Qualifying instrument for evaluation of food and nutritional care in hospital

Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal management dietitian activities." (Nutr Hosp. 2012;27:1170-1177) DOI:10.3305/nh.2012.27.4.5868

Gauging food and nutritional care quality in hospitals

Background: Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods: Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Results: Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p < 0.01). The mean compliance with NCQ criteria in public and private institutions was 51.8% and 41.6%, respectively. The percentage of public and private health institutions in conformity with FSQ criteria was 42.4% and 49.1%, respectively. Most of the actions comprising each corpus, NCQ and FSQ, varied considerably between the two types of institution. NCQ was positively influenced by hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. Conclusions: Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent.

Point-of-sale machines in school cafeterias and parental influence on child food choices

The prevalence of obesity has reached epidemic proportions in the United States. Twenty-five percent of school aged students are overweight. Schools have the opportunity to help slow this epidemic. School cafeterias in the United States feed millions of students every day through the National School Lunch Program.^ Point-of-sale machines are used in most school cafeterias to help streamline the process of purchasing school lunches. The point-of-sale software allows school personnel to place special notes on student's accounts to provide alerts about parental requests. This study investigated what the alerts are used for, who uses the alerts, and if there are any patterns by demographic characteristics. ^ Counts and percentages were used to determine what the alerts were used for and who used them. This study found that students who were white non-Hispanic, paid status, or in elementary school were most likely to have alerts placed on their accounts. Also, the majority of point-of-sale alerts were used as allowances (i.e., allowed to purchase snacks from the balance on the school lunch account), rather than restrictions (i.e., restricted from purchasing high calorie foods or specific food items). Using chi-square analysis, a total of 688 alerts were analyzed. There were significant differences in alert frequencies for intent category by grade level (p=0.000), snack access (p=0.000), and gender (p=0.002). Therefore, the results are significant, and one can conclude there is a significant relationship between gender, grade level, and snack access, and the presence of an alert on the school lunch account.^ Also, school administrators may want to take into consideration possible changes to their program, such as requiring more time to run the software. The results of this study can assist school administrators to better understand that a point-of-sale alert program may help their school lunch programs run more efficiently, while also providing parental influence on students’ food choices at the point-of-sale.^ School food service authorities should consider implementing a structured point-of-sale alert policy to encourage parental input on their children's food choices. When implementing the point-of-sale policy, schools should publicize this policy online, through school lunch menus, and parent communications increase participation throughout the school district.^

Food services.

Cover title.

Food buying guide for child care centers /

"FNS-108."

Food stamp program : implementation of electronic benefit transfer systems : report to the ranking minority member, Committee on Agriculture, Nutrition, and Forestry, U.S. Senate /

"GAO-02-332."

A program evaluation of the Department of Veterans Affairs Dietetic Service /

"August 1990."

Food buying guide for child nutrition programs /

Includes index.

Recipes for quantity service /

Latest issue consulted: Rev. 1972.

Food buying guide for child nutrition programs /

Includes index.

Trends in the Quick Service Restaurant Industry

By 1990 the quick sevice restaurant industry(QSR) achieved 54 percent of commercial food service market share. QSR has a significant role to play in the rapidly-growing global hospitality industry and is expanding into institutional food service to increase its market share. It is expected to be the dominant player in the U.S. food service industry. The authors include an analysis of current and emerging trends in this industry.

Fresh Food Vending Trends and Practices

Fresh food vending represents $1.5 billion in sales each year in the United States. The implications for a better understanding of fresh food vending are significant in terms of profitability and improved market share for vending operators. Of equal importance is a better understanding of the significance of the route driver on the overall fresh food vending operation. Developing a better understanding of this area of the food service industry will help vending operators increase profits and provide better product choices to consumers

Fast-Food Franchises: An Alternative Menu for Hotel/Casinos

In their discussion - Fast-Food Franchises: An Alternative Menu for Hotel/Casinos - by Skip Swerdlow, Assistant Professor of Finance, Larry Strate, Assistant Professor of Business Law, and Francis X. Brown, Assistant Professor of Hotel Administration at the University of Nevada, Las Vegas, their preview reads: Hotel/casino food service operations are adding some non-traditional fare to their daily offerings in the form of fast-food franchises. The authors review aspects of franchising and cite some new Las Vegas food ideas.” The authors offer that the statewide food and beverage figures, according to the Nevada Gaming Abstract of 1985, exceeded $1.24 billion. Most of that figure was generated in traditional coffee shops, gourmet dining rooms, and buffets. With that kind of food and beverage figure solidly on the table, it was inevitable that fast-food franchises would move into casinos to garner a share of the proceeds. In a March 1986 review of franchising, Restaurant Business reported the following statistics: “Over 60 percent of all restaurants are franchisee owned. This relationship is also paralleled in dollar sales, which has exceeded $53 billion.” “Restaurant franchising expansion has grown at an annual rate of 12 percent per year for the past five years.” The beginning of the article is dedicated to describing, in general, the franchise phenomenon; growth has been spectacular the authors inform you. “The franchise concept has provided an easy method of going into business for the entrepreneur with minimal business experience, but a desire to work hard to make a profit,” say professors Swerdlow, Strate, and Brown. Lured by tourist traffic, and the floundering Chapter 11 afflicted, Riviera Hotel and Casino in Las Vegas, Burger King saw an attractive opportunity for an experiment in non-traditional outlet placement, say the authors. Although innately transient, the tourist numbers were way too significant to ignore. That tourist traffic, the authors say, is ‘round-the-clock. Added to that figure is the 2000-3000 average employee count for many of the casinos on the ‘Vegas strip. Not surprisingly, the project began to look very appealing to both Burger King and the Riviera Hotel/Casino, the authors report. In the final analysis, the project did work out well; very well indeed. So it is written, “The successful operation of the Burger King in the Riviera has sparked interest by other existing hotel/casino operations and fast-food restaurant chains. Burger King's operation, like so many other industry leadership decisions, provides impetus for healthy competition in a market that is burgeoning not only because of expansion that recognizes traditional population growth, but because of bold moves that search for customers in non-traditional areas.” The authors provide an Appendix listing Las Vegas hotel/casino properties and the restaurants they contain.

Consumers’ Reactions to Sanitation in Casual Dining, Quick-Service, and Fine Dining Restaurants

Consumers’ concern about food safety, sanitation, and health has increased since food-borne illnesses still frequently occur in the US. This article explored consumers’ perceptions, emotions, and behavioral intention about the sanitation of the physical environment in three different restaurant settings, casual dining, quick-service, and fine dining restaurants. Disgust was the most strongly felt negative emotion, but no significant differences were found for negative emotional reactions to dirty conditions among the three types of restaurants. Positive emotional reactions were significantly different among the restaurant types. Behavioral intention was also significantly different among the three restaurant types as a reaction to dirty food. The findings help restaurant owners and managers understand how consumers feel and react to “dirty” food, service staff, or dining room tables in casual, quick-service and fine dining restaurant.

Previous Holocaust Experiences Continue to Affect Food Attitudes in Survivors

A qualitative study was conducted to determine if Holocaust survivors’ food attitudes are influenced by their earlier experiences. The 25 survivor interviewees (14 males, 11 females) ranged in age from 71 to 85 years and resided in Miami-Dade and Broward, Florida counties. Most (56%) were interned in concentration camps during the Holocaust. Interviews were tape-recorded and later transcribed. Results showed earlier experiences influenced food attitudes. The most common themes were: 1) Difficulty throwing food away - even when spoiled; 2) Storing excess food; 3) Craving a certain food; 4) Difficulty standing in line for food; and 5) Anxiety when food is not readily available. Sub-themes included healthy eating and empathy for those currently suffering from hunger. Fourteen (56%) fast for religious holidays, but 7 (28%) said they already had “fasted enough.” Dietitians and others are encouraged to evaluate food service programs to minimize uncomfortable food-related situations for Holocaust survivors.