Food-Service-Manual-for-Health-Care-Institutions

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Food Service Manual for Health Care Institutions 266 Exhibit 9.1. Food and Nutrition Screening Form Name__________________________________________________ Room No.________ Age_________ Male___________ Female___________ Child___________ Adult___________ Elderly______________ Diagnosis_____________________________________________________________________________ Diet order_______________________________ Physician_____________________________________ CLINICAL DATA: Medical history before admission: (past 1–3 months) Decubitus ulcer?_____________ Radiation therapy?______________ Chemotherapy?______________ Surgery?____________________ Acute illness longer than 3 days?__________ Height_____________ Weight___________ Loss past 3 months___________ Gain past 3 months_________ UBW________ IBW_____________ Condition of mouth, lips, tongue, gums__________________________________ Pain that interferes with eating? Yes_____ No_____ Where?___________________________________ Are you being treated for pain? Yes_____ No_____ BIOCHEMICAL DATA: Serum albumin__________________ Transferrin_______________ Nitrogen balance______________ FOOD AND NUTRITION HISTORY BEFORE ADMISSION: Diarrhea_______________ Constipation____________________ Nausea/vomiting________________ Heartburn_________________ Bloating_____________________ Cramping______________________ Appetite_________ Loss_________ Increased__________ Chewing/swallowing problems___________ What is your fluid intake?________________________ Fiber included in daily diet? Yes____ No____ NPO or limited intake longer than 3 days?_________________ Home TPN/EN?__________________ Diabetic?___________ IDDM_____________ NIDDM___________ Number of calories____________ Any other diet modifications? Yes____ No____ What?________________________________________ Bulimia? Yes____ No____ Anorexia nervosa? Yes____ No____ MEDICATIONS:________________________________________________________________________ ______________________________________________________________________________________ Vitamins_________________________________Minerals______________________________________ Other supplements (include all herbs)_____________________________________________________ SCREENED: _____ Patient screened at Level I—no nutritional intervention required at this time. Provide basic food service (selective menu, etc.) _____ Patient screened at Level II—requires assistance of nutritional care team; no malnutrition but may be at low risk. Provide basic food service, follow-up in 3–5 days. Document in patient’s medical history. _____ Patient screened, severe malnutrition, referred to the TPN/EN team and R.D. Referenced to outpatient nutrition clinic, referring physician and/or community agency. Document outcome in medical history. Forward data to appropriate person/agency. Screened by:______________________________________Date:_______________Time:____________ Note: Abbreviations: IBW, ideal body weight; IDDM, insulin-dependent diabetes mellitus; NIDDM, noninsulin-dependent diabetes mellitus; NPO, nothing by mouth; TPN/EN, total parenteral or enteral nutrition; UBW, usual body weight. Source: © Ruby P. Puckett, used by permission.
Table 9.3. Physical Signs Indicative of Malnutrition Body Area Normal Appearance Signs Associated with Malnutrition Hair Shiny; firm; not easily Lack of natural shine, dull and dry; thin and plucked sparse; fine, silky, and straight; color changes (flag sign); easily plucked Face Skin color uniform; Skin color loss (depigmentation); skin dark over smooth, pink, healthy cheeks and under eyes (malar and supraorbital appearance; not swollen pigmentation); lumpiness or flakiness of skin of nose and mouth; swollen face; enlarged parotid glands; scaling of skin around nostrils (nasolabial seborrhea) Eyes Bright, clear, shiny; no Pale eye membranes (pale conjunctivae); redness sores at corners of eyelids; of membranes (conjunctival infection); Bitot’s membranes healthy, pink spots; redness and fissuring of eyelid corners and moist; no prominent (angular palpebritis); dryness of eye membranes blood vessels or mound of (conjunctival xerosis); dull appearance of cornea tissue or sclera (corneal xerosis); soft cornea (keratomalacia); scar on cornea; ring of fine blood vessels around cornea (circumcorneal injection) Lips Smooth, not chapped or Redness and swelling of mouth or lips (cheilosis), swollen especially at corners of mouth (angular fissures and scars) Tongue Deep red in appearance, Swelling; scarlet and raw tongue; magenta not swollen or smooth (purplish color) tongue; smooth tongue; swollen sores; hyperemic and hypertrophic papillae; atrophic papillae Teeth No cavities, no pain, bright Missing or erupting abnormally; gray or black spots (fluorosis); cavities (caries) Gums Healthy, red, not bleeding, not swollen Spongy and bleed easily; recession of gums Glands Face not swollen Thyroid enlargement (front of neck); parotid enlargement (cheeks become swollen) Skin No signs of rashes, Dryness of skin (xerosis); sandpaper feel of skin swellings, dark or (follicular hyperkeratosis); flakiness of skin; skin light spots swollen and dark; red swollen pigmentation of exposed areas (pellagrous dermatosis); excessive lightness or darkness of skin (dyspigmentation); black and blue marks due to skin bleeding (petechiae); lack of fat under skin Nails Firm, pink Spoon-shaped nails (koilonychia); brittle, ridged nails Muscular Good muscle tone, Wasted appearance of muscles; baby’s skull and skeletal some fat under skin, bones thin and soft (craniotabes); round swelling systems ability to walk or run of front and side of head (frontal and parietal without pain bossing); swelling of ends of bones (epiphyseal enlargement); small bumps on both sides of chest wall (on ribs); beading of ribs; baby’s soft spot on head not hardened at proper time (persistently open anterior fontanelle); knock-knees or bowlegs; bleeding into muscle (musculoskeletal hemorrhages); inability to get up or walk properly Cardiovascular Normal heart rate and Rapid heart rate (above 100 beats per minute; system rhythm, no murmurs or tachycardia); enlarged heart; abnormal rhythm; abnormal rhythms, normal blood pressure for age elevated blood pressure Clinical Nutrition Care Management continued on next page 267
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Food Service Manual for Health Care
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Contents Figures, Tables, and Exhib
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Figures Figures, Tables, and Exhibi
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8.3. Excerpt from a Performance Eva
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19.1. Flow of Products in Food Serv
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6.2. Sample Job Description and Job
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Foreword It is truly an honor for m
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Preface The health care environment
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Acknowledgments The following indiv
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Introduction This edition of Food S
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Chapter 14 explains safety, securit
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Part One Management of the Food Ser
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Chapter 2 Leadership: Managing for
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oriented or people oriented and tha
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in an orderly manner, to manage the
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so as to anticipate and plan for fu
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Planning Through planning, the futu
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Reward or punitive power is the str
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• Building a team mind-set • Co
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of these three factors jeopardizes
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McClelland claims that “in some b
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• Define limits of what situation
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who have seen programs, processes,
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Leebov, W., and Scott, G. Health Ca
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Chapter 4 Quality Management A prim
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Figure 4.2. Deming’s PDCA Cycle A
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Move to CQI in Health Care The term
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care. Often these choices conflict.
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Supplier Partnerships A customer or
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analysis. Key benefits to having a
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Exhibit 4.1. Team Documentation For
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Figure 4.3. CQI Flowchart Quality c
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Exhibit 4.2. Inspection Criteria fo
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Once the departmental strategy is w
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Before hiring a consultant, managem
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selected for the issue in question.
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Figure 4.6. Cause-and-Effect Diagra
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not identical. CMS standards vary i
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the concurrent stay using critical
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Garvin, D. A. Managing Quality: The
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Chapter 6 Organization and Time Man
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Figure 6.1. Functional Organization
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Process departmentalization allows
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Characteristics of High-Performance
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outcome. Team building should conce
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necessary to assure that food servi
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Figure 6.4. Organization of a Small
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Figure 6.9. Organization of a Food
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skilled-nursing unit in the hospita
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service operations other than the c
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Distributing Authority Authority, t
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• What types of service does the
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Exhibit 6.1. (continued) Why? Which
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Exhibit 6.2. Sample Job Description
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equires, and the best means of moti
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Calculating FTE Needs Full-time equ
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Exhibit 6.3. Sample Productivity Fo
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Figure 6.10. Example of a Daily Sch
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Figure 6.12. Example of a Work Sche
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Figure 6.13. Example of a Manager
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Figure 6.14. Example of a Food Serv
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Lane, B. Managing People. Sunnyvale
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Page 244 and 245: Food Service Manual for Health Care
Page 277 and 278: Chapter 9 Clinical Nutrition Care M
Page 279 and 280: Planning As already shown, a manage
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Page 283 and 284: Figure 9.2. Organizational Chart—
Page 285 and 286: among professional staff whose memb
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Page 289 and 290: Nutrition service professionals can
Page 291 and 292: Figure 9.4. (continued) Food histor
Page 293: Figure 9.6. Goal of Nutrition Scree
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Page 301 and 302: • Assessment: what the data mean
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Page 305 and 306: Chapter 10 Management Information S
Page 307 and 308: Elements of an MIS In addition to t
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Page 317 and 318: Figure 10.2. Sample Purchase Order
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Page 327: Bibliography Alexander, J. Selectin
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Excerpt from Annual Food Service De
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Sample Monthly Operating Statement
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Labor Cost Analysis 334 Figure 11.5
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336 Exhibit 11.6. Example of a Mont
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Part Two Operation of the Food Serv
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352 Exhibit 12.2. Selection of Wast
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354 Exhibit 12.4. Selection of Wast
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Figure 13.6. HACCPs for Cook-and-Ch
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Restaurant-Style Health Care Menu f
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Chapter 16 Product Selection Produc
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Figure 16.2. Procurement Subsystem
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The USDA organic seal appears on fo
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Figure 16.5. Grade Stamps and Inspe
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A carcass of good grade is blocky a
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e accomplished by scalping, which p
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Table 16.1. (continued) Meat Descri
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harvesting and processing. This tas
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Poultry Poultry products or domesti
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Weight and Size of Shell Eggs Shell
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Table 16.3. Manufacturing and Inspe
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Eggnog Eggnog contains milk product
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Natural, Processed, and Imitation C
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Table 16.4. Common Cheeses Cheese D
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• Bamboo shoots • Bean sprouts
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Celery Celery, mainly the Pascal va
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Size is another factor that affects
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Fruit and Vegetable Specifications
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Corn, , sunflower, and safflower oi
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Organic Flour Organic flour is from
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Relatively small quantities of wild
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Herbal Tea Herbal teas do not come
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alloy, the result is stainless stee
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Summary Food service purchasers mus
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U.S. Department of Agriculture, Agr
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Chapter 18 Receiving, Storage, and
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Figure 18.1. Receiving System Items
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Merchandise Receipt Receiving, Stor
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Receiving, Storage, and Inventory C
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disposed of promptly. The storeroom
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Issuing of Food and Supplies Receiv
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A perpetual inventory record alone
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Inventory Turnover Slow inventory t
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Figure 18.2. Comparison of Par Stoc
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Receiving procedures must ensure th
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Appendix 19.1 A Culinary Glossary
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Hors d’oeuvre Side dish or relish
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Chapter 20 Distribution and Service
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• What is the best type of servic
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Figure 20.1. Typical Tray Makeup Li
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Tray Delivery Because the point of
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quality. In recent years, food serv
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carrying their filled trays to thei
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plate is not used. Place coffee or
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minimized. The type of meal service
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Standards that should be monitored
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Exhibit 20.2. Sensory Assessment fo
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Herz, M. L. Analysis of Alternative
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Index A ABC method, 603 Absenteeism
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CDC (Centers for Disease Control an
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Delivery of products, 575-576 Deman
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Exit interviews, 239, 240e Exotic v
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described, 461; developing, 461-463
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Horizontal communication tract, 194
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Main-dish salads, 652 Maintenance-m
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Nutrient analysis, 296 Nutrition aw
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PERT (program evaluation and review
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(1993), 4, 203; Federal Employee Po
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Standing operational planning. See
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Waste audit, 349 Waste-handling equ
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