Best Management Practices Research Articles

Identifying and assessing pond best management practice under future climate scenarios

Climate change can play important roles in the hydrological processes within watershed with ponds as the Best Management Practice (BMP). Unlike several other studies, this study integrated remote sensing technique with hydrological model to identify and simulate pond BMP. Limited studies have been carried out to evaluate pond BMP in relation to the climate change impacts on hydrology and water quality particularly in Mississippi watersheds. The objective of this study was to classify ponds on satellite imagery within the Big Sunflower River Watershed (BSRW) using Google Earth Engine (GEE) and incorporate this data with Soil and Water Assessment Tool (SWAT) model to evaluate future hydrological and water quality outputs. The SWAT model was calibrated and validated against streamflow (R2 and NSE values from 0.81 to 0.56) and sediment (R2 and NSE values from 0.91 to 0.40). Future climate data for the mid (2040–2060) and late (2079–2099) centuries were utilized to create climate change scenarios (e.g., RCP 4.5 and 8.5). Results of this study projected that the average annual flow and sediment load will increase by 26–46%, and 107-150% respectively by the late century compared to the baseline period (2002–2021). However, the projected sediment load with modified pond BMP data used in the SWAT model could decrease average annual sediment load by 44–46% under both RCP scenarios. Seasonal data analysis determined that spring, summer, and fall sediment loads were projected to decrease up to 42%, 52%, and 46% respectively under both RCP scenarios due to pond BMP. This study can be useful for the development of climate-smart management strategies in agricultural watersheds.

Community Forest Management and the Resilience of Karen Indigenous Knowledge in Northern Thailand.

This study investigates the resilience of indigenous knowledge in five Karen villages, located in Thailand's Chiang Mai, Chiang Rai, and Lampang provinces, that have been recognized for best practices in community forest management (CFM). The CFM model was initiated by local communities to promote forest conservation and community engagement. Data on CFM practices, land-use rights, social networks, and indigenous knowledge were collected through 17 in-depth interviews and 5 focus group meetings. The findings include how these Karen communities have adopted payment for environmental services (PES) to fund conservation projects and social welfare. More specifically, PES generates social capital by facilitating coordination with stakeholders from the private sector, academia, and government. These social networks promote markets for local products and advocate for indigenous land-use rights. The PES model also serves as a tool whereby Indigenous Peoples can shape their identities as innovative forest guardians and legitimize their residence within the forest. Additionally, the study reports on how Karen people have diversified their livelihoods to include hosting academic tourism, handicrafts, and livestock, reducing their dependence on forest resources.

EXPLORING THE ASSOCIATION BETWEEN HOUSEHOLD SANITATION AND WOMEN’S MENSTRUAL HYGIENE MANAGEMENT IN RURAL ODISHA, INDIA

IntroductionAccess to water, sanitation, and hygiene (WASH) facilities has been globally recognized as a critical need, especially for women and girls to ensure their menstrual hygiene. This study aimed to investigate the association between household sanitation and women’s menstrual management experience in Odisha, India. MethodsA cross-sectional study was conducted in Balasore district of Odisha state in India among 694 rural women and girls aged 15-45 years selected using a multi-stage sampling method. The Performance Monitoring and Accountability (PMA) 2020 questionnaire was used for data collection. Multivariate logistic regression analysis was carried out using SPSS version 25. ResultsMore than two-third (68.4%) of rural families used improved sanitary facilities. Around 30% of households have been using an unimproved sanitary facility, which means the practice of open defecation is still prevalent in rural areas. About 40.6% of women and girls reported using clothes as their primary menstrual hygiene material. Further, women and girls with improved sanitation facilities (aOR = 1.56, 95% CI: 1.09 - 2.59) were more likely to change menstrual materials at the main household sanitation facility than those with an unimproved sanitation facility. In contrast, households using improved sanitation facility were less likely to use bedroom/sleeping areas to change the menstrual materials (aOR=0.65, 95% CI: 0.42-0.99) than those with an unimproved facility. ConclusionAvailability of improved household sanitation is critical to good menstruation management practices. State-specific policy for menstrual health and hygiene could provide the much-needed impetus to strengthen WASH infrastructure in rural and tribal regions of Odisha.

Combined impacts of climate and land use scenarios on sediment loads in small agricultural watershed in Tunisia

This study investigates the impact of conservation practices, specifically mulching and terracing, on soil erosion in the Kamech watershed (2.6 km²) situated in the Cap Bon region of northeastern Tunisia, under both current and future climate scenarios. Utilizing the Soil and Water Assessment Tool (SWAT) model, the research evaluates the effectiveness of these Best Management Practices (BMPs) in reducing soil loss, revealing significant reductions of 1.5 t ha⁻¹ yr⁻¹ for mulching and 2 t ha⁻¹ yr⁻¹ for terracing. The findings indicate that these practices play a crucial role in enhancing soil conservation amidst climate change challenges, including altered precipitation patterns and increased temperatures. Additionally, the study highlights a notable decline in average monthly rainfall projected for the period 2051 to 2100 under the RCP8.5 scenario, further emphasizing the importance of implementing effective soil management strategies. This paper indicates that both methods, mulching and terracing, significantly contribute to reducing soil erosion under future scenarios (2051-2100). Their implementation proves essential for effective soil conservation, helping to mitigate the impacts of climate change and maintain soil health in the Kamech watershed. The results contribute to a better understanding of BMP performance in addressing soil erosion, water quality, and hydrological responses in the face of evolving environmental conditions. By enhancing our understanding of these interactions, this research aims to provide valuable insights for sustainable watershed management, particularly in regions prone to water scarcity and land degradation.

Building a theoretical framework for financial risk management in emerging markets: Applying global best practices to the oil and gas industry in developing economies

Financial risk management is crucial for the sustainability and growth of the oil and gas industry in developing economies, where volatility and regulatory uncertainties present significant challenges. This abstract explores the construction of a theoretical framework for financial risk management, adapting global best practices to the specific contexts of emerging markets within the oil and gas sector. In developing economies, the oil and gas industry faces unique risks such as geopolitical instability, currency fluctuations, and regulatory changes. Effective financial risk management mitigates these risks through proactive strategies that balance risk exposure with strategic objectives. Adopting global best practices involves the integration of comprehensive risk assessment methodologies, scenario planning, and hedging techniques tailored to local market conditions. Key components of the theoretical framework include risk identification through comprehensive analysis of market, operational, and financial factors. This approach enables oil and gas companies to anticipate and mitigate risks before they escalate, ensuring financial stability and resilience in volatile environments. Furthermore, the application of global best practices in financial risk management fosters transparency and accountability, enhancing investor confidence and facilitating access to capital. By aligning risk management strategies with international standards and benchmarks, developing economy oil and gas firms can navigate uncertainty more effectively, thereby optimizing operational performance and sustaining long-term growth. However, challenges such as limited access to sophisticated financial instruments and expertise may hinder effective implementation. Overcoming these barriers requires capacity building, collaboration with experienced partners, and continuous adaptation of strategies to evolving market dynamics. In conclusion, building a theoretical framework for financial risk management in the oil and gas industry in developing economies is essential for mitigating volatility and maximizing opportunities. By applying global best practices tailored to local contexts, companies can strengthen their resilience, attract investment, and drive sustainable development in emerging markets.

Strategic leadership and management within non-profit organizations: An in-depth review of practices contributing to sustainable impact

This study provides an in-depth review of strategic leadership and management practices within non-profit organizations (NPOs) and their contribution to sustainable impact. Employing a systematic literature review and content analysis, the research aims to explore the evolving landscape of strategic leadership, define the scope of leadership and management in achieving sustainable impact, and identify innovative management practices that enhance organizational sustainability. The methodology involved a comprehensive search across peer-reviewed journals, conference proceedings, and grey literature from 2013 to 2023, focusing on empirical evidence, theoretical frameworks, and case studies relevant to NPOs' strategic leadership and management. Key findings reveal that adaptive leadership, innovative management practices, stakeholder engagement, and technology integration are crucial for NPOs to navigate operational complexities, engage stakeholders effectively, and achieve mission-driven objectives. The study proposes strategic recommendations for NPOs to enhance their sustainable impact, including adopting adaptive leadership styles, fostering innovation, integrating technology, and building resilient organizational frameworks. The study underscores the importance of policy development to guide non-profit leaders towards best practices in strategic leadership and management. It also highlights future research directions, emphasizing the need to explore the impact of emerging technologies, globalization, and cross-cultural dynamics on NPOs. Conclusively, the research affirms that effective strategic leadership and management are indispensable for enhancing the sustainable impact of NPOs, advocating for continuous innovation and adaptability in the non-profit sector.

Development of an automated process for monitoring of amiodarone treatment

Abstract Background Amiodarone treatment requires repeated laboratory evaluations of thyroid and liver function due to risk of side effects during long-term administration. Robotic process automation (RPA) represents the use of software robots to automate repetitive and routine tasks typically performed by humans. Purpose We aimed to develop an RPA using a diagnostic classification algorithm and clinical support system for follow-up of amiodarone treatment. Methods Based on international guidelines and clinical specialist advisory we constructed an RPA which was studied in a test environment in parallel with routine amiodarone treatment. Expert advice was integrated through a series of collaborative workshops, ensuring alignment of the algorithm with current best practices in thyroid and liver disease management. The RPA provided recommendations on the time interval to next laboratory testing and suggestions for patient management to the physician, who was serving as a human-in-the-loop responsible for clinical decisions. Results After iterative improvements the RPA was evaluated against physician orders (n=390 paired orders) without technical failures. The recommended time interval to next follow-up was (mean ± SD) 4.5 ± 2.4 vs. 3.1 ± 1.4 months for RPA vs. physician (p<0.0001). While normal laboratory findings resulted in recommended follow-up in 6 months by the RPA (72.2%) this was only ordered in 9.9% by the physician (Figure). Physicians’ orders clustered between 3-4 months (58.5%). All patients diagnosed with new side effects (n=12) were detected and communicated correctly by the RPA, whereas only 8 were correctly detected and responded to by the physician (Table). Conclusions An automated process constitutes a reliable alternative to the current fully manual management of amiodarone follow-up. It may reduce manual labour, frequency of laboratory testing and detect side effects with increased precision, thereby reducing costs and enhancing patient value. While the RPA shows promise, further research is needed to explore its adaptability to other treatment scenarios.

The adoption of Best Management Practices: empirical evidence from oil palm farming in rural Ghana

ABSTRACT Purpose We examine how farmer characteristics, farm, institutional, perception and shock factors influence the adoption of the Best Management Practices (BMPs). A thorough understanding of how relevant drivers affect the adoption decision of diverse BMPs can contribute to the development of evidence-based policies. Approach We use a household survey of 1031 smallholder oil palm farmers in the forest zones of Ghana to assess the determinants of farmers’ adoption decisions. We employ a seemingly unrelated regression (SUR) model after a principal component analysis is used to extract five latent components. Findings Our findings indicate that different farmer characteristics, farm, institutional, perception and shock factors have differential associations with the adoption of diverse BMPs. Key among these are the positive perception of BMPs, access to mills, perception of soil fertility and pests and diseases. Practical implications Specific BMPs must be tailored to meet the prevailing individual socio-economic characteristics and challenges of farmers to facilitate their adoption and scale-up. Educational programmes and dissemination of information by extension agents and research institutions are needed in the promotion of BMPs to enhance effective uptake. Theoretical implication The paper contributes to the growing literature especially on the uptake of diverse management practices, utilizing both behavioural and socio-economic theories underpinning adoption, thus providing empirical evidence that adoption is influenced by both behavioural and socio-economic factors. Originality/value In the bid to increase agricultural productivity, while preserving ecosystem services, the adoption of sustainable management practices remains key for all stakeholders and policy makers. This paper presents credible information for policy makers in Ghana and Africa in designing polices to influence their adoptions.

Effect of Different Weed Management Practices on growth and yield in Potato at Khumaltar, Lalitpur, Nepal

Potato (Solanum tuberosum L.) is the fifth most important crops in the world in terms of production with an estimate of 375 million metric tons. In Nepal, potato ranks second in terms of production and sixth in terms of area coverage. Potato production is affected by weed infestation. Weeds compete with crops for nutrients, water and other resources, which eventually reduce the crop yield. The critical period of crop-weed competition for potato is 25-40 days from planting depending on the climatic-zone and planting seasons. The most common method of weed control in Nepal is manual method, while herbicides are uses in less areas. Weeds are considered as the major problem in conventional and organic farming, due to lower yields by weeds and higher costs of labor for weed control. Mulching is one of the best and safest practice for effective weed management in potato due to which micro-climate manipulation is developed. Metribuzin is widely used herbicides in potato that controls a range of broadleaf weed species and suppresses many grassy weeds. To study the performance of different weed management practices in potato ten treatments were set up viz., three herbicides (pendimethalin@ 1.0 kg a.i ha-1, metribuzin@ 0.5 kg a.i ha-1 and atrazine @ 0.25 kg a.i ha-1) constituting seven treatments, one mulching with rice straw, one treatment with two manual hoeing, and another treatment with no any weed management practices as control.The treatments were laid out in RCB design with 4 replications. The potato variety Janak Dev was planted on 12th Feb 2021 and 23rd Jan 2022 with tuber rate of 4.1 t.ha-1 with row spacing of 60 cm and plant to plant 20 cm in a plot size of 4 x 3 meter in flat bed. Growth parameters such as plant height, plant fresh and dry biomass were recorded. Data on weed density, weed dry biomass, and tuber yield were taken.The economics of the different treatments were calculated. Among the treatments metribuzin@ 0.25 kg a.i ha-1 as pre-emergence proved effective in controlling weeds showing highest weed control efficiency (200.7 %) and tuber yield (32.79 t ha-1) . However, the treatment rice straw mulch @ 6 t ha-1 produced the highest tuber yield (38.31 t ha-1), 73.4 % increased yield over control, weed control efficiency(147.1%), economic benefit (NRS 13,40,850), benefit cost ratio (4.93).The treatment rice straw mulch @ 6 t ha-1 showed superiority among the different weeds management practices.

An Integrated Spatial Fuzzy‐Based Site Suitability Assessment Framework for Agricultural BMP Placement

ABSTRACTAssigning crisp class boundaries to landscape features can result in the loss of vital information for land evaluation objectives, especially when these boundaries lack clear definitions. This challenge becomes particularly pronounced when land suitability is assessed for implementing agricultural best management practices (BMPs)—conservation measures aimed at reducing the environmental risks of farming activities to aquatic ecosystems while simultaneously achieving water quality and economic objectives. To address the limitations associated with Boolean suitability assessment frameworks, we have introduced an integrated spatial, fuzzy‐based land evaluation framework that considers a range of hydrological and economic determinants for BMP placement. By employing data‐driven fuzzy membership functions and overlay operators, this framework generates a joint suitability index for BMP placement across agricultural watersheds. The application of the proposed framework to the Thames River Watershed in southwestern Ontario, Canada, produced the first joint suitability index of the watershed. Further analysis of the average farm‐level joint suitability scores identified statistically significant clusters of highly suitable and unsuitable lands for BMP placement, with 85% of highly suitable lands being situated in the upper basin areas. The proposed framework is adaptable to various agricultural production geographies, especially in data‐limited environments, allowing for strategic BMP placement to mitigate the global impacts of anthropogenic nutrient loadings on aquatic ecosystems. For optimal results, context‐specific applications should prioritize research on locally relevant fuzzy membership functions and BMP implementation drivers.

Optimizing pharmaceutical inventory management: A global framework for efficiency and cost reduction

Pharmaceutical inventory management is critical in ensuring continuous drug availability and cost efficiency in healthcare institutions globally. However, maintaining optimal inventory levels is challenging due to factors such as overstocking, stockouts, and global supply chain disruptions. This paper reviews best practices for efficient pharmaceutical inventory management, emphasizing the integration of data analytics and predictive models to forecast demand, reduce waste, and streamline procurement. It explores strategies for implementing unified inventory systems across diverse healthcare settings, balancing cost efficiency with uninterrupted drug availability. Additionally, the paper examines the impact of global supply chain disruptions on pharmaceutical supply and recommends solutions for building resilience. Through real-world examples and recommendations for future improvements, this review highlights the potential for enhanced global inventory management practices to reduce costs while ensuring the continuous availability of essential medications. Keywords: Pharmaceutical Inventory Management, Data Analytics, Cost Efficiency, Predictive Models, Supply Chain Resilience, Drug Availability

Streamlining budgeting and forecasting across multi-cloud environments with dynamic financial models

This review paper explores the complexities of financial management in multi-cloud environments, emphasizing the need for streamlined budgeting and forecasting processes. It begins by addressing the challenges inherent in managing finances across multiple cloud platforms, such as integration difficulties, data silos, and cost management issues. The paper then provides an overview of dynamic financial models, detailing their components and benefits in overcoming these challenges. It highlights the role of automation, real-time data utilization, and predictive analytics in enhancing financial accuracy and efficiency. Furthermore, the paper discusses the importance of collaborative platforms in fostering stakeholder communication and coordination. Finally, strategic planning, best practices for multi-cloud financial management, and emerging trends and prospects are outlined. The review underscores the significance of aligning financial models with organizational goals and leveraging advanced technologies to achieve optimal financial outcomes in multi-cloud settings. Keywords: Multi-Cloud Financial Management, Budgeting and Forecasting, Dynamic Financial Models, Automation in Finance, Predictive Analytics.

Commons land management in Southern, post-unification Italy: New evidence from a micro analysis on Salerno province

Abstract The aim of this study is to observe the ability of Southern Italian municipalities to respond to and redefine the management of common lands following the national privatisation and partition policies promoted by the State during the second half of the nineteenth century. The hypothesis tested is whether, through the analysis of new archival sources such as management rules, it is possible to identify good practices of management of common lands, along with the presence of resilience on the part of local communities during a period defined as one of uncontrollable ‘decline’ for these resources. Three Apennine areas (Campania Region) were identified as the observation sample. The analysis revealed that for these specific cases, it is imprecise to speak of decline and a lack of propensity to develop good management practices, but rather of institutions that are attentive to the protection and preservation of their commons through specific rules.

LLMOps: Operationalizing Language Models for the Enterprise

This comprehensive article explores the emerging field of LLMOps (Language Model Operations), a specialized branch of MLOps focused on deploying and managing large language models (LLMs) in production environments. The article examines the LLM lifecycle, challenges in scaling LLMs, essential LLMOps tooling, best practices for effective management, and future trends. Drawing on recent industry studies and statistics, it highlights the growing significance of LLMOps in enterprise AI applications, its potential to streamline operations and reduce costs, and its role in addressing critical issues such as model performance, scalability, data privacy, and ethical AI deployment

Application Research on the Use of Multiple Comparison Methods in The Evaluation of the Effectiveness of Total Nitrogen and Total Phosphorus Reduction Measures

With the problem of water pollution becoming increasingly serious, excessive discharge of nitrogen and phosphorus has become a key factor affecting water quality and ecological balance. In order to evaluate the effectiveness of different pollution reduction measures in total nitrogen and total phosphorus control, this study evaluates multiple best management practices (BMPs) using multiple comparison methods, in particular Tukey HSD testing. The results of the statistical analysis of the reduction effects of the different measures showed that all the treatment groups with measures were significantly better than the control group without measures. In particular, BMP 8, BMP 7 and BMP 6 showed the best reduction effects. This study not only provides a scientific basis for pollution control decisions, but also lays the foundation for follow-up research, highlighting the importance of multiple comparison methods in environmental science.

Postpartum Management of Hypertensive Disorders of Pregnancy in Six Large U.S. Hospital Systems: Descriptive Review and Identification of Clinical and Research Gaps.

Hypertensive disorders of pregnancy (HDPs) are a key contributor to maternal morbidity and mortality. Several gaps in knowledge remain regarding best practices in the postpartum management of HDPs. In this review, we describe postpartum HDPs management among six large academic U.S. hospital systems: Medical College of Wisconsin, University of Pittsburgh, University of Wisconsin-Madison, Northwestern University, University of Minnesota, and Boston Medical Center. We identified that all six health systems discharge patients with HDPs diagnosed with a blood pressure (BP) cuff and use the same two antihypertensive medications, nifedipine and labetalol, as first- and second-line treatment of HDPs. Northwestern University routinely adds oral furosemide for 5 days for patients with BP that exceeds 150/100 mm Hg. Most hospital systems administer magnesium sulfate routinely when readmission for HDPs occurs. In contrast, there was variation in BP threshold for antihypertensive treatment initiation, use of remote BP monitoring program, use of a transition clinic, delivery or lack of education on long-term cardiovascular disease risk, and BP management through the first 6 weeks postpartum and beyond. Based on the clinical review, we identified clinical gaps and formulated considerations for research priorities in the field of postpartum HDPs management. KEY POINTS: · Several gaps in knowledge remain regarding best practices in postpartum management of HDPs.. · There is a variation in the BP threshold for antihypertensive treatment initiation.. · Data are lacking on the reduction in severe maternal morbidity (SMM) and racial disparities in SMM with remote monitoring..

Clostridial Infections in Cattle: A Comprehensive Review with Emphasis on Current Data Gaps in Brazil.

Clostridial infections in cattle are a significant concern for Brazilian livestock. These diseases are caused by various species of Clostridium, which are known for their ability to produce potent toxins. Botulism in cattle is a serious and often fatal condition caused by the ingestion of neurotoxins produced by C. botulinum. This bacterium thrives in decomposing organic matter, such as spoiled feed, carcasses, and contaminated water. Tetanus is less common, but it is a serious disease that follows the contamination of wounds with Clostridium tetani spores. It results in muscle stiffness, spasms, and often death due to respiratory failure. Blackleg (C. chauvoei) is a disease that primarily affects young cattle, leading to acute lameness, swelling, and high fever. Malignant edema (C. septicum and others) is characterized by rapid onset of swelling at wound sites, and it can occur after injuries or surgical procedures. Enterotoxemia is triggered by the rapid growth of C. perfringens in the gut following excessive carbohydrate intake. This leads to toxin production that causes sudden death. In conclusion, clostridial bovine infections remain a persistent challenge for Brazilian cattle farmers. With continued focus on vaccination, good management practices, and research, the impact of these diseases can be minimized, safeguarding the livestock industry's economic viability.

Testing best practices in small scale fisheries management: Evidence from a collaborative intervention in two marine protected areas of the central Mediterranean Sea

Adopting best practices (BPs) in small scale fisheries (SSF) is generally acknowledged to enhance ecological and social conditions, improving SSF management overall. Yet studies that empirically assess the effects of BPs on social-ecological outcomes (e.g., fishers' catches, revenues, and level of support towards management measures) remain limited. This study aimed to assess the effects of adopting BPs on catch per unit of effort (CPUE), revenue per unit of effort (RPUE) and small-scale fishers' perceptions in two Marine Protected Areas (MPAs) in Campania, Italy (Santa Maria di Castellabate (CAS-MPA) and Regno di Nettuno (NET-MPA)). Two BPs were implemented and tested in the two MPAs: i) five selective gears with three different mesh/hook sizes and ii) a participatory approach to increase dialogue between fishers and managers. The results from 36 surveys with small scale fishers and 158 SSF operations monitored using photo-sampling and image analysis techniques (between 2020 and 2022) are presented. Analyses of landings showed that significant differences in CPUE and RPUE between mesh/hook sizes were found in a limited number of cases (i.e., combination of fishing gears used in the 2 MPAs). Significant but divergent effects were found on CPUE in the two MPAs for gillnet used to target amberjack (GNA) only. RPUE was significantly higher in the NET-MPA when adopting the largest mesh size for GNA and the largest hook size for bottom longlines (BLL). When analyzing perceptions, fishers generally reported that the BPs adopted had a positive impact on their revenues, improved their relationship with MPA managers and increased their support for the MPA. In addition, eight stakeholder focus groups were held which helped investigators better understand the context, feedback the data gathered from the research and open up dialogue between the relevant stakeholders. The study concluded that increasing mesh/hook sizes, within the range tested here, does not negatively impact fishers’ revenues, while likely improving the status of target populations. Moreover, increasing dialogue between fishers and decision-makers can generate more positive perceptions towards the MPA and improve mutual understanding, helping to reconcile biodiversity conservation with human wellbeing for SSF.

Management Model Using Standardized Contracts and BIM Tools for the Optimization of PPP Projects in Peru

Public–private partnerships (PPPs) are contractual schemes that have relative success in Latin America due to their configuration, where the spirit of the contract lies in an appropriate distribution of risks. This is both the most important and fundamental aspect of this contractual scheme but also the most complex, as it is the main cause of contract modifications (addenda) in countries across the region. In this context, different concessionary contractual frameworks for PPPs on the national road network of Peru were evaluated, revealing common failure indicators that lead to contract modifications within the first six years of the concession. This study offers the development of a management model that includes the good practices of contractual management of NEC4 Option F and the application of BIM information management processes, optimizing the management of infrastructure through emerging technologies of information management supported by agile contractual schemes.

Adherence to optimal delirium management practices in intensive care units in Brazil: a nationwide survey.

Effective delirium management is crucial, considering its association with adverse outcomes. Adherence to best practices has the potential to reduce the incidence and prevalence of delirium and improve health outcomes. The objectives of this project were to describe self-assessed adherence to best practices in delirium management by health care professionals in intensive care units (ICUs) in Brazil, assess the health care professionals' perception of the importance of adequate delirium prevention and treatment in ICUs, and compare the compliance rates with best practices between public and private ICUs. A cross-sectional study was conducted in Brazil using an online questionnaire consisting of three parts, namely, data about the health care professionals and the ICU in which they worked; statements about the 17 best practices; and questions related to perceptions of delirium prevention and management by ICU physicians and nurses. The survey was sent to email addresses registered with the Brazilian Association of Intensive Care Medicine. The compliance rate exceeded 50% for only eight best practices. These included the identification and management of pressure sores and falls in delirium patients, with compliance rates of 77.8% and 74.1%, respectively. Among ICU professionals in Brazil, adherence to best practices in delirium management is low, particularly for practices involving patient education and involvement of their relatives in their care. These results emphasize the importance of enhancing delirium management in Brazilian health care institutions, regardless of hospital classification. http://links.lww.com/IJEBH/A274.