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The nursing shortage is negatively affecting the quality, effectiveness, and timeliness of patient care, which warrants a transformation of the nursing work environment. The Nurse-Friendly (NF) Hospital Project assisted 30 rural or small hospitals implement 12 NF criteria into hospital policies to create a positive work environment. The NF criteria represent organizational attributes necessary for ensuring quality patient care, positive work environment, professional development, and nurse satisfaction. The authors discuss nurses' perception of presence of NF criteria before and after they were incorporated at each hospital and the implementation outcomes.