Citty Bridges Education, Research and Patient Care

Sandra Citty, a clinical assistant professor in the College of Nursing.

A step toward better health

Nursing professor working to improve processes regarding nutritional supplements

By Veronica Garcia

Sandra Wolfe Citty, Ph.D., R.N., ARNP-BC, has been involved in health care from the start. Her parents owned a medical transcription company.

“I was constantly around hospitals making deliveries of medical records with my dad,” she said.

Now, in her own work at the College of Nursing and in UF Health Shands Hospital, Citty is finding ways to improve electronic medical records, specifically regarding how nutritional supplements are documented, ordered and administered.

Citty, who earned her Ph.D. in nursing at UF and her bachelor’s and master’s of science in nursing at the University of Miami, is a clinical assistant professor in the College of Nursing.

Although she spends much of her time instructing undergraduate nursing students and mentoring graduate students in the Doctor of Nursing Practice program, she also is leading a clinical quality improvement project designed to improve outcomes for patients who require oral nutritional supplements.

Malnutrition is a common problem among hospitalized patients, Citty said. Oral nutritional supplements have been shown to improve outcomes for these patients. Because these supplements are so important for patients, she led a process improvement project to find out how electronic health records could help improve how they are administered.

Over a four-week period, Citty and her team reviewed the records of 124 patients. They found that 76 percent of the oral supplements ordered for patients were returned to the formula room.

“Nutrition is a low-hanging fruit,” she said. “We can make big impacts by providing nutritional supplements for our patients. I‘m really an advocate for patients and as a nurse I want to make sure they get better.

“My role as a clinical assistant professor allows me a unique opportunity to teach students, care for patients, and potentially evaluate and solve problems affecting patient’s outcomes and health care delivery,” she said.

Through the project, Citty hopes the processes involved in administering and documenting oral nutritional supplements will be standardized across units and facilities at UF Health. This will help providers know whether patients have received their supplements, and if not, why. Improving this process could help improve healing, reduce patients’ length of stay and reduce costs, she said.

“I think it is important as nurses that we really do a good job to promote healing,” she said. “Improving this process is a step in a direction that will improve patient care, and that’s what I get excited about.

“It is an exciting time at UF Health. The collaboration between UF Health and the UF College of Nursing is strong and blossoming. We have a growing number of faculty, clinicians and students who are leading and collaborating on clinical projects that directly affect bedside clinical care and outcomes at UF Health.”