Food safety practices and readiness to implement HACCP programs in assisted-living facilities in Iowa.

OBJECTIVE: To evaluate current food-handling practices and employee food safety knowledge and attitudes and to provide baseline data for implementing the Hazard Analysis and Critical Control Point (HACCP) program in assisted-living foodservices for elderly persons. DESIGN: Food-handling practices were observed at each assisted-living facility using a structured observation form. A validated questionnaire was used to determine demographic information and employees' attitudes and knowledge about food safety. SUBJECTS/SETTING: A convenience sample of 40 assisted-living facilities in Iowa was recruited from a list obtained from the Iowa Department of Elder Affairs. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to summarize data. One-way analysis of variance was used to assess differences in attitudes and food safety knowledge among the managers, cooks, and other foodservice employees. Multiple linear regression determined the relationship between manager and facility demographics and the food safety practice score. RESULTS: Proper food-handling practices were followed in many assisted-living facilities, but areas in need of improvement were identified. Some HACCP prerequisite programs were found to be inadequate, including a lack of written standard operating procedures, documentation of food safety practices, and training. Temperatures and chemical concentrations need to be checked routinely. Foodservice employees had a significant amount of food safety knowledge (14.6+/-3.0 out of 20 possible points), and employees with food safety certification scored higher than those with no certification (15.6+/-2.6 and 13.9+/-3.1, respectively; P

Food safety practices and HACCP implementation: perceptions of registered dietitians and dietary managers.

OBJECTIVE: Assess perceptions of consultant registered dietitians (RDs) and dietary managers about food safety practices and Hazard Analysis and Critical Control Point (HACCP) implementation in assisted-living and long-term care facilities for the elderly. DESIGN: A mail questionnaire was developed using a modified Delphi process. Respondents were asked to assess food safety concerns in facilities where employed, identify prerequisite programs, rate barriers to implementation of HACCP, and provide demographic information. SUBJECTS/SETTING: The survey was sent to a random sample from national membership in the American Dietetic Association's Consultant Dietitians in Health Care Facilities dietetic practice group (n=1,181) and to all dietary managers who listed assisted living as their employment location as part of membership in the national Dietary Managers Association (n=274). STATISTICAL ANALYSES PERFORMED: Descriptive statistics were calculated for each questionnaire item for all respondents. Factor analyses and t test comparisons of items and factors determined if significant differences existed between perceptions of RDs and dietary managers. RESULTS: Both RDs and dietary managers identified employee knowledge and experience and food practices as food safety concerns. More than 80% of both RDs and dietary managers agreed that the majority of listed HACCP prerequisites were necessary. Respondents identified the greatest barriers to implementation of HACCP as those related to time. CONCLUSIONS: Findings indicate a need to develop written policies for food safety, such as access to production areas. To minimize risk of foodborne illness to the elderly, barriers to implementation of HACCP should be addressed, including commitment of time and resources to develop systems, train employees, and retain employees.

Microbiological evaluation of foodservice contact surfaces in Iowa assisted-living facilities.

A study of 40 assisted-living facilities in Iowa was conducted to assess the microbiological quality of food-contact surfaces (work tables/counters, cooking equipment such as mixing bowls, and cutting boards) and a surface that could cross-contaminate food (refrigerator or freezer handles) to determine the effectiveness of cleaning and sanitation. Standards were set for foodservice for aerobic plate count, Enterobacteriaceae, and Staphylococcus aureus . Two facilities met standards for all five surfaces for each of the three tests. Fewer facilities met the standard for aerobic plate count than for the other two tests, and nearly three fourths of the facilities failed to meet the aerobic plate count for cutting boards. Critically, cross-contamination from these surfaces could result in contamination of food; thus, attention needs to be given to training and supervision to ensure proper hand washing and appropriate cleaning and sanitation procedures to reduce or eliminate cross-contamination.