Understanding Postoperative Cognitive Dysfunction
Course #30100 - $30 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
Postoperative cognitive dysfunction (POCD) is a significant and sometimes devastating complication that can occur in the hours, days, or even months following surgery. Although biomarkers may help identify when POCD has occurred, there are currently no routinely used preoperative predictors that are both highly sensitive and specific. Additionally, therapeutic interventions remain limited, and no gold-standard pharmacologic or neurocognitive treatment has been established. While many patients experience only transient cognitive changes, a subset may suffer prolonged executive function impairment, leading to decreased productivity, impaired activities of daily living, social challenges, increased morbidity, and higher mortality risk. This course provides an in-depth overview of POCD, including its pathophysiology, clinical manifestations, duration patterns, and modifiable and nonmodifiable risk factors. Participants will examine the current state of evidence regarding biomarkers, prevention strategies, and supportive management approaches. Emphasis will be placed on the critical role nurses play across care settings in early recognition, patient and family education, environmental safety, risk mitigation, and interdisciplinary collaboration.
This course is designed for nurses involved in the care of patients before and after operative procedures.
The purpose of this course is to enhance nurse's understanding of postoperative cognitive dysfunction (POCD) by reviewing its clinical presentation, risk factors, and current evidence regarding biomarkers, prevention, and management, while identifying supportive care strategies to mitigate functional impact and promote patient recovery.
Upon completion of this course, you should be able to:
- Review the concept of executive function and its relation to postoperative cognitive dysfunction (POCD).
- Identify tools available to assess neuropsychologic function.
- Compare and contrast the available intravenous anesthetics, particularly ketamine and propofol.
- Describe the mechanism or action of the inhaled anesthetics.
- Distinguish between POCD and other postoperative neurologic conditions.
- Discuss the POCD risk associated with various operative procedures.
- Analyze the possible mechanisms underlying POCD.
- Outline the treatment and prognosis of POCD.
Richard E. Haas, BSN, MSN, EdM, PhD, CRNA, LTC US Army Nurse Corps (Retired), is a retired nurse anesthetist and prehospital registered nurse (instructor) who has published extensively in various areas of healthcare research while providing clinical care in arenas ranging from academic medical centers to austere environments in the third world during both wartime and peacetime. He has a bachelor’s degree in nursing from Georgetown University, Master’s degrees in education (Boston University) and nursing specializing in anesthesia (State University of New York in Buffalo and U.S. Army), and a PhD from the University of South Carolina. He is a retired lieutenant colonel in the U.S. Army Nurse Corps. He has taught nursing anesthesia, pharmacology, and physiology; mentored students in doctoral programs; and used advanced patient simulation to train students. Dr. Haas has worked in clinical, administrative, education, and research roles. He continues to work as an independent consultant, while taking more time to enjoy life with his wife of nearly 50 years and their children and grandchildren.
Contributing faculty, Richard E. Haas, BSN, MSN, EdM, PhD, CRNA, LTC US Army Nurse Corps (Retired), has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Mary Franks, MSN, APRN, FNP-C
The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.
The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.