الفهرس 
Nutrition Care ServiceOnly 14 pages are availabe for public view
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Abstract
Healthcare food service touches almost every patient who is admitted to a hospital. The quality and service of the food have a significant impact on the health and happiness of the patient and the patient’s family because of the importance of food in our daily lives. Nutritional intake is one of the critical elements in the recovery of the patient making the study of healthcare food service of great value.
This study is an attempt to evaluate the quality of nutrition care and feeding activities of patients as regards the quality, adequacy and accuracy of the diet offered to hospitalized patients, to evaluate the managerial system of the dietary services in Ain Shams Hospitals and to assess the patient’s attitude towards hospital food service, factors affecting his attitude and the impact of his attitude on accepting or rejecting the served food.
The main results of the study were:
• Food purchasing is made by hospital administration through approved suppliers.
• Food is delivered either in open vehicles or closed ones but refrigerator temperature is not assessed at the time of food delivery.
• Dry foodstuffs are stored in special stores that are under supervision and control of the hospital administration but there are foodstuffs for extra one day to be used if food delivery is delayed. These foodstuffs are stored in refrigerators in the kitchen.
• There is a fixed menu for hospitalized patients except for seasonal vegetables and fruits. So patients’ likes and dislikes are not considered.
• Food items have been prepared in separate sections, but it is mostly prepared manually.
• Food is distributed twice daily by dietitian aids or workers. Breakfast and dinner are distributed around 9.00 am while lunch is distributed around 1.00 pm daily.
• Average score of the checklist used to assess the sanitary condition was 47.25%.
o The maximum score (100.0%) was for plumping condition, safe water supply either hot or cold, valid licenses and (83.3%) for food purchasing and delivery.
o Average score of (50.0%) was for kitchen lightening and ventilation and Insect, rodent and animal control.
o Observation of toilet and hand washing facilities scored (16.6%), Food protection scored (13.0%) personnel scored (12.5%).
o The minimum score (0.0%) was for food equipment and utensils cleaning and storage, cleanliness of floors and walls and floors and walls are nit cracked or not.
o Dish washing facilities are not available in the hospital.
• Low sanitation score can be attributed to two main factors
o Defects of the infrastructure and equipment of the kitchen.
o Defective knowledge and awareness of the personnel about food safety measures.
Therefore, food safety education and increased awareness among food services staff in hospitals regarding safe food handling practices have great importance to comply with (HACCP) requirements. Also, dietary department staff should be trained and certified to provide nutrition service complying with the scientific basis of nutrition care process.
As regards nutrition care process of the patients, the following were the main results:
• Some data essential for nutritional risks screening, nutritional status assessment and reassessment are defective with the subsequent effect on further nutrition care of the patient.
• Only 45.0% of the interviewed patients stated that they received medical advice about the diet appropriate for their health condition, while 55.0% did not receive that advice
• Accordingly, nutrition care process is not properly implemented evidenced by
o Absence of nutrition assessment, reassessment of the patient.
o Lack of communication between physicians and dietary department staff evidenced by non awareness of physicians about what food items prepared in the kitchen.
o Defective nutrition education of the patient.
o Defective documentation of the nutrition plan of the patient.
As regards patients’ attitude towards hospital diet, the following were the main results:
• Though 94.0% of the patients stated that they get meals in regular times, only half of them (50.0%) are satisfied with meal time. The majority of patients were not satisfied with dinner time (82.0%).
o Gender and residence differences are statistically significant factors affecting patients’ satisfaction with meal time; one quadrant of male patients (25.0%) was satisfied with meal time vs. (64.1%) of females. More than half (56.1%) rural residents were satisfied with meal time vs. (41.9%) of urban residents.
o Meal time dissatisfaction resulted in considering served food non acceptable among 52.7% of patients thought that served food is not acceptable. Also it is one of the factors that have significant effect on the amount that the patient eats of served food.
o About one third of the patients satisfied with meal time (30.7%) eat all served food vs. 8.0% of patients not satisfied with meal time.
• Only 45.0% of the patients thought that served food is acceptable.
o Factors that render served food non acceptable were; decreased appetite (29.1%), dislike of served food type (41.9%), meal time is not suitable (52.7%), the way of cooking is not palatable (43.6%), hospital food is not clean (5.5%) and hospital food is not suitable for health condition (29.1%).
o Gender and residence differences also have high statistical significant factors that affect patients’ opinion about the degree to which served hospital food are acceptable; half of female patients (51.6%) think that hospital food is acceptable vs. (33.3%) males. Also (54.4%) of rural residents think that hospital food is acceptable vs. (32.6%) of urban residents
• About two thirds of the patients (66.4%) think that the amount of served food at hospital is adequate.
o Gender, residence and age are highly significant factors that affect patients’ opinion about the degree to which the amount of served food at hospital is adequate. Most of male patients (85.2%) think that the amount is adequate vs. (55.7%) of females. Urban residents think that the amount of food is adequate more than rural residents (76.0% vs. 59.1%). The majority of patients aged ≥ 46 years (75.9%) think that the amount is adequate. The percent decreased to be 53.3% among those aged from 31 to 45 years
• The majority (92.0%) of patients get food other than hospital served food. Most of the patients (82.0%) get home made food.
o Reasons for having food other than hospital diet; food cooking is not palatable (34.8%) or hospital food is not suitable for health condition (27.2%) and patient does not like hospital food (14.1%).
• Most of the patients (75.4%) eat part of the served food, 19.3% eat all served food while 5.3% do not eat hospital food.
o Patient’s residence and age are highly significant factors that affect the portion that the patient eats of served food at hospital. None of the urban residents eat all served food, vs. (33.9%) of rural residents.
o Meal time satisfaction and acceptable food are highly significant factors that affect the portion that the patient eats of served food at hospital. About one third of the patients satisfied with meal time (30.7 %) eat all served food while patients not satisfied with meal time do not eat all served food. About one third (34.1%) of the patients that think that served food is acceptable eat all served food vs. (7.3%) of patients think served food is not acceptable.
So, patient considerations should be included while establishing food service of the hospital.