Publications by authors named "Courtney Glass"

10 Publications

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Factors influencing the development and implementation of nurse practitioner candidacy programs: A scoping review.

Int J Nurs Stud 2022 Jan 8;125:104133. Epub 2021 Nov 8.

School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia. Electronic address:

Background: To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes.

Aim: To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences.

Methods: A scoping review of research and grey literature was conducted using Joanna Briggs Institute methodology. For the research literature, eight electronic databases (Embase, Medline, CINAHL, Web of Science, Cochrane Library, Joanna Briggs Institute, PubMed and PsycINFO) were searched followed by a hand search of the reference lists of published systematic reviews and relevant topical papers. A review of national and international grey literature sources was completed.

Findings: Identification of a service gap, developing and promoting a clear role for the nurse practitioner candidate, integration into a multi-disciplinary team with strong mentorship/preceptorship support, continuing professional development, and evaluation of the program were identified as key factors in the research and grey literature.

Conclusion: A well-designed candidacy program can facilitate transition of the candidate into an autonomous, fully independent nurse practitioner. Recommendations to support the implementation of these roles into the clinical setting have been generated. Tweetable abstract: Key to nurse practitioner candidate programs: Identification of a service gap, clear role, integration, mentorship, training and evaluation.
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January 2022

Factors affecting hospital readmission rates following an acute coronary syndrome: A systematic review.

J Clin Nurs 2021 Nov 22. Epub 2021 Nov 22.

School of Nursing and Midwifery, Edith Cowan University, Perth, Australia.

Aim: To synthesise quantitative evidence on factors that impact hospital readmission rates following ACS with comorbidities.

Design: Systematic review and narrative synthesis.

Data Sources: A search of eight electronic databases, including Embase, Medline, PsycINFO, Web of Science, CINAHL, Cochrane Library, Scopus and the Joanna Briggs Institute (JBI).

Review Methods: The search strategy included keywords and MeSH terms to identify English language studies published between 2001 and 2020. The quality of included studies was assessed by two independent reviewers, using Joanna Briggs Institute (JBI) critical appraisal tools.

Results: Twenty-four articles were included in the review. All cause 30-day readmission rate was most frequently reported and ranged from 4.2% to 81%. Reported factors that were associated with readmission varied across studies from socio-demographic, behavioural factors, comorbidity factors and cardiac factors. Findings from some of the studies were limited by data source, study designs and small sample size.

Conclusion: Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates. It is recommended that nurses are supported to influence discharge planning and lead the development of nurse-led interventions to ensure discharge planning is both coordinated and person-centred.
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November 2021

The effectiveness of goal setting on glycaemic control for people with type 2 diabetes and prediabetes: A systematic review and meta-analysis.

J Adv Nurs 2021 Oct 29. Epub 2021 Oct 29.

University of Otago, Dunedin, New Zealand.

Aim: This review assessed the effectiveness of interventions using a goal-setting approach on glycaemic control for people diagnosed with prediabetes or type 2 diabetes.

Design: A systematic review guided by the Joanna Briggs Institute methodology for conducting systematic reviews of primary research studies was conducted.

Data Sources: Randomized controlled trials and experimental studies with a minimum follow-up period of 6 months were considered for inclusion. The primary outcome was change in glycaemic control as measured by glycated haemoglobin (%) and/or fasting plasma glucose (mg/dl). A systematic search of seven electronic databases was completed in October 2020.

Review Methods: Papers meeting the inclusion criteria were critically appraised using the Joanna Briggs Institute tools for critical appraisal followed by data extraction. A Grading of Recommendations Assessment, Development and Evaluation assessment was conducted to assess the overall certainty of the evidence. Fixed-effect meta-analyses were completed to demonstrate the mean effect for each outcome of interest.

Results: Twenty one studies were included in this review. Goal setting was more effective than usual care for glycaemic control in prediabetes at 6 months and at 12 months for fasting plasma glucose (mg/dl) and glycated haemoglobin (%). Goal setting was more effective than usual care for glycaemic control in type 2 diabetes for fasting plasma glucose (mg/dl) at 6 months, fasting plasma glucose (mg/dl) at 12 months, glycated haemoglobin (%) at 6 months and glycated haemoglobin (%) at 12 months.

Conclusion: The evidence suggests goal setting is effective in supporting people to achieve glycaemic targets in prediabetes and type 2 diabetes.
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October 2021

Factors influencing community-dwelling older adults' readiness to adopt smart home technology: A qualitative exploratory study.

J Adv Nurs 2021 Dec 3;77(12):4847-4861. Epub 2021 Sep 3.

School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.

Aims: Ageing-in-place for older people could be more feasible with the support of smart home technology. Ageing in-place may maximize the independence of older adults and enhance their well-being and quality of life, while decreasing the financial burden of residential care costs, and addressing workforce shortages. However, the uptake of smart home technology is very low among older adults. Accordingly, the aim of this study was to explore factors influencing community-dwelling older adults' readiness to adopt smart home technology.

Design: A qualitative exploratory study design was utilized.

Methods: Descriptive data were collected between 2019 and 2020 to provide context of sample characteristics for community-dwelling older adults aged ≥65 years. Qualitative data were collected via semi-structured interviews and focus groups, to generate an understanding of older adult's perspectives. Thematic analysis of interviews and focus group transcripts was completed. The Elderadopt model was the conceptual framework used in the analysis of the findings.

Results: Several factors influenced community-dwelling older adults' (N = 19) readiness to adopt smart home technology. Five qualitative themes were identified: knowledge, health and safety, independence, security and cost.

Conclusion: Community-dwelling older adults were open to adopting smart home technology to support independence despite some concerns about security and loss of privacy. Opportunities to share information about smart home technology need to be increased to promote awareness and discussion.

Impact: Wider adoption of smart home technology globally into the model of aged care can have positive impacts on caregiver burden, clinical workforce, health care utilization and health care economics. Nurses, as the main providers of healthcare in this sector need to be knowledgeable about the options available and be able to provide information and respond to questions know about ageing-in-place technologies to best support older adults and their families.
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December 2021

Clinical staff perceptions on the quality of end-of-life care in an Australian acute private hospital: a cross-sectional survey.

Aust Health Rev 2021 Dec;45(6):771-777

Hollywood Private Hospital, Monash Avenue, Nedlands, WA 6009, Australia. Email:

Objective To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt confident in their ability to talk to the patient and family. Almost one-third had not received specific training in the area. Conclusions Hospitals need to take the lead in ensuring end-of-life care processes are embedded across clinical areas. This includes providing staff with end-of-life care education and support in the delivery of end-of-life care. These strategies will facilitate safe and quality end-of-life care, including better collaboration between patients, families and staff. What is known about the topic? Key to providing quality end-of-life care in hospitals are strategic guidelines that support good clinical governance and adequately trained staff to deliver the care. What does the paper add? This study highlights the importance of clinical staff in all areas having skills and confidence in providing care to dying patients and their families. What are the implications for practitioners? It is important that all health practitioners implement strategies to overcome gaps in staff education and support, to ensure all patients and families receive quality end-of-life care.
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December 2021

Improving the safety and quality of end-of-life in an Australian private hospital setting: An audit of documented end-of-life care.

Australas J Ageing 2021 Dec 3;40(4):449-456. Epub 2021 Aug 3.

Hollywood Private Hospital, Nedlands, WA, Australia.

Objective: This study reviewed the audit outcomes of the documented end-of-life care in a private hospital against the Australian Commission on Safety and Quality in Health Care's five recommended processes of care (Essential Elements (EE) 1-5).

Methods: A retrospective database review of deaths over a three-year period was undertaken. This was followed by a sequential medical record audit (n = 100) to evaluate the end-of-life care documented in the three days preceding death.

Results: There were 997 deaths from 2015 to 2017. The audit found communication to family the patient was dying (91%) and to the patient (36%) (EE1); evidence of specialist referral (68%) (EE2); assessment of the ability to eat/drink in the last 72 hours (86%) (EE3); advance care directives (13%) and hospital resuscitation plans (92%) (EE4); and response to patient or family concerns (100%) (EE5).

Conclusions: Components of the processes of care of the Essential Elements need to be addressed to improve patient-centred communication and shared decision-making.
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December 2021

How is organisational fit addressed in Australian entry level midwifery job advertisements.

BMC Health Serv Res 2021 Feb 27;21(1):183. Epub 2021 Feb 27.

School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027.

Background: Midwifery job retention is an ongoing global issue. Prior research has recognised that considering an individual's attributes in relation to their work environment may assist in improving job satisfaction among midwives, leading to improved long-term job retention in the midwifery profession. The aim of this study was to evaluate whether, and how organisational fit is addressed in current entry level midwifery job advertisements within Australia.

Methods: Midwifery jobs were searched for within 12 search engines, using the search term 'midwife', including , , government employment websites for all Australian states and territories, and private health organisation websites. Data were extracted from eligible job advertisements by three independent researchers. Extracted data encompassed elements addressing person-job fit and person-organisation fit. Content analysis involving chi-square and Fischer exact tests were completed on extracted data.

Results: Key findings demonstrate private health care organisations (29.2%) are more likely than public health care organisations (8.8%) to ask potential candidates to have additional qualifications, however, public health care organisations (34.1% vs. 16.7%) are more likely to ask for dual registration as a midwife and nurse. This is further supported by private health care organisations being more likely to refer to the candidate as a midwife (72.9% vs. 48.4%) than as a nurse. Private health care organisations more often noted access to support for employees and were more likely to mention access to employee assistance programs (41.7% vs. 13.2%), orientations (16.7% vs. 0%) and included benefits (72.9% vs. 42.9%). Clinical skills and personality traits were more frequently addressed in public health organisation advertisements; these included a requirement of employees to be accountable (49.5% vs. 6.3%), innovative (28.6% vs. 0%), have teamwork (69.2% vs. 52.1%) and conflict resolution skills (36.3% vs. 8.3%), and have knowledge of legislation (44.0% vs. 25.0%) and contemporary midwifery issues (28.6% vs. 4.2%).

Conclusion: This study highlights that organisations employing midwives may be unwittingly contributing to the problem of midwife attrition through inattention to factors that endear midwives to workplaces in job advertisements. Further work developing employee selection and recruitment processes that are informed by the concept of person-job-organisation fit, is necessary.
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February 2021

Exploring the role of goal setting in weight loss for adults recently diagnosed with pre-diabetes.

BMC Nurs 2020 15;19:67. Epub 2020 Jul 15.

Edgar Diabetes and Obesity Research, Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054 New Zealand.

Background: The management of prediabetes in the community setting is a global priority. We evaluated the feasibility of a 6-month multilevel practice nurse-led prediabetes dietary intervention which involved goal setting. The aim of this paper is to explore the weight loss goals and strategies reported by participants to achieve their weight loss goals as recorded by practice nurses, and report on factors that influenced dietary behaviours.

Methods: This study used a convergent mixed-methods design. A six-month pragmatic non-randomised pilot study with a qualitative process evaluation was conducted in two neighbouring provincial cities in New Zealand. A structured dietary intervention delivered by practice nurses was implemented in four practices in 2014-2016. Content analysis of the text and descriptive statistics were used to analyse the data.

Results: One hundred and fifty seven people with prediabetes were enrolled (85 intervention, 72 control). The intervention group lost a mean 1.3 kg more than the control group ( < .0.001). The majority of the intervention group indicated either a high level of readiness ( = 42, 53%) or some readiness ( = 31, 39%) to make food changes. The majority of weight loss goals aligned with clinical guidelines (between 5 and 10% of body weight). While just over half ( = 47, 55%) demonstrated weight loss at the end of the six month period, the majority of participants did not achieve their predetermined weight loss goal ( = 78, 83%). Gender, ethnicity and budget were not related to weight loss at six months. Readiness to change and reported challenges to making dietary changes were related to weight loss at six months. Negative factors or set-backs included sporadic adherence to diet due to other health problems, change in context or environment and coping with ill health, most notably stress and low mood.

Conclusions: The data relating to weight loss and dietary goals provided insight into the challenges that people faced in making dietary changes for weight loss across a six month period. Simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the person, in a socially supportive environment, may increase the success of goal achievement.

Trial Registration: ANZCTR ACTRN1261500080656. Registered 3 August 2015 (Retrospectively registered).
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July 2020

The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review.

J Med Internet Res 2020 06 1;22(6):e17331. Epub 2020 Jun 1.

School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.

Background: Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults.

Objective: The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults.

Methods: Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews.

Results: In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment.

Conclusions: Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made.

Trial Registration: PROSPERO CRD42019143504;
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June 2020

Hospitalized Adult Patient Characteristics Associated With Participation in a Volunteer-Assisted Mobility Program: A Feasibility Study.

J Nurs Care Qual 2020 Oct/Dec;35(4):341-347

Edith Cowan University, School of Nursing and Midwifery, Joondalup, Western Australia (Dr Dermody and Ms Glass); Washington State University Health Sciences Spokane College of Nursing, Spokane, Washington (Dr Odom-Maryon); and Providence Holy Family Hospital, Spokane, Washington (Ms Zimmerman).

Background: Physical inactivity during hospitalization commonly results in functional decline. Structured multidisciplinary programs/approaches may be useful to promote mobility in hospitalized adults.

Purpose: The purpose was to determine whether a volunteer-assisted mobility program was feasible to improve the ambulation of hospitalized patients, and examine the characteristics of patients associated with willingness to participate in the program.

Methods: A prospective descriptive correlation study was conducted in 2 acute care units. A volunteer-staffed program was implemented with the aim of improving the ambulation of hospitalized patients.

Results: Hospitalized patients (N = 490) were approached, with 39.2% (n = 192) agreeing to ambulate an average of 109.7 m (interquartile range = 51.45-172.2 m). Patients with a low clinical frailty score, high body mass index, or physical therapy order were more likely to participate in the volunteer-assisted mobility program.

Conclusions: The findings suggest that a volunteer-assisted interdisciplinary program is a feasible way to promote the ambulation of some patients.
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April 2021