short-Term Solutions of Nursing Shortage on Nursing Outcome, Nurse Perceived Quality of Care, and Patient Safety. American Journal of Nursing Research, 9(2), 35–44. https://doi.org/10.12691/ajnr-9-2-1