n additional limitation of this study is the use of a
cross-sectional design that prevented us from testing
causality. Longitudinal designs and panel data may help
provide evidence regarding causality. Causality is
important to study because causality ensures the influence
of a cause (e.g. nursing accreditation level in this
study) on a consequence (e.g. patient safety). Future
studies are encouraged to adopt longitudinal designs to
replicate the study to provide evidence for causality
among the study constructs.