FoodNet Survey of Food Use and Practices in Long-Term Care Facilities

Abstract

Foodborne illness is an important problem among the elderly. One risk factor for foodborne illness and diarrhea-associated mortality among the elderly is residence in a long-term care facility (LTCF); thus, these facilities must implement measures to ensure safe food. To assess safe food practices, knowledge, and policies, we used a mailed, self-administered questionnaire to survey food service directors at LTCFs that were certified to receive Medicare or Medicaid at eight Foodborne Diseases Active Surveillance Network (FoodNet) sites. Surveys were distributed to 1,630 LTCFs; 55% (865 of 1,568) of eligible facilities returned a completed questionnaire. Only three LTCFs completely followed national recommendations for prevention of Listeria monocytogenes contamination. Nine percent of LTCFs reported serving soft cheeses made from unpasteurized milk. Most LTCFs reported routinely serving ready-to-eat deli meats; however, few reported always heating deli meats until steaming hot before serving (only 19% of the LTCFs that served roast beef, 13% of those that served turkey, and 11% of those that served ham). Most LTCFs (92%) used pasteurized liquid egg products, but only 36% used pasteurized whole shell eggs. Regular whole shell eggs were used by 62% of facilities. Few LTCFs used irradiated ground beef (7%) or irradiated poultry products (6%). The results of this survey allowed us to identify several opportunities for prevention of foodborne illnesses in LTCFs. Some safety measures, such as the use of pasteurized and irradiated foods, were underutilized, and many facilities were not adhering to national recommendations on the avoidance of certain foods considered high risk for elderly persons. Enhanced educational efforts focusing on food safety practices and aimed at LTCFs are needed.

Knowledge, attitudes and self-reported practices of food service staff in nursing homes and long-term care facilities

“…However, preventing cross-contamination has a crucial role in food safety risk management. Similar results have been obtained from previous studies in hospitals (Angelillo, Foresta, et al, 2001;Angelillo, Viggiani, et al, 2001;Askarian et al, 2004;Buccheri et al, 2007) and in LTCFs (Nelson et al, 2008).…”

“…Therefore, the knowledge on food hygiene is insufficient to promote positive attitudes and safe behaviours. As reported in previous studies on hospital and LTCF catering (Angelillo, Foresta, et al, 2001;Angelillo, Viggiani, et al, 2001;Askarian et al, 2004;Buccheri et al, 2007;Endevelt, Werner, Goldman, & Karpati, 2009;Nelson et al, 2008), there is the need for continuous training and for alternative educational strategies. In our study, although food safety knowledge were high, food-handling practices were not always consistent with accepted standards.…”

Gastroenteritis and Food‐Borne Disease in Elderly People Living in Long‐Term Care

“…Paid sick-leave programs for employees significantly reduce the risk of outbreaks [62]. While food may become contaminated outside the facility, many outbreaks result from contamination occurring within the LTCF from food handling errors during storage and preparation or unintentional contamination by residents [16,46,53]. Many foods have caused food-borne disease outbreaks in LTCFs, including eggs, poultry, salads, cornmeal, powdered milk and protein supplements, red-meats, peanut butter, and water [12,15,24,65].…”

“…The close living arrangements of elderly people and contact with visitors and staff make LTCFs a unique environment for the spread of infectious agents [9,13,14]. In addition, centralized preparation and service of food to LTCF residents has inherent risks for transmission of food-borne agents [15,16]. …”

Safe Handling of Food in Homes and Food Services

“…hospitals, child daycare and aged care centers) where they may be exposed to food prepared in food service operations. Authorities have taken action to recommend the avoidance of certain foods for vulnerable populations in institutions; however, adherence to these guidelines has been reported to require improvement (Dalton et al, 2010;Nelson et al, 2008).…”