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

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Food Service Manual for Health Care Institutions 390 Otherwise, it is classified as being of unknown etiology. The CDC reports that for outbreaks of unknown etiology, the following are the probable toxic agents: Symptoms within one hour of eating indicate probable chemical poisoning; symptoms from 1 to 7 hours after eating indicate probable staphylococcal food poisoning; symptoms from 8 to 14 hours after eating indicate probable C. perfringens food poisoning; and symptoms more than 14 hours later indicate other infectious or toxic agents. Chemical Hazards Chemical Contamination A number of chemicals are not allowed in food, and others have established “safe” limits. There are basically two types of chemical hazards, those occurring naturally in food and those added during the processing of food. Chemicals that occur naturally in foods can cause illness. Mycolaxin, an aflatoxin, is a harmful chemical produced by fungi growing on such foods as grains, nuts, and milk. Aflatoxins may be found in corn, tree nuts, peanuts, cottonseed, and milk. When eaten in large amounts, they can cause abnormalities in digestion and absorption, hemorrhage, liver damage, edema, and in some cases, death. The most commonly “added” chemicals include food additives, which are used to enhance flavor and to keep products fresh longer. These are described further in the section below. Naturally Occurring Chemical Hazards Better known naturally occurring chemical hazards include shellfish and mushroom toxins, undercooked red beans, and honey made from rhododendron nectar. Added chemical hazards are chemicals that have been added to food from planting to consumption. Most chemicals are not hazardous if added in safe amounts and proper instructions are followed. Added chemical hazards included food additives, pesticides, toxic metals, and toxic housekeeping products. Harmful chemicals at high levels can cause severe poisoning and allergic reactions. Food Additives Food additives may be intentionally or unintentionally added to foods. Food additives that may cause a reaction in some individuals include FDRC Yellow #5, sulfur dioxide and sulfides, sodium nitrate, and monosodium glutamate. Sulfides and nitrates can be a major concern for some people. In some states, notice of the use of either chemical must be on the menu or posted in a visible place within the facility. FDA and industry standards prohibit the use of sulfides by food service establishments. Sulfides used in food processing are highly regulated. Products that contain any type of additive must show it on the label. Agricultural Chemicals Agricultural chemicals include pesticides, fungicides, fertilizers, antibiotics, hormones, insecticides, and herbicides. Most of these chemicals are regulated by the Environmental Protection Agency (EPA), which states how the chemical can be used and the maximum allowable residue. Products from unapproved sources may contain a higher-than-accepted level of residue. Pesticides are used in food service facilities to control insects and rodents. An improper or wrong use can contaminate food. Manufacturers’ directions for use should always be followed. If an outside agency is employed, food service management should make certain that the chemicals being used are safe to be used in a food service establishment.
Toxic Metals Food Safety, Sanitation, and Hazard Analysis Critical Control Points Metal poisoning includes contamination by copper, lead, zinc, cadmium, tin, arsenic, and mercury. Lead is the most common contaminant. Ceramic containers that are glazed with a leadbased paint can be hazardous for food storage if the glaze becomes chipped or deteriorates during dish washing. Lead poisoning in some areas is high, especially in drinking water (from pipes). Mercury may be used in fungicides to protect seed grains during storage. Soil may contain a high level of mercury, which can be absorbed by plants. Fish from mercury-contaminated water can contain high levels of mercury (Table 13.3). Housekeeping Products Cleaning chemicals, pot and pan dishwashing compounds, and other cleaning and sanitizing products can result in chemical food poisoning when these chemicals are not properly labeled, stored, and used. Chemicals should never be stored with food; they should especially never be stored in the food production area because many of the chemicals are white granules that have the same appearance as sugar and salt. Food handlers should always read labels and follow the material safety data sheets for proper use and storage of all chemicals. Table 13.3. Nonbacterial Illnesses of Infrequent or Rare Occurrence Name of Causative Foods How Introduced Preventive or Illness Agent Usually Involved into Food Corrective Procedures Arsenic, Insecticides Any foods Either during Thoroughly wash all fluoride, lead Rodenticides accidentally growing period fruits and vegetables poisoning contaminated or accidentally when received, store in kitchen insecticides and pesticides away from food, properly label containers, follow use instructions, use carefully, guard food from chemical contamination Copper Copper–food Acid foods and Contact between Prevent acid foods or poisoning contact surfaces carbonated metal and acid carbonated liquids liquids food or carbonated from coming into beverages contact with exposed copper Cadmium Metal plating Fruit juices, Acid foods Discontinue use of and zinc on food fruit gelatin, and dissolve cadmium cadmium-plated poisoning containers other acid foods and zinc from utensils as food stored in containers in containers; prohibit use metal-plated which they are of zinc-coated utensils containers stored for preparation, storage, and serving of acid fruits and other foods or beverages Cyanide Silver polish Any foods Failure to wash Discontinue use of poisoning accidentally and rinse polished cyanide-based silver contaminated silverware polish or wash and thoroughly rinse silverware thoroughly 391
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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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Chapter 9 Clinical Nutrition Care M
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Planning As already shown, a manage
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• Room service for inpatients and
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Figure 9.2. Organizational Chart—
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among professional staff whose memb
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Designing a Nutrition Services Paym
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Nutrition service professionals can
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Figure 9.4. (continued) Food histor
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Figure 9.6. Goal of Nutrition Scree
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Table 9.3. Physical Signs Indicativ
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• A constant and valuable source
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earlier, the patient may need to be
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• Assessment: what the data mean
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• Gives patients greater protecti
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Chapter 10 Management Information S
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Elements of an MIS In addition to t
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automatically to report all vending
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Usually, systems investigation is t
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Function Function refers to the spe
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located in a relatively clean envir
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Figure 10.2. Sample Purchase Order
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Figure 10.3. (continued) Inventory
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Figure 10.5. Beef Barley Soup, Scra
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Patients’ tray cards can be print
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een entered into the menu, each ite
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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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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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