Depending on the risk that certain levels of environmental contamination may pose to patients, a hospital is divided into two areas: critical risk (ORs, ICUs, neonatal, etc.) and semi-critical risk (rehabilitation, ERs, laundry, etc.). This second group also includes the kitchen. This means that above and beyond the care that anyone would have when handling food, hygiene becomes an even greater priority in a hospital.

For proper storage, food is kept in different refrigerators, one for each type of food. Red meats are stored in one, fish in another, and vegetables and cooked foods go in separate refrigerators as well. Separate and nonporous utensils are used to handle each of the foods and avoid cross-contamination. For example, if you use a cutting board for chopping chicken, use another board to chop vegetables. "All foods are handled separately, since all utensils and cutting boards can become a major source of germ contamination in the kitchen”, says Montse Sallés, Head Nurse of the Evaluation, Support and Prevention Unit of the Hospital Clínic in Barcelona.

 

 

As in any professional kitchen, a hospital kitchen must implement an effective cleaning and disinfecting system. Cleaning products and disinfectants be used but under no circumstances will brooms be used. Instead of dry cleaning methods, use wet or dust mops. The phrase “top-down, inside-out and clean to dirty" is a kind of health mantra, Montse Sallés points out.

The cleaning and disinfection plan, however, “should be reinforced in advance with an appropriate design of the facilities that allows a workflow that advances only forward, with a marked separation of clean and dirty areas”, says Maite Pelayo, from the Silestone Institute Advisory Council. "It is appropriate”, she adds, “for this design to include the implementation of “Passive Food Safety Systems (SPSA). This new concept, developed by Maite Pelayo herself, involves state-of-the-art materials and equipment that enhance microbiological safety in the kitchen without substantially altering user habits”. Within this broad group, we highlight materials and coatings with bacteriostatic treatments, tools and utensils with antibacterial protection and automatic, sensor-triggered soap and water dispensers.

It may go without saying that the kitchen “should avoid having inaccessible spaces, like corners and crannies, in its structure (pipes, cables, etc.) where dirt can build up”, adds Maite Pelayo.

 

"A facility that allows forward flow and the implementation of SPSA positively reinforces the cleaning and disinfection plan”.

 

A seemingly insignificant gesture such as hand washing can actually save lives, since it has been proven that unclean hands is the top reason for patient contagion. Personal hygiene should be supplemented by scrubs consisting of a coat, mask and cap. Kitchen gloves, however, tend to be phased out or replaced by other materials because "most are made of latex and cause many allergic reactions both in glove wearers and in the people who eat the food they prepare”, adds Maite Pelayo.

The management of hygiene in a hospital kitchen involves periodic fumigation and strict waste control. No waste is discarded in street garbage containers or through the drainage pipes. The management of waste collection, in addition to following established protocol, is outsourced to specialized services.

 

 

According to the World Health Organization (WHO), 50% of healthcare-related infections are the cause of patients’ death and disability. Naturally, these figures include infections related to worldwide health care in general (not specifically related to bad practices in the kitchen) and include both developed and developing countries. However, what stands out about these figures is that by only focusing on hygiene many diseases could be prevented, especially those that are transmitted by contact and by food in some cases, such as salmonella. Whether in the hospital kitchen or in other areas, washing hands with soap—standard or antibacterial—and water or rubbing them with an alcohol solution is crucial before handling food or medicine. As Montse Salles rightly points out, "washing hands saves lives”.

 

Silestone Institute is a pioneer platform in Spain for the exchange of views, the study of hygiene in the kitchen and the dissemination of how it affects people’s health and welfare. Among other outreach materials, the Institute has created a Food Safety Handbook for professionals. It is available free of charge here!