Background: Bad dietary habits and sedentary lifestyles alter body composition, increasing disease risk. Methods: We conducted a prospective, comparative, longitudinal observational study among nursing students from Complutense University of Madrid. Data were collected in two periods: before exams (January 2024) and during exams (May 2024). Body composition was assessed via bioimpedance (Beurer BF 1000), dietary habits through the modified Kidmed survey, and physical activity using the IPAQ. Results: During exam preparation, fat mass significantly increased (25.43% to 28.79%, p = 0.016), muscle mass significantly decreased (39.70% to 36.20%, p < 0.001), and visceral fat rose notably (2.34 to 3.52, p < 0.001). Students exhibiting poor dietary quality increased (54.2% to 80.0%, p < 0.001), vigorous physical activity dramatically decreased (84.7% to 11.1%, p < 0.001), and sedentary time increased significantly (408.24 to 543.61 min/day, p < 0.001). Conclusions: Our findings suggest dietary deterioration and reduced physical activity during exams adversely affect students’ body composition.

Background: Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment—also known as morphofunctional assessment—should be conducted. This includes evaluating body composition (muscle and fat mass), muscle strength, and functional capacity. Methods: We conducted an observational, prospective, pre-post interventional study involving 138 patients undergoing major elective surgery. Each patient received a morphofunctional assessment and an individualized prehabilitation program, including nutritional supplementation, physical exercise, and comorbidity optimization for 21 days before surgery and one month afterward. Outcomes were assessed through bioimpedance (muscle mass), muscle ultrasound (QRF thickness), dynamometry (strength), and visceral fat ultrasound (fat reduction). Results: The patient’s morphofunctional assessment and subsequent nutritional and physical exercise optimization performed during the month before surgery in the prehabilitation consultation led to an increase in muscle mass (measured by bioimpedance analysis, p = 0.001), and muscle ultrasound, (QRF thickness: p < 0.001) and dinamometry (muscle strength: p = 0.014); a reduction in preperitoneal visceral fat thickness (reduction p < 0.001); and an improvement in the patients’ nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, post-operative complications were effectively prevented (p < 0.001). Conclusions: Pre-operative patient optimization by means of a prehabilitation program led to increased muscle strength, improved muscle mass, reduced complication rates, and shorter hospital stays. In addition, patients maintained their quality of life and functional capacity following surgery.

(1) Background: Prehabilitation programs improve patients’ functional capacity before surgery by enhancing physical activity, nutrition, and psychological well-being, thereby reducing postoperative complications, hospital stays, and readmissions. We propose a centralized model led by an advanced practice nurse and internist to minimize consultations and reduce costs. (2) Methods: We studied 211 patients in a tertiary hospital in Madrid, with 135 enrolled in the centralized prehabilitation program and 76 in standard care (control). We compared complications, hospital stays, blood transfusions, and consultations, estimating costs using public pricing from Madrid’s healthcare authorities. (3) Results: The centralized model significantly reduced blood transfusions (p = 0.014), postoperative complications (p < 0.001), and hospital stays (p = 0.004), leading to annual savings of EUR 593,453.00. (4) Conclusions: A centralized surgical prehabilitation model decreases complications, hospital stays, readmissions, and consultations compared to standard care, significantly reducing healthcare costs.

Background: Emergency laparotomy (EL) carries high morbidity and mortality relative to elective abdominal surgery. While Enhanced Recovery After Surgery (ERAS) principles improve outcomes in elective care, their translation to emergencies is inconsistent. The emergency department (ED) provides a window for rapid risk stratification and pre-optimization, provided that interventions do not delay definitive surgery. Methods: We conducted a PRISMA-ScR–conformant scoping review to map ED-initiated, ERAS-aligned strategies for EL. PubMed, Scopus, and Cochrane were searched in February 2025. Eligible sources comprised ERAS guidelines, systematic reviews, cohort studies, consensus statements, and programmatic reports. Evidence was charted across five a priori domains: (i) ERAS standards, (ii) comparative effectiveness, (iii) ED-feasible pre-optimization, (iv) risk stratification (Emergency Surgery Score [ESS], frailty, sarcopenia), and (v) oncological emergencies. Results: Thirty-four sources met inclusion. ERAS guidelines codify rapid assessment, multimodal intraoperative care, and early postoperative rehabilitation under a strict no-delay rule. Meta-analysis and cohort data suggest ERAS-aligned pathways reduce complications and length of stay, though heterogeneity persists. ED-feasible measures include multimodal analgesia, goal-directed fluids, early safe nutrition, respiratory preparation, and anemia/micronutrient optimization (IV iron, vitamin B12, folate, vitamin D). Sarcopenia, frailty, and ESS consistently predicted adverse outcomes, supporting targeted bundle activation. Evidence from oncological emergencies indicates feasibility under no-delay governance. Conclusions: A minimal, ED-initiated, ERAS-aligned bundle is feasible, guideline-concordant, and may shorten hospitalization and reduce complications in EL. We propose a practical framework that links rapid risk stratification, opportunistic pre-optimization, and explicit continuity into intra- and postoperative care; future studies should test fidelity, costs, and outcome impact in pragmatic emergency pathways.

Background: Prehabilitation emerges as a program designed to enhance the patient’s functional capacity before surgery by addressing three key aspects: physical activity, proper nutrition, and the reduction of anxiety and frustration. Various prehabilitation models exist to optimize patients before surgery, including programs led by anesthesiologists, surgeons, endocrinologists, etc. The existing models demonstrate that appropriate patient optimization before surgery reduces postoperative complications, hospital stay, and re-admissions.(2) Methods: A total of 211 patients were included, of whom 76 were not enrolled in the surgical prehabilitation program based on the advanced practice nursing and internist model (control group), while 135 benefited from this program (intervention group).; (3) Results: Following the surgical prehabilitation model led by an advanced practice nurse in collaboration with an internist, a significant reduction was achieved in blood transfusions (p=0.014), postoperative complications (p<0.001), and hospital length of stay (p=0.004). Likewise, annual costs were reduced by a total of €593,453. (4) Conclusions: Following a surgical prehabilitation model reduces the number of postoperative complications, decreases hospital length of stay, and increases the savings on red blood cell transfusions. Likewise, implementing a model led by an advanced practice nurse in collaboration with an internist significantly reduces the annual costs of a tertiary hospital.

Background: The use of physical restraints in hospital settings remains a controversial practice due to its ethical, legal, and safety implications. Although restraints are intended to prevent falls or manage agitation, their inappropriate use may compromise patient dignity, autonomy, and quality of care. Current healthcare policies emphasize restraint reduction, appropriate documentation, and professional training as key elements of humanized and safe care. Methods: A descriptive cross-sectional study based on an anonymous self-administered survey was conducted in a tertiary university hospital as the diagnostic phase of a quality improvement project aimed at evaluating healthcare professionals’ knowledge, perceptions, and documentation practices related to physical restraint use. A structured ad hoc questionnaire was distributed to registered nurses and nursing assistants working in adult inpatient units using a non-probabilistic convenience sampling strategy. The survey explored training, clinical decision-making, communication with patients and families, awareness of institutional protocols, and use of the electronic health record (EHR). Descriptive analyses and Pearson’s chi-square tests were performed using IBM SPSS Statistics. Results: A total of 241 professionals participated. More than half of respondents (54.8%) reported no formal training in physical restraint use, and only 27.4% considered their training sufficient. Although 86.3% stated they were familiar with restraint indications, only 53.5% were aware of the existence of a structured EHR restraint registry, and just 31.0% consistently completed it. Documentation of restraint removal was particularly low (32.9%). Furthermore, significant discrepancies were observed between regulatory definitions of restraints and professionals’ perceptions regarding practices requiring formal documentation. Statistically significant associations were identified between professional category, perceived training adequacy, and knowledge of physical restraint indications. Conclusions: This diagnostic phase identified substantial gaps between regulatory requirements, professional knowledge, and real-world documentation practices related to physical restraint use. The findings highlight the need for competency-based training strategies, standardized documentation processes, and strengthened institutional leadership to promote patient safety, regulatory compliance, and the humanization of hospital care.