Section 250.1610 Dietary Department Administration

Section 250

Section 250.1610  Dietary

Department Administration

a)         Organization

There shall be

an organized department of dietetics, and a well-defined plan of operation

designed to meet the needs of the patients whether the services are

centralized, decentralized, or provided under contractual agreement.

b)         Staffing:  Dietetic Service Director

The dietetic

department shall have a full-time dietetic service director, preferably a dietitian,

whose responsibilities shall include, but are not limited to, the following:

1)         developing written policies and procedures to include but not

necessarily be limited to:

A)        responsibilities and authority for the operation;

B)        standards of nutritional care for all regular and therapeutic

diets including supplemental feedings;

C)        medically prescribed diet orders and alterations in diets or

diet schedules such as holding trays, late trays, and times for accepting diet

changes;

D)        patient tray identification;

E)        food preparation, storage and service;

F)         personal hygiene;

G)        sanitation and safety;

H)        ancillary dietetic services including food storage preparation

and service in kitchens and dining areas on patient care units; formula supply;

vending operation; and ice making;

I)         conferences--departmental and interdepartmental, clinical,

executive and/or administrative;

J)         training programs for personnel; and

K)        patient education programs

anitation and safety;

H)        ancillary dietetic services including food storage preparation

and service in kitchens and dining areas on patient care units; formula supply;

vending operation; and ice making;

I)         conferences--departmental and interdepartmental, clinical,

executive and/or administrative;

J)         training programs for personnel; and

K)        patient education programs.

2)         planning menus for all general and therapeutic diets in

accordance with the current Recommended Dietary Allowances of the Food and

Nutrition Board, National Research Council, and in accordance with the

principles of good dietetic management;

3)         planning, organizing, directing, controlling, and evaluating

all management aspects of the dietetic services including such things as budget

and/or interpretations of financial reports, purchasing and/or requisitioning

food, dietetic supplies and equipment, food costs, food storage, food

preparation, food service, safety, sanitation, record keeping, personnel

scheduling, and evaluating;

4)         planning, implementing, and/or conducting education programs

for orientation, on-the job training, in-service and continuing education on a

regular, routinely scheduled basis for all dietary and other appropriate

personnel, and staff development sessions for all professional staff;

5)         administering all the nutritional aspects of patient care

including, but not necessarily limited to:

A)        taking nutrition histories and recording in patients' medical

charts;

B)        interviewing patients regarding food habits;

C)        giving diet counseling to patients and their families;

encouraging patient participation in planning their own diets;

D)        participating in appropriate ward rounds and conferences, or by

other methods; sharing specialized knowledge with medical and nursing staffs

and other appropriate interdisciplinary team members involved in the care of

the patient; and

E)        consulting with patient care teams

counseling to patients and their families;

encouraging patient participation in planning their own diets;

D)        participating in appropriate ward rounds and conferences, or by

other methods; sharing specialized knowledge with medical and nursing staffs

and other appropriate interdisciplinary team members involved in the care of

the patient; and

E)        consulting with patient care teams.

c)         Consultation

1)         When the full-time dietetic service director, for legitimate,

documented reasons, is not a dietitian, the hospital shall employ a dietitian

on a part-time (minimum of 20 hours per week) or on a consulting basis. The

hours of consultation in the hospital shall be dependent upon the size, needs

and complexity of the hospital, and dietetic service but in no case shall there

be less than a minimum of eight hours of consultation per month.

2)         If consultant dietetic services are used, the consultant's

visits are to be scheduled at appropriate times of sufficient duration and

frequency to allow for the consultant to liaise with medical, nursing, and

patient care teams, to advise the administrator, to give patient counseling, to

give guidance to the director and staff of the dietetic service, to approve all

menus and administrative nutritional aspects of patient care, to participate in

development and/or revisions of dietetic policies and procedures, and to assist

with planning and conducting orientation, in-service and continuing education

programs for dietary and other appropriate personnel.

d)         Staff

1)         There shall be a sufficient number of properly trained and

supervised dietary personnel, including one or more clinical dietitians where

warranted, competent to carry out all the functions of the dietetic service in

an efficient, effective manner.

2)         Dietary personnel shall be scheduled and on duty to allow for

the dietary department to be open and in service a minimum of 12 hours a day

here shall be a sufficient number of properly trained and

supervised dietary personnel, including one or more clinical dietitians where

warranted, competent to carry out all the functions of the dietetic service in

an efficient, effective manner.

2)         Dietary personnel shall be scheduled and on duty to allow for

the dietary department to be open and in service a minimum of 12 hours a day.

e)         Health and Hygiene

1)         Personnel shall be in good health, free of infections or

communicable disease, and free of boils, infected wounds, sores, or lesions.

Persons suspected of having a communicable, contagious, or infectious disease

shall be subject to the requirements of the Control of Notifiable Diseases and

Conditions Code and the Food Code.

2)         The outer clothing of all employees shall be clean and street

clothing shall not be worn as outer clothing by employees while engaged in the

preparation and serving of food.

3)         Employees shall wear hair nets, headbands, or other effective

hair restraints to prevent the contamination of food or food-contact surfaces.

4)         Employees shall thoroughly wash their hands and exposed

portions of their arms with soap and warm water before starting work, during

work as necessary to keep them clean, and after smoking, eating, drinking, or

using the toilet.  Employees shall keep their fingernails clean and trimmed.

5)         Except where tasting food is part of the job, employees shall

consume food only in designated dining areas.  An area shall not be designated

as a dining area if consuming food there might result in contamination of other

food, equipment, utensils, or other items needing protection.

6)         Employees shall not use tobacco in any form while engaged in

food preparation or service, nor while in equipment or utensil washing or food

preparation areas. Employees shall use tobacco in any form only in designated

areas

not be designated

as a dining area if consuming food there might result in contamination of other

food, equipment, utensils, or other items needing protection.

6)         Employees shall not use tobacco in any form while engaged in

food preparation or service, nor while in equipment or utensil washing or food

preparation areas. Employees shall use tobacco in any form only in designated

areas.  An area shall not be designated for that purpose if the use of tobacco

there might result in contamination of food, equipment, utensils, or other items

needing protection.

7)         Employees shall handle soiled tableware in a way that avoids

contamination of their hands.

8)         In the event food service employees are assigned duties

outside the dietetic service, these duties shall not interfere with the

sanitation, safety, or time required for dietetic work assignments.

9)         Employees shall maintain a high degree of personal cleanliness

and shall conform to good hygienic practices.

10)       Employees shall not

use latex gloves in the preparation and

handling of food.  If latex gloves must be used in the preparation of food due

to a crisis that interrupts a

hospital's

ability to source nonlatex

gloves, a sign shall be prominently placed at the point of order or point of

purchase clearly notifying the public of the temporary change.

(Section

10(a) of the Latex Glove Ban Act)