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      Dietitians View of Foodservice Sanitary Practices and Demands in Long-Term Care Hospitals

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          Abstract

          This study aimed to investigate the current state of foodservice management and demands for improvement in long-term care hospitals. The survey was performed in experienced dietitians working at 25 hospitals. General characteristics, status of sanitary management (document management, self-assessment of importance and performance), necessity and ranking of sanitary management items were investigated. Approximately 2.5 dietitians worked in each hospital, but only 7 (28.0%) hospitals employed clinical dietitians. From the questionnaire, the scores of the importance in sanitary management and performance were 4.5 ± 0.7 and 4.3 ± 0.9, respectively, and were significantly different (p = 0.000). Participants also reported “special therapeutic diets management” and “compliance with standards of refrigerating time, food, method management” had the lowest importance and performance, respectively. The result of Importance-Performance Analysis revealed a significant positive correlation between importance and performance (R 2 = 0.427). However, items such as “performing hand hygiene” and “compliance with standards of refrigerating time, food, method” and etc. had low importance recognition with low performance. All participants reported “preparing sanitary management standards was necessary” is necessary and “development of sanitary management manual” is the most important. These findings suggest that sanitary management is important in food service management of long-term care hospitals, and improving awareness is required. Developing a hospital foodservice hygiene manual would ensure better safety and quality for patient care and public health.

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          Role of hand hygiene in healthcare-associated infection prevention.

          Healthcare workers' hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment. Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs), but healthcare worker compliance with optimal practices remains low in most settings. This paper reviews factors influencing hand hygiene compliance, the impact of hand hygiene promotion on healthcare-associated pathogen cross-transmission and infection rates, and challenging issues related to the universal adoption of alcohol-based hand rub as a critical system change for successful promotion. Available evidence highlights the fact that multimodal intervention strategies lead to improved hand hygiene and a reduction in HCAI. However, further research is needed to evaluate the relative efficacy of each strategy component and to identify the most successful interventions, particularly in settings with limited resources. The main objective of the First Global Patient Safety Challenge, launched by the World Health Organization (WHO), is to achieve an improvement in hand hygiene practices worldwide with the ultimate goal of promoting a strong patient safety culture. We also report considerations and solutions resulting from the implementation of the multimodal strategy proposed in the WHO Guidelines on Hand Hygiene in Health Care.
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            Importance-Performance Analysis

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              Infection in an aging population.

              The global population is rapidly aging. Currently, 566 million people are ≥65 years old worldwide, with estimates of nearly 1.5 billion by 2050, particularly in developing countries. Infections constitute a third of mortality in people ≥65 years old. Moreover, lengthening life spans correlate with increased time in hospitals or long-term care facilities and exposure to drug-resistant pathogens. Indeed, the risk of nosocomial infections increases with age, independent of duration spent in healthcare facilities. In this review, we summarize our understanding of how the aging immune system relates to bacterial infections. We highlight the most prevalent infections affecting aging populations including pneumonia, urinary tract infections, and wound infections and make recommendations for future research into infection in aging populations.
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                Author and article information

                Journal
                Clin Nutr Res
                Clin Nutr Res
                CNR
                Clinical Nutrition Research
                Korean Society of Clinical Nutrition
                2287-3732
                2287-3740
                July 2021
                30 July 2021
                : 10
                : 3
                : 192-205
                Affiliations
                [1 ]Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea.
                [2 ]Department of Food & Nutrition, Yeonsung University, Anyang 14011, Korea.
                [3 ]Department of Food and Nutrition, Hanyang Women's University, Seoul 04763, Korea.
                [4 ]Department of Nutrition, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
                [5 ]Department of Food and Nutrition Services, Hanyang University Hospital, Seoul 04763, Korea.
                [6 ]Department of Nutrition, Hyoja Geriatric Hospital, Yongin 17089, Korea.
                [7 ]Department of Clinical Nutrition, Bobath Memorial Hospital, Bundang 13552, Korea.
                [8 ]Department of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea.
                Author notes
                Correspondence to Wan-Soo Hong. Department of Foodservice Management and Nutrition, Sangmyung University, 20 Hongjimun 2-gil, Seoul 03016, Korea. wshong@ 123456smu.ac.kr
                Correspondence to Yoo Kyoung Park. Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, 1732 Deokyeong-daero, Giheung-gu, Yongin 17104, Korea. ypark@ 123456khu.ac.kr
                Article
                10.7762/cnr.2021.10.3.192
                8331285
                34386439
                8c633d62-fed3-4710-af91-9cef6b96ea95
                Copyright © 2021. The Korean Society of Clinical Nutrition

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Funding
                Funded by: Ministry of Food and Drug Safety, CrossRef https://doi.org/10.13039/501100003569;
                Categories
                Original Article

                long-term care hospital,food service,sanitary management

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