KING KHALID HOSPITALINFECTION PREVENTION

ANDCONTROL MANUAL

NUTRITION SERVICESDr. Nahla Abdel Kader, MD, PhD.

Infection Control Consultant, MOHInfection Control CBAHI Surveyor

Infection Prevention Control DirectorKKH.

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DEFINITION

To provide food services with infection control and environmental health guidelines and standards to prevent food borne diseases.

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A• Food service manager

B• Food Handlers

C• Purchasing and Receiving

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D• Storage• Preparation

E• Transport, Display and Serving

F• Washing and Cleaning

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PROCEDURE A. Food service manager

1. Provide written standards for:a. Safe preparation, handling and storage of food to minimize

contamination by microorganisms and chemicals.b. Cleaning and sanitizing of trays, utensils, tableware and other

surfaces.c. Employee health and work restrictions.d. Employee orientation, education, and training.e. Valid health certificates issued by Infection Prevention & Control

Department.

2. Conduct educational programs for personnel concerning food preparation and storage and personal hygiene and its relevance to food born infections. The educational sessions, should include and not be limited to the following:a. Hand Hygiene. b. Bacterial growth and temperature. c. Food storage, preparation, transportation and display. d. Sanitation and disinfection.e. Personal hygiene.

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PROCEDURE A. Food service manager

3. Assure that food handlers are managed appropriately for intercurrent illnesses.

4. Restrict unauthorized personnel from entering food preparation areas, and food facilities in general.

5. Restrict Visitors entry unless wearing a cover coat and hair restraint.

6. Assure that food handlers carry out all cleaning procedures, which would be consistent with optimum food hygiene.

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PROCEDURE B. Food Handlers

1. Additional to the hospital pre- employment screening requirement, complete a screening process in:

A. Clinical examination (chest, abdomen, skin diseases, communicable disease).

B. Chest X-ray to rule out Pulmonary Tuberculosis.C. Stool analysis for ova and parasites.D. Stool culture for Salmonella, Shigella and Cholera.E. Vaccination for meningococcal disease with a booster

every 5 years. F. Vaccination for typhoid fever with a booster every 5

years.2. Have a valid medical examination certificate indicating

that they are free from infectious diseases and fit to work as a food handler, this certificate must be issued by Infection Prevention & Control Department will be valid for one year and renewable yearly after the assessment of the food handler.

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PROCEDURE B. Food Handlers

3.Repeat clinical examination every six months and when employee leaves on vacation to areas of high risk of communicable diseases.

4.Follow proper and frequent hand hygiene and personal hygiene practices

a. Finger nails: keep trimmed and filed, do not apply finger nail polish or artificial fingernails.

b. Jewelry: Do not wear jewelry on the arms and hands while preparing food to allow proper hand hygiene.

5.Wear and maintain proper clean attire during food handling (clean uniform, apron and hair and beard restraint, clean gloves when needed). Do not wear street clothes in food service areas.

6.Do not eat, drink or smoke while preparing or handling food.

7.Do not go to washroom with masks or gloves.

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PROCEDURE C. Purchasing and Receiving

1. Purchase food from a reputable source, and inspect on delivery for the expiration date and signs of spoilage. Reject damaged food or containers.

2. Select food products in commercially filled, unopened packages whenever possible.

3. Store perishable foods immediately at proper temperature.

4. Eliminate damaged items.

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PROCEDURE D. Storage

1. Store non- perishable food in clean, dry, properly ventilated areas, and inspect periodically for any signs of spoilage or expiration dates.

2. Store food in designated areas. Do not store in housekeeping and dishwashing areas or near any sources of potential contamination.

3. Store food at least 8-10 inches above the floor level and away from walls to facilitate cleaning and allow pest control measures.

4. Rotate food stocks to avoid outdated food to be used.5. Store food products in a way to avoid cross contamination

between cooked and raw foods, washed and non-washed food.

6. Store food covered and labeled at proper temperature for refrigeration, (freezing storage less than -18º C refrigeration 2-7 ºC hot storage above 60º C).

7. Monitor refrigerators’ and freezers’ temperature and record daily in log.

8. Maintain good housekeeping and hygienic conditions.

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PROCEDURE E. Preparation

1. Instruct personnel and supervise for personal hygiene and food safety during food preparation.

2. Wash vegetables and fruits properly.3. Thaw either in a microwave, a refrigerator or under running

water. Do not thaw under room temperature.4. Do not thaw and refreeze.5. Cook food thoroughly to reach correct temperature for different

types of food6. Store prepared food protected at proper temperature once

ready to avoid any contamination. Do not allow to sit uncovered at room temperature.

7. Avoid handling of food with bare hands; use proper and clean utensils like tongs and spoons.

8. Use separate cutting boards for raw meat, poultry, fish, raw fruits and vegetables and cooked food unless boards are non-absorbent (scratch, chip, crack) and can be cleaned and sanitized adequately between uses.

9. Use clean equipment and utensils during food preparation and avoid cross contamination.

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PROCEDURE F. Transport, Display and Serving

1. Transport food to different areas protected in temperature-controlled carts.

2. Establish safe times for food items to be stored in inpatient care areas.

3. Protect food on display from customer contamination by the use of easily – cleanable counter protector devices.

4. Maintain food on display at right temperature whether hot or cold.

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PROCEDURE G. Washing and Cleaning

1. Establish comprehensive cleaning schedules to include different areas, equipment, fixtures, and physical facility structure (walls, floors...).

2. Monitor dishwasher washing and rinsing temperature to achieve proper sanitation and washing of food utensils.

3. After manual washing: Sanitize all utensils and equipment either by hot water 70ºC or the use of sanitizer ( sodium hypochlorite) at appropriate concentrations and exposure time.

4. Wash all working surfaces, thoroughly, rinse and sanitize them after each use with the proper sanitizer, dilution, exposure time and water temperature.

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PROCEDURE G. Washing and Cleaning

5. WaterUse clean, potable and safe water in the food service facility. Test water routinely for its quality and potability.

6. Ice machine• Use ice Dispensing ice machines (preferably). • Use potable water for ice making.• Clean and disinfect ice machines routinely according to a written procedure.• Use a clean scoop to dispense ice. Do not handle ice with bare hands. 7. Waste management

▫ Store garbage in leak and pest proof containers with tight fitting covers.▫ Store all garbage containers either outdoors or above a smooth surface of

non- absorbent material.▫ Wash containers and sanitize routinely in an area provided with a floor

drain connected to a sanitary sewer.

H. Pest Control• Follow appropriate pest control measures to prevent the access and

extermination of pests (sanitation, screens, closure of cracks and holes….)

I. Maintenance• Identify and follow a cleaning and sanitization procedure for each equipment

used in food services.

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