INTRODUCTION

Food poisoning caused by toxins elaborated by contaminating bacteria on food

before it is consumed. Food act as a vehicle for the pathogens on provide

conditions in which the pathogens multiply to produce high number. Out breaks

of food borne infections continue to be a problem in hospital settings. Infected

food handlers are an important source of outbreak in health care facilities. Out

breaks of food borne infections in hospital have both financial and operational

sequences.

Unsafe food has been a human health problem since history was first recorded

and many food safety problems encountered today are not new although

governments all over the world are doing best to improve safety of food supply,

the occurrence of food borne disease remains a significant health issue in both

developed and developing countries. It has been estimated that each year 1.8

million people die as result of diarrheal diseases and most of these cases can be

attributed to contaminated food or water. Proper food preparation can prevent

most food borne disease. More than 200 known diseases are transmitted through

food.

The World Health Organization has introduced 5 keys to Safer Food posters in

2001. It incorporates all the messages of the Ten Golden Rules for safer food

preparation.

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The core messages of the 5 keys to safer food are

1. Keep clean

2. Separate raw and cooked

3. Cook thoroughly

4. Keep food at safe temperatures

5. Use safe water and raw materials

Raw food especially meat, poultry and sea food and their juices can contain

dangerous microorganism which may be transferred onto other foods during food

transportation and storage.

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GENERAL OBJECTIVE:

To observe the adherence of pre-preparation food hygiene and safety policy as

recommended in the MOH guideline at Dietetic Department of Hospital Sg.

Buloh.

SPECIFIC OBJECTIVE :

 To observe safe practices of food preparation before served to consumers

 To observe adherence of food hygiene and control of food borne illness in

hospital as proposed in MOH policy

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LITERATURE REVIEW

Employee hygiene is paramount to plant sanitation and is one of the leading

causes of food contamination. One of the challenge that food processors have to

overcome is how to motivate employees to comply with hand hygiene practices.

(Higgins 2002)

Many pathogens like E coli and Salmonella enter the food processing

environment via raw materials contaminated with these pathogens

(Riordan et al 2001; Tieldan et al 2002)

Mishandling of food plays a significant role in the occurrence of food borne

illness. Improper food handling may be implicated in 97% of all food borne illness

associated with catering outlets.

(Howes,Mc Ewan,Griffiths & Harris 1996)

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METHODOLOGY

Prospective Study :

 Observation on pre- preparation of raw food such as fish, whole poultry,

meat and vegetables before cooking.

 Observation personal hygiene and health of staff during preparation of

food

 Using audit checklist and observation

Period of study : 3 times / week

Locations : Dietetic Department

Target : Food Operators

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DATA COLLECTION AND ANALYSIS

BORANG PEMANTAUAN PROSES PRA PENYEDIAAN MAKANAN

JABATAN DIETETIK SAJIAN MAKANAN
HOSPITAL SG. BULOH

TABLE 1 : (APPENDIX 1)

BIL BAHAN MAKANAN PATUH TIDAK PATUH

1.0 AYAM / DAGING
6 0
1.1 Proses nyahbeku (40-minit-2 jam)
(100%) (0%)
5 0
1.2 Kesesuaian kawasan
(83.3%) (16.7%)
6 0
1.3 Kehadiran bendasing
(100%) (0%)
6 0
1.4 Papan pemotongan berasingan
(100%) (0%)
6 0
1.5 Cara pembilasan
(100%) (0%)
0 6
1.6 Pencucian dan kebersihan peralatan
(0%) (100%)
6 0
1.7 Kualiti / kesegaran
(100%) (0%)

GRAPH 1

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During my observation all process of work was done correctly according to the

time and at the proper area. 16.7% of defrost process and cleaning of meat was

not done at the correct area only 83.3% was done correctly. It was done at the

seafood area.

Cleaning of utensils and chopping board was not done improper because soap

and water was not used to clean, they just rinse under running water.

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TABLE 2 : (APPENDIX 1)

BIL BAHAN MAKANAN PATUH TIDAK PATUH

2.0 IKAN
6 0
2.1 Proses nyahbeku (40 minit - 2 jam)
(100%) (0%)
6 0
2.2 Kesesuaian kawasan
(100%) (0%)
6 0
2.3 Kehadiran bendasing
(100%) (0%)
6 0
2.4 Papan pemotongan berasingan
(100%) (0%)
6 0
2.5 Cara pembilasan
(100%) (0%)
0 6
2.6 Pencucian dan kebersihan peralatan
(0%) (100%)
4 2
2.7 Kualiti / kesegaran
(66.7%) (33.3%)

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GRAPH 2

Cleaning process done at the designated area. 33.3% freshness of fish was not

maintained cause after defrost fish was soaked in water for 2 hours in the sink,

only 66.7% was maintained.

Cleaning of utensils and chopping board was not done in proper because soap

and water was not used to clean, they just rinse under running water.

TABLE 3 : (APPENDIX 1)

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BIL BAHAN MAKANAN PATUH TIDAK PATUH
3.0 SAYUR-SAYURAN
6 0
3.1 Kesesuaian kawasan
(100%) (0%)
6 0
3.2 Kehadiran bendasing
(100%) (0%)
6 0
3.3 Papan pemotongan berasingan
(100%) (0%)
2 4
3.4 Rendam dalam air garam / vege clean
(33.3%) (66.7%)
6 0
3.5 Cara pembilasan
(100%) (0%)
0 6
3.6 Pencucian dan kebersihan peralatan
(0%) (100%)
6 0
3.7 Kualiti / kesegaran
(100%) (0%)

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GRAPH 3

During observation cleaning process of vegetables was done at designated area

but only 33.3% use salt water to clean vegetables for example long beans after

been cut will be rinsed in salt water. 66.7% did not use vege clean to wash

vegetables for example cabbage, salads. They only rinse under running water.

Cleaning of utensils and chopping board was not done in proper because soap

and water was not used to clean, they just rinse under running water.

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 BORANG PEMANTAUAN KEBERSIHAN PERSONEL

JABATAN SAJIAN DIETETIK

HOSPITAL SG. BULOH

TABLE 1 : (APPENDIX 2)

BIL KRITERIA PATUH TIDAK PATUH CATATAN

Pakaian Seragam
1.0
Pengendali Makanan
6 0
1.1 Apron
(100 %) (0%)
6 0
1.2 Penutup kepala
(100 %) (0%)
Penutup mulut (semasa 4 2
1.3
hidang) (66.7%) (33.3%)
6 0
1.4 Bersih
(100 %) (0%)
Kasut yang sesuai dan 6 0
1.5
selamat (100 %) (0%)
Sarung tangan pakai buang 5 1
1.6
(semasa hidang) (83.3%) (16.6%)
Tidak memakai pin tudung,
6 0
1.7 kerongsang, tanda nama,
(100 %) (0%)
manik

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GRAPH 1

Health records of the food handlers were updated and immunizations for typhoid

were carried out.

All food handlers found to be following the proper guidelines except for 66.7% of

them use mask during preparation of food where else the other 33.3% was not

comply with the guidelines. 83.3% of them comply using gloves during

preparation of food but 16.6% was not complying.

TABLE 2 : (APPENDIX 2)
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BIL KRITERIA PATUH TIDAK PATUH CATATAN
2.0 Kebersihan Diri
6 0
2.1 Kuku pendek & bersih
(100 %) (0%)
6 0
2.2 Rambut terurus (bertutup)
(100 %) (0%)
6 0
2.3 Misai / janggut terurus
(100%) (0%)
Tidak menggunakan pengilat 6 0
2.4
kuku / maskara (100 %) (0%)
Tidak memakai barang kemas 6 0
2.5
dan jam tangan (100%) (0%)
Tiada jangkitan kulit yang 6 0
2.6
terdedah (100 %) (0%)
Minyak wangi atau aftershave
6 0
2.7 tidak digunakan di kawasan
(100%) (0%)
penyediaan

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GRAPH 2

All food handlers found to be following the proper guidelines and they look neat

and clean with proper attire. Food handlers with cut or wound at their finger’s

dressing was applied.

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TABLE 3 : (APPENDIX 2)

BIL KRITERIA PATUH TIDAK PATUH CATATAN

3.0 Amalan Kebersihan
Mencuci tangan sebelum / 1 5
3.1
selepas melakukan tugas (16.7 %) (83.3%)
Mencuci tangan selepas ke
3.2 - -
tandas
Tidak makan / minum
4 2
3.3 dikawasan penyediaan
(66.7%) (33.3%)
makanan
6 0
3.4 Tidak meludah
(100 %) (0%)
Menanggalkan apron apabila
2 4
3.5 ke tandas, berehat atau keluar
(33.3%) (66.7%)
dari premis
Sentiasa menggunakan “food
tongs” atau sarung tangan 6 0
3.6
pakai buang semasa (100 %) (0%)
mengendali makanan
Tidak menggunakan telefon 3 3
3.7
bimbit semasa memasak (50%) (50%)

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GRAPH 3

During observation although all guidelines were followed but hand hygiene

practice is lacking among all the food handlers. They are no using soap and

water to wash their hands after preparing raw food and before touching cooked

food and after open the waste bin. They only rinse their hand with water. Only

16.7% comply to hand washing the other 83.3% was not comply. Only 66.7%

comply did not eat at food preparation area but 33.3% did not comply.

Removal off apron when leaving from the kitchen to toilet only 33.3% comply the

other 66.7% was not complied.

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50% of the food handlers complies did not use hand phone while preparing food

the other 50% was not complied.

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DISCUSSION

During my observation was found that all the food handlers did not strictly follow

the guidelines of preparing food. Hand washing is lacking among all the food

handlers when preparing raw meat and cooked food. This will cause cross

contamination of food. Although training has been given to them about hand

washing and guidelines for preparing food but their attitude towards these

practice are lacking.

Proper bin for dispose waste should be used because during observation there is

no pedal waste bin . Staffs used their hand to open the bin to throw the waste

and not washing their hand and continue to handle with raw items. This is

another factor which will contribute to contamination.

All utensils and chopping board should be cleaned with soap and water because

if proper cleaning is not done it will cause bacteria growth. All vegetables should

be thoroughly cleaned to remove dirt, foreign body before cooking.

Eat or drink, using hand phone should be avoided at a food preparing area this is

due to lack of supervision especially in the evening. During my observation

practices are lacking among new staffs because they have not attended training.

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CONCLUSION

During my observations the result was satisfactory; however there is more room

for improvement on the above findings in order for us to strive high standards

and good quality.

Food handlers did not committed to their work and not concern about the

important of hand washing. This due to their attitude and lack of supervise during

preparation of food and very poor facilities for hand washing. The staffs are using

hand towel instead of single use of hand tissue. They also not aware about

prevention of cross contamination which causes food borne illness.

All the utensils, chopping board which used should be washed with soap and

water as it is one of the contributing factor for infection. Proper waste bin is not

used and it should be washed daily.

From observation continuous observation and co operation from Dietetic

department, catering supervisors and infection control team could improve the

safe practices in preparing food in hospital.

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RECOMMENDATION

1. At hand washing area, pedal waste bin and hand paper towel should be

available to ensure staff washes their hands routinely before and after

touching the food.

2. Supervisor should monitor the staff use proper kitchen attire while

handling food to prevent cross contaminations.

3. At pre preparation of food and cooking area preferably foot pedal waste

bin should be provided and to be washed daily to prevent from cross

contamination.

4. In order to maintained safety of the food all utensils must be washing with

soap and water immediately.

5. All food handlers should be given continuous adequate knowledge of food

hygiene to provide quality service in food hygiene and safety. Infection

control team should give continuous education among the food handlers

regarding hand washing techniques and it’s important.

6. To take action against the staff attitude who is not serious when handling

food by management department.

7. Staff from dietetic department together with infection control team should

audit the food handlers.

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REFERENCES

1. WHO Health Organisation. Five Keys to safer Food manual [online]. 2006

[citied 2007 August 10 ].

2. ftp://ftp.fao.org/codex/Publications/Booklets/Hygiene/FoodHygiene_2003e.

pdf

3. Friedman C.Newsom W. editor IFIC Basic Concepts of Infection Contro ,

2007

4. Food and Agriculture Organization of the United Nations. Food Quality and

Safety Systems – A Training Manual on Food Hygiene and the Hazard

Analysis and Critical Control Point (HACCP) System [online]. 1998 [citied

2007 August 10].

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APPENDIX 1

BORANG PEMANTAUAN PROSES PRA PENYEDIAAN MAKANAN

JABATAN DIETETIK SAJIAN MAKANAN
HOSPITAL SG. BULOH

BIL KRITERIA PATUH TIDAK PATUH CATATAN

Pakaian Seragam Pengendali

1.0
Makanan
Proses nyahbeku (40 minit - 2
1.1
jam)
1.2 Kesesuaian kawasan
1.3 Kehadiran bendasing
1.4 Papan pemotongan berasingan
1.5 Cara pembilasan
Pencucian dan kebersihan
1.6
peralatan
1.7 Kualiti / kesegaran
2.0 IKAN
Proses nyahbeku (40 minit - 2
2.1
jam)
2.2 Kesesuaian kawasan
2.3 Kehadiran bendasing
2.4 Papan pemotongan berasingan
2.5 Cara pembilasan
Pencucian dan kebersihan
2.6
peralatan
2.7 Kualiti / kesegaran
3.0 SAYUR-SAYURAN
3.1 Kesesuaian kawasan
3.2 Kehadiran bendasing
3.3 Papan pemotongan berasingan
Rendam dalam air garam / vege
3.4
clean
3.5 Cara pembilasan
Pencucian dan kebersihan
3.6
peralatan

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3.7 Kualiti / kesegaran

APPENDIX 2

BORANG PEMANTAUAN KEBERSIHAN PERSONEL

JABATAN SAJIAN DIETETIK

HOSPITAL SG. BULOH

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BIL KRITERIA PATUH TIDAK PATUH CATATAN
Pakaian Seragam Pengendali
1.0
Makanan
1.1. Apron
1.2 Penutup kepala
1.3 Bersih
1.4 Penutup mulut (semasa hidang)
1.5 1.4 Kasut yang sesuai dan selamat
Sarung tangan pakai buang
1.6
(semasa hidang)
Tidak memakai pin tudung,
1.7
kerongsang,tanda nama, manik
2.0 Kebersihan Diri
2.1 Kuku pendek & bersih
2.2 Rambut terurus (bertutup)
2.3 Misai / janggut terurus
Tidak menggunakan pengilat kuku
2.4
/ maskara
Tidak memakai barang kemas dan
2.5
jam tangan
2.6 Tiada jangkitan kulit yang terdedah
Minyak wangi atau aftershave tidak
2.7
digunakan di kawasan penyediaan
3.0 Amalan Kebersihan
Mencuci tangan sebelum /selepas
3.1
melakukan tugas
3.2 Mencuci tangan selepas ke tandas
Tidak makan / minum dikawasan
3.3
penyediaan makanan
3.4 Tidak meludah
Menanggalkan apron apabila ke
3.5 tandas, berehat atau keluar dari
premis
Sentiasa menggunakan “food
tongs” atau sarung tangan pakai
3.6
buang semasa mengendali
makanan
3.7 Tidak menggunakan telefon bimbit

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 semasa memasak

APPENDIX 3

GANTT CHART

Date 12/10/11- 2/11/11- 14/11/11- 21/11/11-29/11/11

Subject 13/10/11 10/11/11 17/11/11
Identify Topic
Collect Data
Analysis Data
Binding & Submit

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Total words : 2 450

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