Hospital Kitchen Staff knowledge on Allergen Cross Contamination
and Allergen Contamination Complaints made by Patients
ABSTRACT
This study investigates kitchen safety/sanitation knowledge of employees working
in the kitchen of a central NJ hospital and ways to reduce complaints about
allergen cross contamination in the kitchen of the hospital. The research was
conducted by giving 5 volunteering participants a baseline and outcome survey to
determine their level of knowledge on kitchen safety/sanitation and allergen cross
contamination and by using the recorded statistical data in the diet office to assess
number of weekly dietary complaints on allergen contamination. The intervention
for this study included: providing ServSafe kitchen safety education to employees,
creating a binder that highlights major allergens in the hospitals food recipes,
having the diet office keep statistical records on allergen contamination complaints
from patients, and incorporating color coated pans in the kitchen. Findings were
determined by comparing the amount of correct answers from the baseline survey
to the outcome survey and by comparing the number of dietary complaints from
week 2 to the number of dietary complaints from week 14. The outcome survey
showed a 20% increase in correct answers among the kitchen employees when
compared to the baseline survey and the number of allergen contamination
complaints showed an 80% decrease in week 14 when compared to week 2. The
findings of the study proved the intervention to be successful by the outcome of a
20% increase in rate of correct answers amongst kitchen employees and an 80%
decrease in allergen contamination complaints from patients. There were no
implications; however, if this study was to be performed again, a recommendation
would be to provide more education to the employees on cross contamination and
kitchen safety by incorporating a weekly class for employees to join.
INTRODUCTION
Foodborne illnesses can be a serious issue in the hospital. Hospitals are known to
be a hotbed for allergen and bacterial cross contamination. Unhygienic kitchen
staff can easily transfer pathogens and/or allergens from raw food to finished
meals and from foods containing an allergen to foods that does not contain that
allergen. Cross contamination due to allergens during the cooking process is one of
the biggest issues in hospitals (OBP Medical, 2017).
According to a study published by the, “The Iranian Journal of Microbiology,” a
bacteriological analysis was done in a hospital kitchen in Morocco and showed
that the highest rates of compliance with good hygienic conditions were obtained
in baking worktops (77%) and serving meal worktops (50%). In contrary, some
surfaces show a low level of compliance and showed signs off allergen cross
contamination, such as cooking pans (96%). This low level of compliance shows
that using pans and other cooking utensils can contaminate foods and other areas
of the kitchen (Touimi et al., 2019).
For example, a chef may cook pasta containing gluten in a pan, after the pasta has
been cooked, the pan may not be properly sanitized or it may have some residue
left over which may contain gluten. Now if this same pan is used to cook gluten
free pasta, then the residue containing gluten on that pan will contaminate the
gluten free pasta. Thus, contaminating the whole meal, that can be served to the
patient with a gluten allergy. Furthermore, this in return will cause the patient to
get sick and in severe circumstances cause the patient to go into a state of
anaphylactic shock. This issue can arise with any given allergy and it is important to
avoid situations like these.
Akash Verma
Montclair State University
Nutrition and Food Science
METHODS
Ideas and information regarding methods and intervention were obtained by using
Food Journal (Ortiz, 2018), ServSafe’s website and practice exam questions, and
The Iranian Journal of Microbiology (Touimi et al., 2019).
After taking the baseline survey, using ServSafe’s website, printed information on
kitchen safety and sanitation were given to employees at the hospital and were
educated on the importance of safety, sanitation, and detriments of allergen cross
contamination.
The research was conducted and measured by giving 5 volunteering participants a
baseline (January 26th, 2023) and outcome survey (April 10th, 2023). The main
source used for creating baseline and outcome assessment survey was the
ServSafe textbook and ServSafe’s practice exam questions.
A binder containing all the food recipes/ingredients was made. In this binder,
major allergens were highlighted with different colors to show what allergens is in
what recipe. In addition, new cooking pans with color coated handles were
obtained. The reason for this was so cooks can identify what allergen is in the food
they are cooking by looking for the allergen color in the highlighted recipe binder
and then using the same color for the pans to cook the food.
For example, the allergen gluten was highlighted green in the binder. This means
that the cooks will make that food in a green handled pan. The green pan will only
cook foods containing gluten. If gluten residue happens to be left in the pan after it
has been washed and the pan is used again to cook another food, then it won’t be
able to contaminate products that do not contain gluten. Foods that are gluten
free can be cooked in any other colored pans, just not the green pans. This rule
follows with every other major allergen with its own color. The purpose of this
technique was to reduce patient’s complaints regarding allergen contamination in
the diet office. This was measured by the diet office by recording the amount of
allergen contamination complaints made by the patients weekly.
RESULTS/DISCUSSION
The survey used for the baseline assessment contained 10 questions that were
taken from ServSafe's practice exam questions. The double bar graph chart above,
illustrates the percentage of mean that the 5 respondents all together got right for
each of the 10 questions. The blue bar represents the baseline survey and the red
bar represents the outcome survey.
The baseline shows that all 5 respondents scored the lowest on question #9 with
an average of 40% and the highest on question #5 with an average of 100%. The
overall baseline mean for the questions were 71% and the overall outcome mean
was 91%. These results indicate a 20% increase on average % of correct answers
from the start to the end of the intervention. As a result, this shows that the
education aspect of the intervention improved employee’s scores by 20%.
The diet office kept a record of the amount of allergen contamination complaints
made by the patients weekly. The line graph above, illustrates the number of
allergen contamination complaints made by patients every week. At the start of
week 2, the number of complaints showed to be at its peak at 5 complaints.
Towards the end of the intervention on week 14, the number of complaints
significantly reduced to 1 complaint. These results indicate an 80% decrease in
patient’s complaints from the start (week 2) to the end (week 14) of the
intervention. As a result, this shows that the color coated pans and highlighted
allergen binder aspect of the intervention decreased allergen contamination
complaints by 80%.
CONCLUSIONS
Overall, the intervention was proven to be successful. The outcome survey
indicated a 20% increase on average % of correct answers by educating employees
using ServSafe’s website and its materials. Furthermore, cooking with color coated
pans and using the highlighted allergen binder helped to reduce allergen cross
contamination in the kitchen of the hospital. This was proven by an 80% decrease
on allergen contamination complaints made by patients at the hospital.
REFERENCES
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Ortiz, J. C., Galan-Malo, P., Garcia-Galvez, M., Mateos, A., Ortiz-Ramos, M., Razquin, P., &
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https://doi.org/10.1016/j.foodcont.2017.09.003
ServSafe: https://www.test-guide.com/quiz/servsafe-foodhandler-1.html
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Touimi, G. B., Bennani, L., Berrada, S., Benboubker, M., & Bennani, B. (2020). Evaluation of
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https://doi.org/10.18502/ijm.v11i6.2225
ACKNOWLEDGEMENTS
I would like to acknowledge and thank the hospitals kitchen staff, supervisor, and
the diet office for helping and being part of this research.