What’s in Your Hospital’s Kitchen? The Basics of Food Service Hygiene

Foodborne illnesses can be prevented by breaking the chain of infection and eliminating elements of the kitchen from becoming reservoirs for pathogens to flourish.

Infection preventionists (IPs) have a lot on their plate—1 of them including supporting their hospital’s food services department. In a single day, the food services department in a hospital provides the nutritional needs of hundreds of patients, staff members, and visitors.

The CDC estimates each year that 48 million Americans become ill from contaminated foods and beverages. IP’s involvement in their food services department is critical in preventing foodborne illnesses and maintaining a survey-ready environment. They must be on high alert when conducting environment of care rounds in these areas because food safety can impact any individual, particularly the immunocompromised population that can be affected by low numbers of pathogens.

One place food services sometimes forgets about is the shipping in of supplies. The food service staff should limit and manage the volume of cardboard and shipping containers in their kitchens. Boxes and containers can become exposed to unknown contamination. In fact, shipping containers are susceptible to moisture, water, vermin, and bacterial growth because these boxes sometimes travel hundreds of miles before arriving at your hospital; by its nature, packing materials can be an unexpected source of contagion.

Refrigerators and Freezers

Two imperative places for IPs to inspect in the kitchen are the refrigerators and freezers. Food items must be strategically placed in refrigerators and freezers. For example, by placing meats on bottom shelves, an individual eliminates the possibility of any excess fluid from meat contaminating and dripping down on other products such as fruits and vegetables. Shelf liners can also serve as simple tools to create barriers and protect ingredients. IPs must monitor these placements on their rounds to prevent cross-contamination.

Joint Commission Standard CTS.04.03.33 requires that food and nutrition products are stored under proper conditions of sanitation, temperature, light, moisture, ventilation, and security, and food service staff must ensure that these variables are continuously being met, and the IP should verify. Education and demonstrated competency can facilitate that staff understand and monitor these parameters. Staff should also be able to demonstrate through tools such as logs that these parameters are frequently checked, and a system is in place if parameters are outside their optimal window.

Compliance with this standard also should demonstrate that food services personnel are watching for expiration dates and disposing of food when expired. The dates on food packaging are critical for ensuring optimal food quality.

Cross Contamination

As the demand for food and beverages increases, so does the risk for cross-contamination. The food services department includes an array of food options, stations, tools, and surfaces for preparation and serving. Bacterial contaminators such as Escherichia coli, salmonella, campylobacter, norovirus, and hepatitis A are the most prevalent pathogens to cause illness and be extracted from foods and surfaces in kitchens and dining areas. To prevent these pathogens, it is necessary to disinfectant surfaces with hospital-approved and manufacturer-recommended disinfectants before and after preparing meals.

IPs should also verify that cooking utensils are properly sanitized and stored. Cooking personnel should be mindful of how they are using their utensils and with which types of foods, and avoid using the same utensils with both raw and cooked foods.

Most importantly, proper hand hygiene is essential for preventing all foodborne illnesses, and IPs must monitor and verify the food service staff are following the facility's guidelines, since most foodborne illnesses are spread by contaminated hands. As every IP knows, studies indicate that the simple act of washing hands with soap and water reduces incidents of diarrhea from shigella and other causes by up to 35%. IPs can work with management to verify the the easily accessibility of gloves and hand washing stations that can facilitate an environment promoting hand hygiene.

Routinely performing infection prevention rounds in the food services department can ensure that food safety is being maintained in hospitals. From food services to forks, pathogens can enter and disrupt the intended wish to enjoy any meal at any point in time.