Meal delivery to patients under transmission-based precautions

[Thomson, Rachel EA (THS)]

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients?

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

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[Glynis Tudor]

Hello

Answers in red .

Regards,

Glynis Tudor
Infection Control Coordinator
Holmesglen Private Hospital
http://www.holmesglenprivatehospital.com.au

[HGPH – ED Early 2017 – Email Signature]

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients? Although catering staff are meant to deliver to patients on TBp ( excluding airborne), compliance and understanding of the PPE is patchy. Education given frequently, but remains a problematic area!

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Anonymous]

Answers below

Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/health

Our Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our Partnerships

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Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients?

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Anonymous]

Hi Rachel

Please see responses below in red.

Kind regards

Julie

Julie Baile I Clinical Nurse
Infection Prevention & Management
South Metropolitan Health Service
Fiona Stanley Hospital

Ground Floor, Block B, 11 Robin Warren Drive, MURDOCH WA 6150
Postal Address: Locked Bag 100, PALMYRA DC WA 6961
T: 6152 8915
E: julie.baile@health.wa.gov.au
http://www.southmetropolitan.health.wa.gov.au
http://www.fsh.health.wa.gov.au

[FSFHG_signature_block6-01]

Thank you to all those that have responded to my question in relation to meal delivery to patients under transmission-based precautions.

I would still appreciate further responses if people would be kind enough to consider my questions below. I am fundamentally interested in how acute hospitals perceive and manage the risks associated with delivery of meals and drinks to patients under transmission-based precautions.

I note with interest that the CDC have relatively recently made a clarification to when to don PPE (February 2017) by saying
One important change is the recommendation to don the indicated personal protective equipment (gowns, gloves, mask) upon entry into the patient’s room for patients who are on Contact and/or Droplet Precautions since the nature of the interaction with the patient cannot be predicted with certainty and contaminated environmental surfaces are important sources for transmission of pathogens.

Again, look forward to any further responses! My questions again below 🙂

Kind regards
Rachel

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients?

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hello

Answers in red .

Regards,

Glynis Tudor
Infection Control Coordinator
Holmesglen Private Hospital
http://www.holmesglenprivatehospital.com.au

[HGPH – ED Early 2017 – Email Signature]

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients? Although catering staff are meant to deliver to patients on TBp ( excluding airborne), compliance and understanding of the PPE is patchy. Education given frequently, but remains a problematic area!

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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________________________________
“IMPORTANT – This email contains confidential information intended only for the person named above and may be subject to legal privilege. If you are not the intended recipient, any disclosure, copying or use of this information is prohibited. Healthscope provides no guarantee that this communication is free of virus or that it has not been intercepted or interfered with.

If you have received this email in error, please notify the sender by return email, delete this email and destroy any copy. You must destroy the original transmission and its contents. Any views expressed within this communication are those of the individual sender, except where the sender specifically states them to be the views of Healthscope. If this document is not required for record keeping purposes please consider the environment before storing or printing. This communication should not be copied or disseminated without permission”.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Franciska Ferreira]

Hi Rachel,

Our nurses deliver the meals when patients are under transmission-based precautions as mentioned below. They know the meal times and have to make sure their allocated patients are ready (sitting up) to have their meals. Some patients may require assistance.

We had more issues when catering staff delivered the meals into transmission-based precaution room for example:

– There was no room on the over-way trolley to leave the patient meals

– Patients aren’t always in a sitting (upright) position to enjoy their meals

– Catering Staff are asked by patients to hand them all sorts of things in the room and to help them sitting up, which delay the entire meal delivering process for all patients.

– Catering staff don’t adhere to the use of PPE as much as Clinical staff do.

We are a smaller hospital with only one catering staff member delivering the meals per ward. The Catering staff inform the nurse when the meals arrived. The Nurse then deliver her patient’s meal (only the patient/s that is under transmission-based precautions)
We review and discuss this matter every year in our update training. I also conduct 3 monthly, internal Food safety Audits and can confirm that our turnaround time from serving up the meals to delivering it to the patient is: 10minutes – 15 minutes. If our Catering staff had to deliver the meals for patients under transmission-based precautions, it would have taken much longer.

Our Catering Department/ Staff is very sticked with the time ( the 2 – 4 hour rule) of delivering and picking up of the meals. 45 Minutes after the meals have been delivered to patients, the pick-up round commences to collect all eaten or uneaten meals on trays. If patients have not consume their meals yet (for whatever reason)
A plate of fresh sandwiches are then offered as a meal.

I realise that the bigger the hospital the bigger the challenges, however Rachel feel free to contact me if you have any other questions.

Kind Regards

Franciska Ferreira
Infection Prevention & Control/Wound Management Consultant
Burnside War Memorial Hospital
120 Kensington Road, Toorak Gardens, SA 5056
t: 08 8202 7231 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au
[cid:image005.jpg@01D30ABA.EFAFFF80][cid:image006.png@01D30ABA.EFAFFF80]

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients?

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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