PDF Policy & Procedure Manual

Policy & Procedure Manual

Food and Nutrition Services in Healthcare Facilities

Becky Dorner & Associates, Inc.

Becky Dorner, RDN, LD, FAND, President

info@

Policy & Procedure Manual

License Agreement and Restrictions

READ THE FOLLOWING TERMS AND CONDITIONS BEFORE USING THIS MANUAL/CD-ROM OR ELECTRONIC VERSIONS. USING THIS MATERIAL INDICATES YOUR ACCEPTANCE OF THESE TERMS.

LICENSE. The materials that are the subject of this Agreement (hereinafter referred to as the "Licensed Materials") shall consist of printed materials, electronic information, audio or video/DVD information or published information in any form by Becky Dorner & Associates, Inc. (hereinafter referred to as BD&A). Licensee and its Authorized Users acknowledge that the copyright and title to the Licensed Materials and any trademarks and service marks relating thereto remain with BD&A. Neither Licensee nor its Authorized Users shall have right, title or interest in the Licensed Materials except as expressly set forth in this agreement. In consideration of payment, BD&A hereby grants Licensee a non-exclusive, non-transferable, and revocable License to make permitted use of the Licensed Materials and to provide the Licensed Materials to Authorized Users in accordance with this Agreement.

USAGE. The Licensee shall ensure that only Authorized Users are permitted access to the Licensed Materials. Licensee may install and/or use Licensed Materials based on the agreed upon number of Authorized Users per terms of the Purchase Agreement, Letter of Agreement or Invoice. Licensee is not permitted to make unauthorized copies, alterations or modifications to the Licensed Materials unless specified in the Users' Manual or by prior written authorization of BD&A. Other than as specifically permitted in this Agreement, Licensee may not use the Licensed Materials for commercial purposes, including but not limited to the sale of the Licensed Materials or bulk reproduction or distribution of the licensed materials in any form.

MATERIAL CONTENT. The Licensed Materials are provided for your own personal, educational noncommercial use as a resource aid only. If you intend to use this material for the nutritional needs of an aged, sick or injured person or a person who suffers from a chronic disorder or disease, you should first consult that person's physician or physicians and if none, a physician who practices in the applicable field of medicine.

The Licensed Materials are in the nature of general concepts and, therefore, where its use may be appropriate for one person, its use may not be appropriate for another. The Licensed Materials are not intended to be a substitute for professional medical advice. Consequently, BD&A shall not be liable for any loss or damage directly or indirectly to the Licensee or Authorized Users of any material or information contained in the licensed materials.

LIMITATIONS ON WARRANTIES. BD&A shall not be liable to the Licensee for any indirect, special, incidental, punitive or consequential damages, including but not limited to loss of data, business interruption, or loss of profits arising directly or indirectly from or in connection with the license granted under this Agreement. The forgoing applies regardless of whether the claim or damages result or arise under breach of contract, tort, or any other legal theory.

BD&A makes no representation or warranty, and expressly disclaims any liability with respect to the content of any Licensed Materials, including but not limited to errors or omissions contained therein, libel, infringement of rights of publicity, privacy, trademark rights, moral rights, or the disclosure of confidential information. Except for the express warranties stated herein, the Licensed Materials are provided on an "as is" basis, and BD&A disclaims any and all other warranties, conditions, or representations (express, implied, oral or written), relating to the Licensed Materials or any part thereof, including, without limitation, any and all implied warranties of quality, performance, merchantability or fitness for a particular purpose. BD&A makes no warranties respecting any harm that may be caused by the transmission of computer virus, worm, time bomb, logic bomb or other such computer program. BD&A further expressly disclaims any warranty or representation to Authorized Users, or to any third party.

ACKNOWLEDGEMENT. LICENSEE AND AUTHORIZED USERS ACKNOWLEDGES THAT THEY HAVE READ THIS LICENSE, UNDERSTAND IT, AND AGREE TO BE BOUND BY ITS TERMS/CONDITIONS.

COPYRIGHT 2019, 2017, 2013, 2010, 2008, 2005, 2000, 1999, 1995, 1990 by Becky Dorner & Associates, Inc., all rights reserved. With the exceptions indicated in this agreement, no part of the Licensed Materials may be distributed, copied, modified, or revised without the prior written consent of the Becky Dorner & Associates, Inc. for commercial use or financial gain. If the Licensee wishes to purchase a License for additional material reproduction or distribution, contact Becky Dorner & Associates, Inc. at 1-800-3420285.

Forward ii

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

Acknowledgements

Thank you to the following professionals for their tireless effort in revising this and past editions:

Author/Editor: Becky Dorner, RDN, LD, FAND is widely-known as one of the nation's leading experts on

nutrition, aging, and long-term care. An extensively published author and experienced speaker, Becky is Founder/President of Nutrition Consulting Services, Inc., whose dedicated team of RDNs/NDTRs have served health care facilities in Ohio since 1983; and Becky Dorner & Associates, Inc., which provides a broad library of credible continuing education (CE) programs and nutrition resources.

Becky has published more than 300 health care articles, manuals and CE programs; presented more than 500 programs for national, international and state professional meetings in 5 countries and 50 states; and hosted more than 140 national professional CE webinars. Her free email magazine keeps 35,000 health care professionals up to date on the latest news in the field. An active leader, she has held more than 20 board positions on national and state professional associations including the Academy of Nutrition and Dietetics (Academy) and the National Pressure Ulcer Advisory Panel. Honors include: Academy Medallion Award,

le Fellow of the Academy, and the Academy Award of Excellence in Business and Consultation.

Contributing Editors: Liz Friedrich, MPH, RD, CSG, LDN, FAND is a Registered Dietitian and president of Friedrich

p Nutrition Consulting in Salisbury, NC. The company provides a

variety of nutrition consulting services with a focus on gerontological nutrition.

Liz is Board Certified as a Specialist in Gerontological Nutrition. She

m has co-authored numerous articles in journals and magazines and is

an evidence analyst for the Academy of Nutrition and Dietetics (Academy) Evidence Analysis Library. She was Associate Director

aof , a respected website for dietitians. She has

served in numerous national and state positions for the Academy and the North Carolina Dietetic Association (NCDA). She is the

Srecipient of two NCDA awards, the Recognized Young Dietitian of

the Year and the Member of the Year.

Mary Ellen Posthauer, RDN, CD, LD, FAND is a registered dietitian nutritionist and President of MEP Healthcare Dietary Services.

She is a past president of the National Pressure Ulcer Advisory Panel (NPUAP) and is on the Editorial Advisory Boards of Advances in Skin and Wound Care and Nutrition411. Mary Ellen has published extensively and spoken both nationally and internationally on nutrition and wound care. Honors include Indiana Honored Dietitian, NPUAP's Kosiak award, and the Academy of Nutrition and Dietetics Medallion Award. She is a member of the Food and Nutrition Department's Hall of Fame at Purdue University.

Forward iii

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

Past Contributors and Reviewers: Mary Abshire, RD, LD President/Owner, Abshire Dietary Consultants, LLC, El Campo, TX Pam Brummit, MA, RD/LD President/Owner, Brummit & Associates, Inc., Enid, OK Anna de Jesus, MBA, RD President, Nutrition Alliance, LLC, Tempe, AZ Lesli Doshier, RD Dietary Directions, Fresno, CA Sandy Gary, MS, RD, LD Consulting Dietitian, Nutrition Consulting Services, Inc., Akron, OH Mary Ellen Posthauer, RD, CD, LD President, MEP Healthcare Dietary Services, Evansville, IN Vicki Redovian, MA, RD, LD Director of Operations, Nutrition Consulting Services, Inc., Akron, OH

le Terri Raymond, MA, RD, LD

President, Dietitian Consulting Services, LLC, Mercer Island, WA

p Brenda Richardson, MA, RD, LD, CD

Chief Operations Officer, Dietary Consultants, Inc., Salem, IN Gretchen Robinson, MS, RD, LD, FADA Consultant Dietitian, Ada, OH

m Marolyn Steffen, RD, CD

Past Owner Steffen & Associates, Inc., Valparaiso, IN

a Mary Vester-Toews, RD S President, Dietary Directions, Fresno, CA

Data Processing and Proof Reading: Joni Kelly, Office Manager Nutrition Consulting Services, Inc., Dunedin, FL Caryn Heller, RDN, LD Nutrition Consulting Services, Inc., Dunedin, FL

Forward iv

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

This Manual is Approved for Use In:

_______________________________________

_______________________________________

_______________________________________ (Facility Name and Address)

_________________________

_________

Administrator

Date

_________________________

_________

Registered Dietitian Nutritionist

Date

_________________________ Director of Nursing _________________________ Director of Food and Nutrition

le _________________________ p _________________________

Administrator _________________________ Registered Dietitian Nutritionist

m _________________________

Director of Nursing _________________________

a Director of Food and Nutrition S _________________________

_________ Date _________ Date __________ Date

_________ Date _________ Date _________ Date _________ Date __________ Date

_________________________ Administrator _________________________ Registered Dietitian Nutritionist _________________________ Director of Nursing _________________________ Director of Food and Nutrition _________________________

_________ Date _________ Date _________ Date _________ Date __________ Date

Forward v

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

Table of Contents

License Agreement and Restrictions ______________________________________________ ii Acknowledgements __________________________________________________________ iii Approval Form _______________________________________________________________ v Introduction _______________________________________________________________ xiv

Chapter 1: Menus and Therapeutic Diets Menu Planning _____________________________________________________________ 1-1 Sample Menu Shell for Menu Overview__________________________________________ 1-3 Sample Menu Shell for Diet Extensions__________________________________________ 1-4 Sample Production Sheet ____________________________________________________ 1-5 Select Menus ______________________________________________________________ 1-6 Standardized Recipes _______________________________________________________ 1-7 Menu Substitutions _________________________________________________________ 1-8 Menu Substitution Lists ______________________________________________________ 1-9 Sample Menu Substitution Sheet______________________________________________ 1-11 Diet/Nutrition Care Manual___________________________________________________ 1-12 Transmission of Diet Orders _________________________________________________ 1-13 Therapeutic Diets__________________________________________________________ 1-14

le Right to Refuse a Diet ______________________________________________________ 1-15

Diets Available on the Menu _________________________________________________ 1-16 Sample Diet Order Form ____________________________________________________ 1-17 Diet Order Form ___________________________________________________________ 1-18

p Diet Order Audit ___________________________________________________________ 1-19

Sample Diet Order Audit Form________________________________________________ 1-20 Sample Nutrition Supplement Audit Form _______________________________________ 1-21 Sample Weekly Diet Census Sheet ____________________________________________ 1-22 Patient/Resident Making Choices That Are In Conflict With The Diet Order _____________ 1-23

m Use of Salt Substitute ______________________________________________________ 1-24

Food Replacement for Individuals with Diabetes __________________________________ 1-25 Renal Diets ______________________________________________________________ 1-26

a Texture and Consistency-Modified Diets ________________________________________ 1-27

Altered Portions ___________________________________________________________ 1-28

S Festivity Foods or Diet Holiday _______________________________________________ 1-29

Food and Beverages for Activities _____________________________________________ 1-30 Clear Liquid and Full Liquid Diet ______________________________________________ 1-31 NPO Diet Orders (Nothing by Mouth) __________________________________________ 1-32 Resident's Choice Meals in Nursing Facilities ____________________________________ 1-33

Chapter 2: Dining/Meal Service The Dining Experience: Staff Responsibilities _____________________________________ 2-1 The Dining Experience_______________________________________________________ 2-2 The Person Centered Dining Approach __________________________________________ 2-4 Resource: Traits of Great Person Centered Service ________________________________ 2-5 Customer Service __________________________________________________________ 2-6 Dining Room Service ________________________________________________________ 2-7 Dining Atmosphere _________________________________________________________ 2-8 Serving the Meal ___________________________________________________________ 2-9 Service Staff______________________________________________________________ 2-10 Handling Customer Concerns ________________________________________________ 2-11

Table of Contents vi

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

Sample Dining Satisfaction Form______________________________________________ 2-12 Sample Dining Satisfaction Meal Evaluation Form ________________________________ 2-13 Table Setting _____________________________________________________________ 2-14 Condiments, Food Baskets and Food Items at the Table ___________________________ 2-15 Restaurant Style Dining _____________________________________________________ 2-16 Family Style Dining ________________________________________________________ 2-17 Buffet Style Dining _________________________________________________________ 2-18 Open Style Dining _________________________________________________________ 2-20 In-Room Dining (Room Service) ______________________________________________ 2-21 24 Hour Dining ____________________________________________________________ 2-22 Special Occasions ? Holiday and Theme Meals __________________________________ 2-23 Paid Feeding Assistants (Nursing Facilities) _____________________________________ 2-24 Timely Meal Service________________________________________________________ 2-26 Meal Times and Frequency __________________________________________________ 2-27 Early and Late Meals _______________________________________________________ 2-28 Select Menus _____________________________________________________________ 2-29 Meal Identification and Preference Cards/Tickets _________________________________ 2-31 Offering Food Replacements at Meal Times _____________________________________ 2-32 Resource: Sample Available Food Replacements_________________________________ 2-33 Displaying the Menu _______________________________________________________ 2-35 Accuracy and Quality of Tray Line Service ______________________________________ 2-36

le Portion Control ____________________________________________________________ 2-37

Adaptive (Assistive) Eating Devices ___________________________________________ 2-38 Meal Observation__________________________________________________________ 2-39 Following the Meal Service __________________________________________________ 2-40

p Packed Meals Available for Transport __________________________________________ 2-41

Pets ____________________________________________________________________ 2-42 Leave of Absence _________________________________________________________ 2-43 Guest Meals ______________________________________________________________ 2-44 Food Availability___________________________________________________________ 2-45

m Nourishments and Supplements ______________________________________________ 2-46

Sample Nourishments and Supplements Form ___________________________________ 2-47

a Chapter 3: Food Production and Food Safety

Hours of Operation__________________________________________________________ 3-1

S Director of Food and Nutrition Services Responsibilities _____________________________ 3-2

Inventory and Cost Control ___________________________________________________ 3-3 HACCP and Food Safety _____________________________________________________ 3-4 Resource: Foodborne Illness Basics ____________________________________________ 3-5 Resource: Critical Control Points _______________________________________________ 3-7 Resource: Foodborne Illnesses - What You Need to Know___________________________ 3-8 Resource: Pathogenic Microorganisms and Strategies for Their Control _______________ 3-11 Resource: CCP Decision Tree Table ___________________________________________ 3-12 HACCP Principles _________________________________________________________ 3-13 Resource: Sample HACCP Recipe ____________________________________________ 3-15 Resource: Flow Chart ______________________________________________________ 3-16 General HACCP Guidelines for Food Safety _____________________________________ 3-17 Food Procurement and Facility Gardens ________________________________________ 3-20 Accepting Food Deliveries ___________________________________________________ 3-21 Food Storage _____________________________________________________________ 3-22 Sample Freezer and Refrigerator Temperatures Form 1____________________________ 3-24 Sample Freezer and Refrigerator Temperatures Form 2____________________________ 3-25

Table of Contents vii

?2019 Becky Dorner & Associates, Inc.

Policy & Procedure Manual

General Food Preparation and Handling ________________________________________ 3-26 Meat and Vegetable Preparation ______________________________________________ 3-28 Food Temperatures ________________________________________________________ 3-29 Resource: Critical Temperatures for Safe Food Handling ___________________________ 3-30 Resource: Taking Accurate Temperatures ______________________________________ 3-31 Resource: Minimum Cooking, Holding and Reheating Temperatures __________________ 3-33 Sample Food Temperatures Form _____________________________________________ 3-35 Sample Critical Control Point Documentation Form _______________________________ 3-36 Handling Cold Foods for Trayline _____________________________________________ 3-37 Taste Tasting _____________________________________________________________ 3-38 Use of Leftovers ___________________________________________________________ 3-39 Food Allergies ____________________________________________________________ 3-40 Food Brought in from Outside Sources and Personal Food Storage___________________ 3-42 Resource: Food Safety for Your Loved One _____________________________________ 3-43 Providing Food and Supplies for Other Departments ______________________________ 3-44 Sample Special Events Food/Meal Form________________________________________ 3-45 Floor Stock _______________________________________________________________ 3-46 Sample Floor Stock Supply Form _____________________________________________ 3-47 Food and Nutrition Services Problems/Referral to the Director of Food and Nutrition

Services _______________________________________________________________ 3-48 Reporting a Foodborne Illness (FBI) ___________________________________________ 3-49

le Food Safety: Preventing Burns _______________________________________________ 3-51

Food Safety: Ice___________________________________________________________ 3-52

Chapter 4: Sanitation and Infection Control

p Food Safety and Sanitation ___________________________________________________ 4-1

Food Safety ? Director of Food and Nutrition Services' Responsibility __________________ 4-3 Employee Sanitary Practices __________________________________________________ 4-4 Authorized Personnel in Food Service Department _________________________________ 4-5 General Sanitation of Kitchen _________________________________________________ 4-6

m Personal Hygiene and Health Reporting _________________________________________ 4-7

Hand Washing _____________________________________________________________ 4-8 Hand Antiseptic ____________________________________________________________ 4-9

a Bare Hand Contact with Food and Use of Plastic Gloves ___________________________ 4-10

Cleaning Dishes/Dish Machine _______________________________________________ 4-11

S Resource: Sanitation of Dishes/Dish Machine ____________________________________ 4-12

Dish Machine Temperature Log_______________________________________________ 4-13 Sample Dish Machine Temperature and Sanitizer Log Form ________________________ 4-14 Resource: Dish Machine Problems and Solutions_________________________________ 4-15 Maintenance of Dish Machine ________________________________________________ 4-16 Cleaning Dishes - Manual Dishwashing ________________________________________ 4-17 Resource: Sanitation of Dishes/Manual Washing _________________________________ 4-18 Handling Clean Equipment and Utensils ________________________________________ 4-19 Bedside Water Containers ___________________________________________________ 4-20 Dry Storage Areas _________________________________________________________ 4-21 Production, Storage and Dispensing of Ice ______________________________________ 4-22 Isolation Meals ____________________________________________________________ 4-23 Clean-up Procedures for Vomit/Fecal Accidents __________________________________ 4-25 Kitchen Cloths ____________________________________________________________ 4-27 Waste Disposal ___________________________________________________________ 4-28 Pest Control ______________________________________________________________ 4-29

Table of Contents viii

?2019 Becky Dorner & Associates, Inc.

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download