KITCHEN INFECTION CONTROL AND FOOD SAFETY .pptx

Regarding latest guidelines of kitchen infection control and food safety

1. INFECTION CONTROL IN KITCHEN AND FOOD SAFETY DR.P.B.PRAVEENKUMAR SECOND YEAR POST GRADUATE DEPARTMENT OF MICROBIOLOGY THANJAVUR MEDICAL COLLEGE

2. MAIN RESPONSIBILITY..... Providing safe and nutritious food is the prime responsibility of a hospital food service department.

3. WHY FOOD SAFETY IN HOSPITAL IS MORE IMPORTANT THAN RESTAURANT????? Hospitalized patients are more susceptible to infectious diseases Hospital kitchen will supply special feeds like enteral feeding, neonatal feeds Delay in transportation of food and inappropriate storage

4. FACTORS CONTRIBUTING FOOD BORNE INFECTIONS Food items – Proper selection and monitoring (Fresh salads in neutropenic patients Pseudomonas aeruginosa infection)

5. FACTORS CONTRIBUTING FOOD BORNE INFECTIONS... Food handlers and servers – Inadequate hygiene Undue delay – Release of staphylococcal enterotoxin Lack of vaccination of HCWs – Hep A & Typhoid

6. FACTORS CONTRIBUTING FOOD BORNE INFECTIONS... Facilities – Improper design and maintenance Pathogens and it’s sources Patients with comorbities like diabetes, patients on chemotherapy Visitors and caregivers – Giving outside food

7. FOOD BORNE PATHOGENS AND THEIR SOURCES

8. FOOD BORNE PATHOGENS AND THEIR SOURCES....

9. FOOD BORNE PATHOGENS AND THEIR SOURCES....

10. PHYSICAL DESIGN OF KITCHEN DEPARTMENT LOCATION Should be located away from patient care and waste collection area Separate building preferably in ground floor which eases the accessibility No inconvenience (like noise..) to nearby departments

11. PHYSICAL DESIGN OF KITCHEN DEPARTMENT... DEDICATED AREAS IN KITCHEN Raw supply receiving and checking area Storage area for raw materials, vegetables Functional kitchen area (Processing, cooking, Holding area, dispensing counter) Environmental cleaning equipment and disinfectants area Toilet and dress room facility for kitchen personnel Food waste storage area

12. ESSENTIAL REQUIREMENTS IN KITCHEN AREA Restricted entry board Adequate supply of treated water Secured windows Reliable food supplier Metal pallets, Refrigerators – Minimum clearance of 8-12 inches from the floor Adequate ventilation (Exhaust fans/AC) Smooth surface without cracks

13. ESSENTIAL REQUIREMENTS IN KITCHEN AREA.... Separation of cooked and raw food Hand wash facility Separate weighing apparatus No plants No pet animals

14. ENVIRONMENTAL CLEANING IN KITCHEN CLEANING LOCATION PRODUCT FREQUENCY Floor Soap and water Atleast twice a day Clean to dirty area Additional spill cleaning if needed Food storage pallets Soap and water Atleast weekly Surface of food preparation 1% Sodium hypochlorite Contact time – 1 minute Atleast twice a day (or) Before and after use Weighing machines Soap and water Once a day (or) whenever soiled Cooking stoves Soap and water Before and after use Cooking gas cylinders Soap and water Once a day Mop heads/Brushes (Change this two weeks once (or) when they become frayed) Soap and water Before next use

15. CLEANING OF ITEMS USED TO HANDLE FOOD (Utensils, knives...) Washing with soap and hot water (Preferably) Immersion in 0.5% hypochlorite for 1 minute Rinse with plain water and allow it to dry These above steps should be done before first use of the day After first usage, it should be washed with soap and water (or) whenever they appear soiled and then store it in closed cupboard / closed plastic bag when not in use

16. MEDICAL EXAMINATION OF FOOD HANDLERS MEDICAL TEST FREQUENCY (Increased when outbreak occurs) Complete physical examination Once a year Stool examination for ova, cysts and parasites Every three months Stool culture for salmonella Every three months Routine CBC Every three months CXR, Widal test and Stool culture for cholera Only if indicated Medical examination – Initially before joining the job.....Later we are following the below table

17. PERSONAL HYGIENE OF KITCHEN WORKERS Fresh washed clothes everyday Clean apron Hand hygiene (Clean and short nail) Hair cap ( No loose hairs for females & Clean shave for males ) Diagnosis of any illness for kitchen personnel should be properly reported Open wound should be covered with water proof dressing while duty NO SMOKING AND ALCOHOL Respiratory hygiene and cough etiquette

18. EDUCATION AND TRAINING OF KITCHEN WORKERS FREQUENCY : At the time of joining the job, routinely at least twice yearly and after returning from long leaves and during outbreak situations. Education on food borne hygiene , food borne illness Posters and visual signages to reemphasize personal hygiene Vaccinated against Hepatitis A, Typhoid & cholera

19. INFECTION CONTROL MEASURES WHILE HANDLING OF RAW FOOD Gross dirt should be removed Food boxes should be wiped with soap and water Excessive water sprinkle on food items should be avoided

20. STORAGE PRECAUTIONS All food items – Below 8 degrees above 63 degrees Deep frozen food – Below -18 degrees Chilled food – 0-3 degrees Excessive stocking of perishable food items (Egg, bread) should be avoided Clean jute bags / containers used to store grains Vegetables and fruits – Stored in refrigerator (2-4 degrees)

21. CLEANING AND DISINFECTION OF VEGETABLES BEFORE USAGE Thorough wash in running water of drinking quality Damaged areas of vegetables should be discarded Immersion in 0.5% hypochlorite solution for 1 minute Again wash in plain water to remove residual chlorine and then dry it.

22. PROCESSING OF RAW FOOD FOR COOKING Hand hygiene should be followed Clean kitchen equipment Use separate knives and cutting boards Avoid time lapse in serving food Avoid storing and using prepared food as much as possible

23. FOOD PREPARATION, STORAGE AND DISPENSING Use correct temperatures Cook eggs appropriately Use clean container Should be covered during transport Foot pedal to open lid of the storage food Clean plastic gloves should be used while dispensing Clean plates, glasses

24. CARE OF REFRIGERATORS Temperature check atleast once daily Keep away from heat sources Defrosting should be done regularly Labeling (Name, storage date with expiry) Over storage avoided No medicine and clinical items Routine inspection – Atleast twice daily Cleaning should be done properly

25. REFRIGERATOR CLEANING METHOD Switch off the unit Remove all shelves Clean the fridge walls followed by base with soap water and then with clean cloth Shelves replaced and unit can be switched on

26. CARE OF MICROWAVE OVENS It’s usage in hospital setup is limited Never ever reheat the food that is not consumed at meal time

27. CARE OF ICE MAKING MACHINES Usage should be restricted Never handled in bare hands Should be emptied, washed and dried inside and outside at least once a week

28. KITCHEN WASTE DISPOSAL Divided into wet and dry waste Should be disposed daily (or) once get 3/4 th full Should not mixed with bio medical wastage

29. PEST CONTROL IN KITCHEN Entire area sprayed with pesticides every 3 months (or) whenever large number of pests detected Rodent traps should be placed in various areas Pest infestation should be looked for daily and reported immediately

30. RECORD MAINTENANCE It includes Temperature maintenance Cleaning record Food preparation menu Time of dispatch to patients Stock register with date of procurement and expiry THIS SHOULD BE COUNTER CHECKED AND COUNTER SIGNED BY OFFICE IN-CHARGE

31. HACCP IN KITCHEN INFECTION CONTROL Hazard Analysis and Critical Control Point Internationally recognised system To reducing the risk of safety hazards (Biological, chemical, physical) in food

32. THANK YOU