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Kitchen Nightmares

Kitchen Nightmares. What to look for in a Healthcare Kitchen Laura Pettit, R.E.H.S. Health Facilities Engineering Section. Risk Based Inspection. What is most likely to cause foodborne illness? Employee illness Poor hand hygiene Poor food handling Temperature control – the “Danger Zone”.

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Kitchen Nightmares

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  1. Kitchen Nightmares What to look for in a Healthcare Kitchen Laura Pettit, R.E.H.S. Health Facilities Engineering Section

  2. Risk Based Inspection • What is most likely to cause foodborne illness? • Employee illness • Poor hand hygiene • Poor food handling • Temperature control – the “Danger Zone”

  3. Employee Health Policy • The Big 5 • Norovirus • Hepatitis A • Shigella spp. • E. Coli • Salmonella Typhi

  4. Employee Health • Reportable symptoms and illnesses • Diarrhea, vomiting, jaundice, sore throat with fever • Do employees know what to report and when to stay home? • Ask them! • Nobody wants to tell the boss that they have diarrhea. • If I call in sick, do I still get paid? Are employees likely to come in sick anyway to avoid losing their job?

  5. Handwashing

  6. Handwashing • Are sinks accessible? • Soap and paper towel available? • 20 second handwashing? • Observe employees

  7. Limiting the growth of bacteria through proper: • Cooking • Cooling • Thawing • Refrigeration • Elimination of Cross Contamination

  8. The Danger Zone • 41⁰F to 135⁰F • Bacteria grows the fastest when in this range

  9. Cooling • Within 2 hours cool to 70°F • 41°F within 4 more hours • Total of 6 hours • Do they keep cooling logs?

  10. Cooling • Shallow pans • Ice wands • Ice baths • Small amounts

  11. Temperature Monitoring • Temperature logs • Cooking • Refrigeration units • hot/cold holding • Trays to patients • Supplies and equipment

  12. Cross Contamination • Handwashing! Handwashing! Handwashing! • Observe employees • Bare hand contact with Ready to Eat (RTE) foods • Storage of raw and RTE foods

  13. What is wrong here?

  14. What is wrong here?

  15. And this? Where do you even start?

  16. Bare hand contact • Barrier for RTE foods • Gloves, deli paper, utensils, etc. • Gloves do not make you invincible! You do not need to wear gloves all the time… in fact, that can actually hinder proper handwashing.

  17. Cleaning and Sanitizing • Food contact vs. non-food contact surfaces • Chemical and hot water sanitizing • Clean in place equipment

  18. Food contact surfaces • Prep tables • Slicers • Cutting boards • Anything that touches food!

  19. Would anyone like some hand cut French fries?

  20. How about fresh dough?

  21. Nooks and crannies missed during cleaning

  22. Dishwashing • Do they check the dishmachine? • What do they use? • Is a log kept?

  23. Highly Susceptible Population • Pasteurized eggs if undercooked (sunny side up) • No raw/undercooked foods • No time as a control • No reservice of items

  24. More fun

  25. Pest infestations

  26. Resources • Michigan Department of Agriculture and Rural Development (MDARD) www.michigan.gov/mdard • Links to fact sheets, current codes, Emergency Action Plans • CIFOR Foodborne Illness Response Guidelines http://www.cifor.us/projind.cfm • Posters, facility self assessments, outbreak advice • Your local health department • Health facilities Engineering Section (HFES) www.michigan.gov/hfes

  27. Questions? Laura Pettit, R.E.H.S Sanitarian Health Facilities Engineering Section (HFES) Bureau of Health Care Services (BHCS), Department of Licensing and Regulatory Affairs (LARA) 517-241-9927 pettitl@michigan.gov

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