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Read tickets
Fill orders according to diet
Send orders down the line
Re-stock stations during and after shifts
Clean as you go!
Diet Orders
Definition
http://youtu.be/huZ6ymeKFd4
If a patient is on an NDD diet, a liquid consistency
must be entered in order to send liquids.
Side Note:
If you see a diet order missing a fluid consistency,
please contact a supervisor
Example:
NDD#1 - Pureed
• Melted cheese
• Peanut butter
• Scrambled eggs
• Mixed dishes like casseroles, lasagna, ravioli, macaroni and cheese
• Nuts, Raw fruits and vegetables
• Oatmeal
• Bars, cookies, cakes, pies and fruited yogurt
NDD#1 - Pureed
NDD#1 - Pureed
Proper cooking involves waiting for pasta to solidify for 1.5 minutes before plating, warming
up the puree for 3 min with plastic covering on so that it doesn’t burn, should still have a
shape when it’s on the plate
NDD#2 – Mechanically Altered
Definition
The mechanical altered diet includes foods that are moist and tender, and
easy to chew. These foods need to be very moist so they stick together to
form a ball in the mouth. This prevents the foods from pocketing
between their cheeks and gums.
Special instructions
All foods should be served with a sauce or gravy to make sure it is moist
enough to stick together. Meats should be ground or chopped and no
larger than one quarter inch pieces. All foods from the Level 1 Dysphagia
diet are acceptable on this diet as well.
NDD#2 – Mechanically Altered
NDD#3 – Advanced
Definition
This diet consists of food with
nearly normal textures. It
excludes foods that are very hard,
dry, sticky or crunchy. Foods in
this diet still need to be moist,
tender and easy to chew. All
foods should be in “bite-size”
pieces.
NDD#3 – Advanced
Thickened Liquids
Definition
• This diet consists of a combination of dysphagia level #1 and full liquids.
Textures must be smooth, non-fibrous.
• This diet is used for patients who have undergone a facial surgery, typically
to correct a clef pallet.
Ketogenic Diet
Definition
• A high fat, adequate protein, low carbohydrate diet used to prevent
epilepsy in adolescents
• Protein must be PLAIN with no seasoning
Special Instructions
• There is no specific diet order in HealthTouch
• Nurses may ask for large #’s of butter pats, heavy whipping cream or oil
Portion Sizes
Soups
• 4 oz. =
• computer mouse
• deck of cards
• picture in the palm of your
hand
Why does the portion size matter?
Pass around the computer mouse
What should it look like???
Definition
• This means the patient is sensitive to a protein found in wheat, barley and
rye. Oats should be avoided as well due to cross-contamination.
Gluten Free
• French Toast
• Sandwiches
• Pasta (Rice Noodles)
• Hot Breakfast Cereal (Cream of Rice)
• Blueberry Muffins
• Buns (Hamburgers & Chicken Sandwiches)
Gluten Free
Special Instructions
• Call out the allergen to the other cooks.
• Change gloves when preparing a gluten free tray to prevent
cross contamination.
• Separate portioning utensils should be used for wheat
containing products and gluten free products.
• Cover item with dome or plastic lid to prevent cross
contamination.
Gluten Free
Special Instructions
• Gluten free bread should not be toasted in a toaster that
toasts any other kind of bread. A separate toaster should be
used for only gluten free bread.
Gluten Free
Special Instructions
• Do not throw GF bread into a
container of regular bread
• Sanitize counter before gluten
free sandwich making
Milk Allergy
Definition
• This diet is ordered for people allergic to protein in milk
Can cause:
• Rashes, hives, itching, swelling
• Trouble breathing, wheezing, loss of consciousness
Milk Allergy
• Lactaid Milk
• Protein Bowls
• Tacos (without cheese)
• Plain Bagel
• Fried egg
• Egg whites Milk
• Dairy free French toast
• Vegetables
• Boost supplements
Milk Allergy
Special Instructions
• Call out the allergen to the other cooks.
• Change gloves when preparing a tray with a milk allergy to
prevent contamination.
• Cover item with dome or plastic lid to prevent contamination
Egg Allergy
Definition
• This diet is ordered for people allergic to protein in eggs
Can cause
• Skin rashes, hives, nasal congestion, vomiting
• Digestive problems
• anaphylaxis
Egg Allergy
• Yogurt
• Cereal
• Cottage cheese
• Hashbrowns
• Meats and Fish
• Sandwiches
• Any beverages
• Apple crisp
• Rice Krispie treat
Egg Allergy
Special Instructions
• Call out the allergen to the other
cooks
• Change gloves when preparing a
tray with allergens to prevent
cross contamination
• Separate portioning utensils
should be used for egg containing
products.
• Cover item with dome or plastic
lid to prevent contamination.
Fish & Shellfish Allergies
Definition
• This diet is ordered for individuals allergic to the protein in certain types of
fish
• No shellfish on the line
Can Cause:
• anaphylaxis
• Hives, skin rash,
• vomiting./ diarrhea
• Asthma
• Stuffy or runny nose
Fish & Shellfish Allergies
A ticket for a default tray comes down the line- the order includes:
• cheese quesadilla
• salsa
• Corn
• 1% milk