Evidence-based Practice Research Articles

Physical Educators' Training and Confidence in Implementing Evidence-Based Practices for Students With ASD.

Educators working with students with autism spectrum disorder (ASD) should be utilizing evidence-based practices (EBPs) that have been identified for this group of students to promote better outcomes. Physical education (PE) teachers are highly likely to work with students with ASD in educational settings, yet little is known about their level of training and confidence in implementing EBPs for students with ASD. This study used survey methodology to ask PE teachers about their training in EBPs and their perceived confidence in implementing such practices. The results indicate that, although there was little reported training on individual EBPs specific to students with ASD, PE teachers reported feeling relatively confident in supporting students with ASD. Further findings and implications are discussed.

How valuable is an implementation toolkit for midwives? An exploratory study.

Incorporating evidence-based approaches in maternity care throughout the entire trajectory from pregnancy through to the postnatal phase is integral to good public health. Yet, despite developing theories, frameworks, and models to guide midwives' implementation efforts, implementing new evidence-based practices in midwifery practice settings remains challenging. An exploratory study design was used to conduct an initial assessment of the appeal and suitability of an implementation 'how to' Toolkit for Australian change-leader midwives. We aimed to determine the effectiveness of the intervention by evaluating midwives' experience of using the Toolkit, and report on the usability of the Toolkit in maternity care. We also sought to establish the degree to which the intervention could reach a broad cross-section of midwives, confirming the usability of the Toolkit across a range of public and private maternity services. Twenty-four midwives participated in our study. Participants provided practical Toolkit evaluation data, contextual information related to Toolkit content, their understanding of what implementation in a healthcare context is, and factors that hindered midwives' implementation efforts in clinical settings. The importance of co-design research and involving end-users in product development were also highlighted as crucial factors underpinning the effectiveness of resources like ours, particularly those designed to support specialist disciplines and the implementation challenges experienced by health practitioners in clinical environments. It is crucial to progress health care practitioners understanding of how to accelerate the implementation and sustainment of new evidence-based practices in clinical settings, including strategies to support organisational readiness, local barriers or challenges, and partnerships between researchers and end-users. Evaluation of our midwifery-specific implementation Toolkit indicates health professionals require tailored materials and information specific to their disciplines and clinical work environments; ideally, packaged in a centalised, open-access format. Future research is required to evaluate the mid-to-longterm impact of our Toolkit on implementation initiatives in midwifery contexts, and to establish the adaptability of our Toolkit in other settings, and with other disciplines.

Decrease in provider stigma is associated with improved quality health indicators among individuals receiving methadone in primary care centers in Ukraine.

People who inject drugs experience poor health and social outcomes which improve with opioid agonist therapies like methadone, yet provider stigma may influence healthcare utilization. In Ukraine, integrating methadone into primary care centers (PCCs) provides an opportunity to examine provider stigma and its impact on patient outcomes. This sub-analysis included patients randomized to receive methadone in PCCs as part of an implementation trial in which the control group received methadone in specialty addiction clinics in Ukraine. Methadone integration in PCCs was supported through continuous tele-education for providers. Provider stigma towards people who inject drugs, methadone, and attitudes towards evidence-based practices were assessed at baseline, 12, and 24 months using standardized scales (range 1-10). Patient-level outcomes were measured bi-annually over 24 months using a quality health indicator (QHI) score, a percentage of guideline-concordant primary and specialty health services accessed. Linear mixed-effects models examined the changes in provider stigma and attitudes, and the association of these measures with patient outcomes. The sample included 583 patients and the 112 providers in 24 clinics. Provider fear and stereotypes toward people who inject drugs improved significantly, by 0.6 (95 % CI 0.2-1.1) and 0.4 points (95 % CI 0.1-0.8), respectively, as did preference for methadone over abstinence-based treatment (0.7 points, 95 % CI 0.2-1.1). A 1-point improvement in provider prejudice correlated with a 7.0-point increase (95 % CI: 1.1-13.0) in patient primary care QHI scores at 12 months, while improved attitudes towards evidence-based practices were associated with an 8.3-point increase (95 % CI: 1.1-13.0). Preference for methadone maintenance over abstinence was associated with a 3.7-point increase (95 % CI: 0.6-6.7) in specialty care QHI scores at 12 months, and reduced stereotypes were associated with a 10.9-point increase (95 % CI: 1.2-20.7) at 24 months. Integrating methadone into PCCs with the support of provider tele-education may reduce provider stigma, particularly fear and stereotypes, toward people who inject drugs and methadone maintenance. Reducing provider stigma has the potential to improve patient outcomes through increased access to preventive care and screenings.

Exploring the Scholarly Value and Impact of DNP-Prepared Nurses Through the Lens of Nursing Leaders.

To explore organizational nursing leaders' perceptions of impact, value, and support for doctor of nursing practice (DNP)-prepared nurses engaging in practice scholarship. DNP nurses are educated to lead change at the system level and direct practice-based initiatives to enhance health outcomes. Organizational support and the value of DNP scholarship need to be better understood. An exploratory cross-sectional survey of organizational nursing leaders (N = 87) who participated in hiring or interacting with DNP-prepared nurses was implemented. More than half of the organizational nursing leaders reported that scholarship competencies were integrated into DNP-prepared nurses' job descriptions, yet almost half reported no time allotment for scholarship activities. Respondents reported that the highest impact of the DNP-prepared nurse was on the quality of care, and the greatest value reported was the implementation of evidence-based practice and quality improvement initiatives, the development of innovative roles, and as change agents. Consistent organizational support for DNP-prepared nurses to engage in practice scholarship could maximize the value and impact of these highly educated nurses on healthcare systems and health outcomes.

Context for Practice: Moving from Best- to Evidence-Based Practice in Ostomy Care.

Context for Practice: Moving from Best- to Evidence-Based Practice in Ostomy Care.

AGA Clinical Practice Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals.

Hepatitis B reactivation (HBVr) can occur due to a variety of immune-modulating exposures, including multiple drug classes and disease states. Antiviral prophylaxis can be effective in mitigating the risk of HBVr. In select cases, clinical monitoring without antiviral prophylaxis is sufficient for managing the risk of HBVr. This clinical practice guideline update aims to inform frontline health care practitioners by providing evidence-based practice recommendation for the management of HBVr in at-risk individuals. The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The panel conducted a systematic evidence review to identify new studies since publication of the first version of this clinical practice guideline in 2014. The Evidence to Decision framework was used to develop recommendations regarding the role of antiviral prophylaxis and monitoring without antiviral prophylaxis for management of HBVr. Clinical recommendations were based on the balance between desirable and undesirable effects, patient values, costs, and health equity considerations. The panel agreed on 4 recommendations. Based on evidence and baseline risk assessment, the panel made a strong recommendation in favor of antiviral prophylaxis for individuals at high risk of HBVr. For individuals at moderate risk of HBVr, a conditional recommendation was made in favor of antiviral prophylaxis. For individuals at low risk of HBVr, a conditional recommendation was made in favor of monitoring alone without antiviral prophylaxis. Monitoring should be performed at 1- to 3-month intervals, and must include assessment of hepatitis B viral load in addition to assessment of alanine aminotransferase. For individuals deemed to be at-risk of HBVr, the panel agreed on a strong recommendation in favor of testing for HBV; given universal Centers for Disease Control and Prevention screening guidance for hepatitis B for all adults 18 years and older by testing for HBV surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody, stratifying screening practices by magnitude of HBVr risk is no longer needed. This document provides updated guidance for the management of HBVr in at-risk individuals. Limitations and gaps in the evidence are highlighted. This guideline is expected to require updating in 5 years from publication.

Optimizing neuromuscular block monitoring and reversal: A large-scale quality improvement initiative in a diverse healthcare setting.

Residual neuromuscular block (NMB) after anesthesia poses significant risk to patients, which can be reduced by adhering to evidence-based practices for the dosing, monitoring, and reversal of NMB. Incorporation of best practices into routine clinical care remains uneven across providers and institutions, prompting the need for effective implementation strategies. An interdisciplinary quality improvement initiative aimed to optimize NMB reversal practices across a large multi-campus urban medical center. Using the Institute for Healthcare Improvement (IHI) framework, interventions were designed to increase Train-of-Four (TOF) monitoring and promote evidence-based and cost-effective use of the NMB reversal agents. Process and outcome measures were tracked through Plan-Do-Study-Act (PDSA) cycles. Qualitative interviews provided insights into clinician perspectives. The study encompassed 35,198 surgical cases utilizing NMB agents. The interventions led to a sustained increase in TOF monitoring from 42% to 83%. Significant increases were also observed in TOF ratio documentation and utilization of sugammadex. Postoperative respiratory complication rates decreased by 41% (RR 0.59, 95% CI 0.32-0.96) over the course of the initiative. The most pronounced increases in TOF monitoring were associated with financial incentives for the achievement of department-wide target monitoring rate. This initiative demonstrates successful large-scale integration of quantitative TOF monitoring and evidence based NMB management across a diverse medical center, while highlighting important barriers in implementation. These findings contribute to the broader discussion on translating evidence into practice, offering insights for improving patient care and safety through tailored implementation strategies.

The effect of caregiver opinion leaders to increase demand for evidence-based practices for youth anxiety: A cluster randomized controlled trial.

Dissemination initiatives have the potential to increase consumer knowledge of and engagement with evidence-based treatments (e.g., cognitive behavioral therapy [CBT]). Opinion leaders (OLs) have been used in public health campaigns, but have not been examined for the dissemination of mental health treatments. This study uses the Theory of Planned Behavior to test the dissemination strategy of involving an OL in an educational presentation to increase caregiver demand for CBT for youth anxiety. Participants (N = 262; 92% female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety treatment through their child's school. Schools within 1.5-hr drive of Philadelphia, PA were cluster-randomized (k = 25; two-arm prospective randomization) to the OL condition (presented by a clinical researcher and local caregiver OL; n = 119 participants) or the researcher-only condition (n = 143 participants). Presentations occurred from May 2021 to May 2022. Measures were completed pre- and post-presentation and at 3-month follow-up. Relative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but less credible than the researcher co-presenter. In both conditions, there was a significant pre-post increase in participants' knowledge of, attitudes about, subjective norms related to, and intention of seeking CBT for youth anxiety, but not stigma. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at follow-up. Although involvement of a caregiver OL did not increase caregiver demand for evidence-based treatment for youth anxiety, the outreach presentation was associated with increases in knowledge of, attitudes about, subjective norms related to, and intention to seek CBT for youth anxiety. Involving OLs in researcher-delivered dissemination efforts may not be necessary for all consumer audiences, but may be beneficial for engendering a sense of relatability, similarity, and connection with disseminators.

Role of psychologists in enhancing care quality for individuals with serious mental illnesses: Introduction to a special section.

This special section underscores the importance of psychologists in improving and enhancing care for individuals with serious mental illnesses (SMIs). People with diagnoses typically included in the category of SMIs-schizophrenia, schizoaffective disorder, bipolar disorder, and other diagnoses with symptoms severely impacting functioning-typically have layered marginalities and experience significant social stigma in addition to mental health symptoms. The complexity of challenges commonly experienced by individuals with SMI requires that treatment providers have specialized knowledge, training, and skills to provide specialty care needed to support mental health recovery. The included articles illustrate the breadth of the impact of psychologists on care for this population to date as well as the need to address growing care gaps for people with SMI through specialized training support to increase the provision of evidence-based practices and high-quality care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Students’ perceptions of assessment feedback in an undergraduate nursing and midwifery subject: a mixed-methods study

Background: In an undergraduate Bachelor of Nursing course, students enrol in an evidence-based Practice (EBP) subject. Three scaffolded tasks assess students’ ability to find, summarise and synthesise professional literature. For each assessment task, students are provided feedback that informs subsequent assessments. It is unclear how students use the feedback, and what elements of feedback are perceived as being most useful. Aim: This study aimed to examine nursing students’ perspectives of receiving feedback from scaffolded assessments and how feedback received influenced the development of the final assessment task. Design: A mixed-methods approach was used with a cross-sectional survey and online qualitative interviews. Setting: This research was conducted at Deakin University, School of Nursing and Midwifery in Melbourne, Australia. Participants: One hundred forty-eight students (17.4%, n = 851) participated in the cross-sectional survey. Seven students participated in the online qualitative interviews. Methods: Students enrolled in the EBP subject in Trimester, 2023 were invited to participate in a survey where they rated their experience of assessment feedback using a Likert scale. Students were also invited to participate in an online qualitative interview that further explored their perceptions. Results: Assessment exemplars were highly beneficial to understanding the assessment task (87.8% agree/strongly agree, n = 107). Responding to feedback was challenging (38.5%, n = 47). Qualitative themes identified were engagement with assessments, appropriateness of feedback, and use of scaffolded feedback. Conclusions: This study highlights that scaffolded feedback is valuable for student learning. Feedback in each rubric criterion helps with the alignment of learning outcomes. Resources that support students in how to respond to feedback are important.

Understanding literature reviews: a guide for enhancing nursing practice globally.

Literature reviews are essential in nursing for integrating research into practice, informing clinical guidelines and shaping health policy. They comprehensively synthesise the available evidence, supporting nurses in making informed decisions that improve patient care. It is therefore crucial when researchers are selecting the method most appropriate for investigating their clinical questions that they understand the different types of literature review. To explore the characteristics, strengths and limitations of narrative, systematic and scoping reviews, as well as highlight their significance in nursing practice globally. Narrative reviews provide broad, flexible overviews of topics; however, they lack methodological rigour, which can potentially result in bias. Systematic reviews provide high-quality, reliable evidence by using a structured approach to synthesising data from multiple studies; this makes them valuable for clinical decision-making and the development of guidelines. Scoping reviews map the scope of research onto emerging topics, identifying gaps and future research priorities, though they do not typically assess the quality of included studies. Literature reviews are vital tools for nurses worldwide. Understanding the differences between types of literature review enables nurses to effectively use the one most appropriate to their needs. This is essential for evidence-based practice, informs clinical and policy decisions, and supports high-quality patient care, as well as contributing to nurses' professional development. Nurses who engage with literature reviews can stay informed about the latest research, improve patient outcomes and participate in the advancement of nursing knowledge globally.

Assessing Clinical Nurse Educators' Perceptions of Factors Influencing Evidence-Based Nursing Policy Implementation Within a Large Pediatric Healthcare System.

To identify barriers and facilitators to implementation of new evidence-based nursing policies among nurse educators. Evidence-based practice promotes safe patient care through the combination of the best available research, clinical expertise and patient preferences. Policies are utilised by nursing to drive patient care and thus should be evidence-based. Nurse educators are identified as champions of evidence-based practice and policy dissemination. Therefore, understanding nurse educators' perceptions surrounding barriers and facilitators to nursing policy implementation and attitudes regarding evidence-based practice can help drive successful policy implementation and foster evidence-based practice in patient care. Descriptive, cross-sectional. A 7-item survey was electronically distributed to all nurse educators within a large pediatric healthcare system to assess barriers and facilitators to policy implementation as well as attitudes surrounding evidence-based practice and policies. The most significant barriers were lack of time and poor understanding of policy development. The most significant facilitators were a standardised policy dissemination process and leadership support of policy implementation efforts. Most nurse educators agreed that evidence-based practice is valuable to patient care. However, nurse educators report that they have a neutral to poor understanding of evidence-based practice. Findings were consistent with the literature, thus adding to the body of literature that supports the need for further development around policy dissemination and evidence-based practice education for nurse educators. This paper supports the need for professional development for nurse educators, standardisation of policy dissemination and leadership support of policy dissemination and promotion of evidence-based practice. No patient or public contribution. This paper adheres to the SQUIRE 2.0 guidelines.

Effectiveness of using implementation frameworks to facilitate the implementation of a stroke management guideline in the traditional Chinese medicine hospitals in China: protocol for a factorial randomised controlled trial

IntroductionTraditional Chinese medicine (TCM) is commonly used alongside Western medicine for stroke management in China. However, there is significant variation in TCM practice, and the utilisation of evidence-based clinical practice...

Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders

BackgroundPermanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management—including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted (“negative”) PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation’s largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups.MethodsWe used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles’ PSH program from 2016–2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and mixed race/ethnicity]) in controlled models and accounting for competing risk of death.ResultsIn competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61–25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs; however, this association was not statistically significant (95% CI: 0.85–4.37). African American/Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85–1.64), indicating no evidence of an association with negative PSH exits. Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75–1.66), similarly indicating no evidence to suggest an association with negative PSH exits.ConclusionsThese findings suggest relationships between SUDs and negative PSH exits differ between racial/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups.

Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study

Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study

Taking a Pulse on Quality and Safety Education

Background: The COVID-19 pandemic radically reshaped nurses’ education with a prominent shift to online learning. While there are emerging studies on quality and safety education post-pandemic, large-scale studies examining the pandemic’s impact on nurses’ quality and safety education are not available. Purpose: We examined quality and safety education in a national sample of nurses who were first licensed to practice in 2020, 2021, and 2022, adjusting for demographic, education, and work characteristics. Methods: We used correlational research design to analyze data from 821 nurses, which corresponded to a weighted population estimate of 170 824. Weighted logistic regression was used to model the nursing degree type on quality and safety education variables. Results: Approximately 90% of nurses reported receiving sufficient training in patient-centered care, teamwork and collaboration, and evidence-based practice. Approximately 75% received sufficient training in quality improvement. Conclusions: In a national survey conducted post COVID-19 pandemic, nurses reported a high level of preparedness in quality and safety education. One area that may require additional attention is quality improvement education.

Evaluating the Impact of an Educational Intervention on Nursing Labor Support Practices and Cesarean Birth Rates.

Background: Over 30% of births in the United States occur via cesarean section despite increased risks to the birthing person and neonate. Evidence-based nursing practice related to fetal monitoring, patient positioning, and management of the second stage of labor can decrease the incidence of cesarean birth. Objective: The objective is to decrease the cesarean birth rate by 3% in a Midwestern suburban hospital. Methods: Baseline data on demographics, labor interventions, and birth outcomes were collected for 4 weeks (n = 85 births). The intervention included a sample of 24 labor nurses who took a pretest, viewed a narrated PowerPoint on methods to promote vaginal birth, and completed a posttest. Data were then collected for another four weeks (n = 90 births). Results: The mean improvement in posttest scores was 4.792 points, providing strong evidence that this education would result in a score increase between 3.9 and 5.6 with 95% confidence. There was no increase in the number of nursing interventions utilized during labor. The overall cesarean birth rate increased from 18.8% to 28.9%. Conclusions: The education was highly effective in increasing nurse knowledge, but this did not affect a change in nursing practice or cesarean birth rate. Implications for Nursing: High-quality education is not enough to change practice or outcomes. Additional research is needed on barriers that prevent the translation of knowledge into practice.

Insights into prescribing patterns for antidepressants: an evidence-based analysis

BackgroundAntidepressants are a primary treatment for depression, yet prescribing them poses significant challenges due to the absence of clear guidelines for selecting the most suitable option for individual patients. This study aimed to analyze prescribing patterns for antidepressants across healthcare providers, including physicians, physician assistants, nurse practitioners, and pharmacists, to better understand the complex factors influencing these patterns in the management of depression.MethodsLeast Absolute Shrinkage and Selection Operator (LASSO) regression was employed to identify variables that explained the variation in the prescribed antidepressants, utilizing a large number of claims. Models were created to identify the prescription patterns of the 14 most common antidepressants, including amitriptyline, bupropion, citalopram, desvenlafaxine, doxepin, duloxetine, escitalopram, fluoxetine, mirtazapine, nortriptyline, paroxetine, sertraline, trazodone, and venlafaxine. The accuracy of predictions was measured through the Area under the Receiver Operating Curve (AROC).ResultsOur analysis revealed several key factors influencing prescribing patterns, including patients’ comorbidities, previous medications, age, and gender. A history of high antidepressant use (four or more prior medications) was the most common factor across antidepressants. Age influenced prescribing patterns, with mirtazapine and trazodone more frequent among older patients, while fluoxetine and sertraline were more common in younger individuals. Condition-specific factors included trazodone for insomnia, and amitriptyline or nortriptyline for headaches. Paroxetine, venlafaxine, and sertraline more often prescribed to females, while bupropion and doxepin were commonly prescribed for patients with tobacco use disorder and opioid dependence. Predictive factors per medicine ranged from 51 (doxepin) to 168 (citalopram), with cross-validated AROC scores averaging 76.3%.ConclusionsOur findings provide valuable insights into the nuanced factors that shape evidence-based antidepressant prescribing practices, offering a foundation for more personalized, effective depression treatment. Further research is needed to validate these models in other extant databases. These findings contribute to a more comprehensive understanding of antidepressant prescribing practices and have the potential to improve patient outcomes in the management of depression.

SQUARE-IT: a proposed approach to square the identified research problem in the literature with the objectives, the appropriate clinical research question, and the research hypothesis

The purpose of this article is to design and introduce the SQUARE-IT approach to help scientists and clinicians in research to align important research problems with the objectives, the appropriate clinical research questions to be answered, and the research hypotheses to be investigated in medical and therapeutic specialties. Research ideas can be generated primarily through simple methods such as brainstorming and mind mapping. However, transforming ideas into a valid research question is not as easy as it may seem, as the mere presence of an idea does not guarantee that the researcher has already uncovered existing knowledge on a particular topic or identified the actual research problem. Therefore, the SQUARE-IT items are developed, described, and critically discussed with reference to the scientific literature. They ask whether the identified research problem is ‘Specific’, ‘Quantifiable’, ‘Usable’, ‘Accurate’, ‘Restricted’, ‘Eligible’, ‘Investigable’, and ‘Timely’. Before formulating the focused clinical question, SQUARE-IT can be used as a preparatory step to enable researchers to organize the relevant information that has been explored to date and to assess whether additional information is needed, thereby identifying current research gaps. In addition, it should facilitate the effectiveness and efficiency of evidence-based practice to ensure high quality patient care. Using SQUARE-IT as a framework, further elaboration of the approach and addition of other aspects are warranted to advance the discussion and improve methods of evidence-based practice in medical and therapeutic specialties for quality improvement of patient care.

Using Appreciative Inquiry in Correctional Health Care: An Integrative Review.

This integrative review examines the use of appreciative inquiry in correctional health care settings, following the guidelines of Whittemore and Knafl. Using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool, it assessed the level and quality of the evidence. Search terms included appreciative inquiry AND healthcare, appreciative inquiry AND nursing practice, and appreciative inquiry AND criminal justice. Nine of the 92 articles reviewed used steps of the appreciative inquiry process and were selected for the final review and analysis. Most study authors recommended organizational change. In carceral settings, appreciative inquiry was used to reduce bias, increase empowerment, and improve workplace relationships. Wider dissemination of the usefulness of this process is needed to address workforce shortages.