6 Central commissary and 2 conventional school foodservice operations were assessed in terms of time-temperature relationship and microbiological quality, and monitoring control methods were identified through hazard analysis during the phases of prodution and distribution. 2 conventional schools from Seoul and 6 commissary schools from Kyungkido were participated in the survey. Meals produced in central commissary were distributed to satellites, therefore delivery practices of foods were identified as critical. Microbiological test results for commissary and conventional schools revealed that microbiological quality of foods was mainly related to time-temperature management, types of food, and equipment sanitation not to the foodservice system used. Time-temperature profiles at temperature danger zone (7.2-60$^{\circ}C$) observed were to be related to the following sanitary practices: cooked vegetables were held at temperature danger zone for relatively longer delayed time (15-38$^{\circ}C$: 15-226 min, 7-60$^{\circ}C$: 75-226 min), and same results were observed for deep-fat fried cutlets (15-38$^{\circ}C$: 15-151 min, 7-60$^{\circ}C$: 33-151 min). Menu items with various ingredients and frequent contacts with hands and equipments during the production flow were held at temperature danger zone for longer delaying time than other menu items with brief prodution stages. Based on hazard analysis critical control points, microbiological quality was collectively affected by time-temperature relationships, equipment sanitation, proper cooking methods, and sanitary management competencies of dietitians. Microbiological test results of working equipments and surface of dishes and trays showed that immediate action should be taken. Cutting boards used in central kitchen were also showed similar results of potential dager of cross-contamination. Effective sanitary control methods were urgently needed.
This study examined food safety management at preschool establishments in Daegu and Gyeongbuk province, to provide data that can be used for food safety improvements. Field assessments of 60 foodservice establishments were executed from July to October, 2007. Statistical analyses of the data were conducted using the SPSS package program (version 14.0 for windows). The results are summarized as follows: 93.3% of the preschool foodservices were self-operated, and 24.1% of the child care centers and 96.7% of the kindergartens had employed dietitians. According to the averaged food safety evaluation scores the kindergartens (80.73) had a significantly higher score than the child care centers (50.37), and the public centers (85.00) had a significantly higher score than the private centers (54.29). While the average score of facilities that employed dietitian (73.58) was significantly higher than that of facilities that did not employ a dietitian (52.65). In addition, the average score of facilities that served meals in a dining room (80.83) was significantly higher than that of facilities that served meals in a classroom (59.33). The highest scoring food safety items included verifying employee health inspection reports (1.87), utilizing non-municipal water and routinely cleaning and well-maintaining the water storage tank (1.85), and disposing small amounts of leftovers in a vat after serving (1.83). In contrast, the lowest scores were for physical separation of clean areas and unclean areas to prevent cross-contamination (0.52), and physical separation between staff and food material entry areas (0.62). In conclusion, the preschool foodservice evaluated in this study required improvements in food safety management, and many of the child care centers were in need of immediate attention. To improve food safety at these establishments, administrators should implement prerequisite food safety programs.
This study was carried out on hospitalized patients receiving diet therapy satisfaction and awareness of nutrition education in small and medium-sized hospitals in southern Gyeonggi area. By the face-to-face interview with questionnaire method, the survey was carried out on 150 subjects (99 males and 51 females). The patients (64.7% of males, 52.9% of females) heard the description of diet therapy without the aid of written manual. Patients were moderately satisfied by food that was rated based on these indicators: tastiness (2.45), saltiness (2.23), smelliness (2.23), and appetizing appearance (2.39) as a 4 point scale. Most of the patients (80.8% of males, 69.8% of females) wanted to continue diet therapy. The importance of diet was correlated with the tastiness, saltiness, and appetizing appearance of diet. And the help of dietitians' explanation was correlated with appetite. 55.6% of males and 35.4% of females received nutrition education before (p<0.05). The number of times nutrition education was received was once for male (33.3%) and three times for female (44.4%). Most nutrition education satisfaction that was calculated on a 4 point scale was well understood (3.03), recognized importance (3.44 for males, 2.78 for females) and help for disease management (p<0.01). Also they were satisfied with the explanation of disease (3.20). Nutrition education satisfaction was correlated positively with explanation about food related to disease, the current dietary treatment, how to prepare diet recipes, and dietitian's kindness, but negatively with satisfaction with explanation of diet therapy, and the description and help for disease management. In conclusion, the most important factor in practicing diet therapy was meeting with the dietitian. Intensive nutrition education after the patient's discharge is necessary for patients to continue diet therapy.
Purpose: The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings. Methods: The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis. Results: Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses. Conclusion: The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.
To evaluate the current practices of the tube feeding and the status of tube feeding patient 76 adult in-patients at 6 hospitals located in Seoul and Chung-buk province were examined through reviewing patient charts observing patients and interviewing patients nurses dietitians patients' family or care-givers. The results were as follows : 1) An average age of the patients was 54.5 years with 41% over 60 years old. Patients with decreased mental status dysphagia esophageal obstruction and respiratory problem were fed by tubes. 2) The range of duration of tube feeding is between 4 days and 6 years. Most patients were received formula through nasogastric tube(89.5%) while 7.9% of gastrostomy and 2.6% of jejunostomy. Administration method for formula were bolus feeding regardless of the route of formula delivery. 3) Mean total calories received for men were 1590 kcal and 1450 kcal for female. Mean volume per meal was 282m, l and mean frequency of feeding was 5.68 while mean feeding interval 3$\frac{1}{4}$ hours and mean rate of infusion 68.4ml/min. All patients received hospital-blenderi-zed formula as the major source of nutrition. Home-blenderized formula and commercial formula as a supplement were used 35%, 13.2% respectively. 4) Thirty-eight percent of patients was hypoalbuminemia and 61% was at the moderate level of deficiency in hemoglobin. 5) Complications associated with tube feeding were diarrhea (22.4%) constipation(21.1%) vomiting(11.8%) and so on. 6) Serum albumin levels of patients who have complications associated with tube feeding were significantly lower than those of patients without complications In planning a tube feeding regimen the type of a formula must be integrated with both a delivery system and a protocol for administering the tube feeding. the multidisciplinary effort required to deliver enteral therapy is essential to improve current practices used at hospitals.
The purpose of this study was to measure patients satisfaction and expectation with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out on 383 hospitalized patients of 7 hospitals in Deagu, Busan, Changwon with 350 beds to determine the quality satisfaction with foodservices. The subjects were 50.5% male and 49.5% female. 62.6% of the subjects were over 40 age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7-14 days. The mean score for taste of diet was 2.79, temperature 3.23, appearances 2.96. Most subjects agreed with following foodservice characteristics that meals of movement (4.03), dress of employees (3.84), kindness of employees and meals arrived exactly the same time every day (3.47) and cleanliness of foods (3.34) and dishes (3.33). The unsatisfied quality attributies were information provide (2.82), variety of the meals (2.91), mixing of meals (2.95), the opportunity to meet with a dietitian (2.97) and prompt dealings with meal complaints (3.01). Most subjects expectation that the decrease the multiple of menus, increase provide of fruits in hospital meals and selective menus in hospital foodservices operations. In conclusion, it would seem to be desirable that hospital foodservices departments introduce selective menus, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.
The aim of this study was to investigate the perception of students, their parents, and nutrition teachers regarding environment-friendly foods (EFF) and the satisfaction with school meals at elementary schools. Questionnaires were sent to nutrition teachers at five elementary schools located in the Jindo area, Jeonnam province, and were distributed to students and their parents. A total of 351 questionnaires from students and 334 from parents were collected from March to April, 2013. In addition, 43 nutrition teachers/dietitians working at elementary schools in the Jindo area responded to questionnaires. Nutrition teachers primarily recognized the classification and certification standards of EFF, and verified the certification mark of EFF when they purchased foods. However, 13.4% of students and 38.6% of parents replied as 'know well' regarding the classification and certification standards of EFF and they verified the mark of EFF less often than the nutrition teachers (p<0.001). Most of the nutrition teachers and parents indicated 'safety' as the main advantage of EFF. The students and parents were satisfied with EFF at home and school meals because of the safety and favorable effect on health. The results showed that EFF compromised 20~40% of monthly food costs for 51.1% of nutrition teachers. The overall score for satisfaction with school meals for students was 3.88 based on a 5-point Likert scale; however, that of the parents was 3.72. The nutrition teachers realized that the parents were more interested in EFF and satisfied with EFF than the students. The major barriers to using EFF in school meals were 'lack of information about EFF' and 'unstable supply.' Therefore, the above results suggested that there should be improvement in the supply of EFF to include more EFF in school meals and efforts should be made to provide students and parents with more information for understanding EFF.
Lee Min-A;Yang Il-Sun;Yi Bo-Sook;Kim Hyun-Ah;Park So-Hyun
Journal of Nutrition and Health
/
v.39
no.1
/
pp.74-83
/
2006
The purposes of this study were to (1) identify the evaluation categories, areas, attributes, and criteria of the school food service program using both a qualitative and a quantitative analyses, (2) define the relative importance of the evaluation categories, areas, attributes, and criteria of the school food service program using analytic hierarchy process, (3) organize the evaluation system to improve quality of the school food service in Korea. A survey was conducted from August to October 2004 to collect data from 172 dietitians, 15 school food service officials at the educational board, 10 professionals of school food service. Statistical analyses were performed on the data utilizing the SPSS 12.0 for Windows and Excel, such as Descriptive statistics and analytic hierarchy process was performed. The result of the analytic hierarchy process indicated that relative importance of evaluation category was 0.4319 (food service manage ment), 0.2369 (nutrition education), 0.1455 (satisfaction) and 0.0912 (parent involvement program). 'Sanitation, safety and facility (0.1739)' was the most important area among the subcategories of food service management, followed by nutrition management (0.1581), procurement (0.1375), production (0.1345), organization and personnel management (0.0662), planning (0.0644), food service evaluation (0.0585), financial accountability (0.0555), and information management (0.0554). There existed a relative importance on the three areas of the nutrition program and satisfaction evaluation category: students (0.5281, 0.6221), parents (0.1812, 0.1491), and teachers (0.1838, 0.1618). In the parent involvement program evaluation category, relative importance of committee and monitoring management was 0.4658 and information communication was 0.3724. The quality of food and service to school children can be improved by the appropriate application of the developed evaluation tool for the school food service program.
In Korea, the school foodservice program has been expanding rapidly in recent years, partly as a result of increased government support. With the growth in the number of schools offering foodservice programs, food safety and sanitation concerns have been increasing. To assist with program improvement, a situation analysis was carried out, with the focus on equipment and sanitary management of school foodservice programs under flour different management systems. A questionnaire was mailed to the foodservice directors of 234 randomly selected schools chi[h included elementary, middle and high schools at the national level. Among them, one hundred and sixty-five responses reasonably completed were used for the analysis. This study classified each school's foodservice management into one of four types : independent-conventional, independent-commissary, contract-conventional, and contract-delivery. The results show that the monitoring of employees' health and personal hygiene, and employees' sanitary education was well conducted, but that the sanitary education of the voluntary parent workers was largely ignored. Eighty-six percent of the schools had their drinking water tested for sanitation, and the results showed that more effort is needed in careful management of drinking water in order to prevent foodborne illnesses and bacillary dysentery. In general, contract management showed lower scores in foodservice equipment and their efficiency, compared with independent management. A relatively high number of schools on the contract-delivery management system employed nurses and leachers instead of dietitians and foodservice directors. The adoption of the HACCP (Hazard Analysis Critical Control Point) system was lowest in contract-conventional and contract-delivery management systems, and highest in elementary schools using the independent-conventional system.
In order to create a worker-friendly environment for institutional foodservice, facilities operating with a dry kitchen system have been recommended. This study was designed to compare the work safety and work environment of foodservice between wet and dry kitchen systems. Data were obtained using questionnaires with a target group of 303 staff at 57 foodservice operations. Dry kitchen facilities were constructed after 2006, which had a higher construction cost and more finishing floors with anti-slip tiles, and in which employees more wore non-slip footwear than wet kitchen (76.7%). The kitchen temperature and muscular pain were the most frequently reported employees' discomfort factors in the two systems, and, in the wet kitchen, "noise of kitchen" was also frequently reported as a discomfort. Dietitian and employees rated the less slippery and slip related incidents in dry kitchens than those of wet kitchen. Fryer area, ware-washing area, and plate waste table were the slippery areas and the causes were different between the functional areas. The risk for current leakage was rated significantly higher in wet kitchens by dietitians. In addition, the ware-washing area was found to be where employees felt the highest risk of electrical shock. Muscular pain (72.2%), arthritis (39.1%), hard-of-hearing (46.6%) and psychological stress (47.0%) were experienced by employees more than once a month, particularly in the wet kitchen. In conclusion, the dry kitchen system was found to be more efficient for food and work safety because of its superior design and well managed practices.
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