Medical ID in foodservice kitchens: ankle and shoe alternatives

Terri Waller, a Master of Public Administration student at Troy University and a certified food safety manager and instructor, writes in this guest blog:

I come from a long line of diabetics, Type I and II. We hold the importance of medical identification jewelry close to our hearts — literally. Being a foodservice professional and having to wear medical identification jewelry myself, it’s sad that the only piece of jewelry approved to be worn by foodservice professionals working in kitchens is a plain band ring.

Foodservice professionals (owners, managers and policy makers) should be made aware of alternatives to medical identification wrist bracelets and medical identification necklaces. In a life or death situation it’s more important to me for my colleagues to know that I am diabetic or allergic to penicillin instead of them knowing that I am married or in a committed relationship.

Medical Identification started with military Dog Tags, which evolved into Medical Bracelets. The dog tags were primarily used for the identification of the dead and wounded along with providing essential basic medical information for treatment. During World War I an additional red tag with pertinent information was issued and worn with the dog tags to identify military members with medical conditions that required special attention.

Because foodservice professionals are not able to wear wrist bracelets or necklaces, here are two life-saving alternatives: ankle braclets or shoe tags.

If an individual is unconscious or otherwise unable to communicate, when an Emergency Medical Technicians (EMT) arrives on the scene they are trained to look for medical identification information to communicate to them any vital information when time is crucial. It is important that hiring/HR managers as well as employees are aware of these alternatives because they can be the difference between life and death. EMTs serve as a means for people to get access to medical care in times when they are in most desperate need for it—help them save a life by informing managers and employees on the alternatives.

Colts win in stunner; stadium food service company denies media access to witness food safety improvements

Maybe it was the stadium food that somehow lifted the Indianapolis Colts to a stunning come-from-behind 35-34 victory over the New England Patriots in another chapter of the U.S. football rivalry of the decade, Peyton Manning (right) versus Tom Brady (below, left).
After being hammered by local health types, the folks who run the food concessions at Lucas Oil Stadium swooped into town and promised to set things straight. WISH went out to ask some tailgaters to see how confident were about buying food inside the stadium.

Tailgater Glen Vigar reacted to the news,"(It’s) a little scary. I mean it’s a brand new building. I wouldn’t expect it."

Vigar said that he wouldn’t eat the food there anymore.

Centerplate said it planned to have 15 of its own food safety inspectors inside the stadium Sunday to make sure conditions are clean.

24-Hour News 8 had asked to be inside the stadium to see how that was going, but a Centerplate spokesperson denied that request.

Supermarket Guru says stickers on clamshells a good food safety idea to go

Supermarket Guru picked up on our food safety stickers for takeout food and suggested it was one way retailers could turn food safety into a competitive advantage, and wrest takeout business from nearby restaurants.

Which was exactly one of our thoughts when we began experimenting with food safety stickers about five years ago.

While doesn’t know the full details of their proposed label, we suggest that besides basic date and serving information, it also clearly states whether a food might contain allergens like peanuts or gluten. In our opinion, supermarkets have failed so far to truly differentiate themselves in prepared foods and easy takeout. This is one value-added step that could help food stores retain the takeout volume that fell in their laps when the economy cratered, and people curbed their restaurant visits. They didn’t really earn the windfall, but they got it, and now they have to address consumer concerns about food safety in order to burnish their image as takeout sources.

Perhaps a special opportunity for this approach is in the small-format stores modeled after Tesco’s Fresh & Easy, which emphasize takeout offerings, and are already battling convenience stores, which are stepping up their meal programs. Safe food-handling stickers could add professionalism to the displays and confidence in consumers, and make the prepared foods section a more frequent destination.

We’ll work with anyone who is interested in developing the sticker concept for their own food business — large or small. Any new sticker would have a different phone number and website than those depicted (below) and would be based on research tailored to a specific operation.

Customer can’t get south of the border, shoots Taco Bell staff

It must suck to work in food service. Minimum wage, nerds like me telling staff to pay attention to food safety, and occasionally getting shot at by customers.

A man who was refused service around three in the morning by staff at Taco Bell on the outskirts of Miami waited outside in his white sports utility vehicle and when staff exited, he shot and wounded one female employee in the leg.

The victim was treated at a local hospital. Police are asking for help with their inquiry.

Top 5 Records top ten list of riskiest foods

I love High Fidelity. The book introduced me to Nick Hornby, the movie introduced me to Jack Black and the soundtrack introduced me to Bruce Springsteen.

Okay, I knew about the Boss before, but the soundtrack indirectly led me to discover Thunder Road (which has helped me forget Dancing in the Dark).

The High fidelity-esque, Top 5 Records Rob Gordon-style, Center for Science in the Public Interest released a list of the top ten "riskiest" foods.

I place riskiest in dick fingers not because I want to be a dick, but because I don’t think that’s the right word. The list has been generated through data collected from CDC outbreak listings, state health departments and other various sources. The list should be called "The top 10 foods that are in dishes with foods regulated by the FDA, at some point, which have caused the most microbial foodborne illness outbreaks". But that title is too long.

CSPI is better than anyone else at pulling this stuff together and has an outbreak database that I use all the time. The missing bit of information which is not captured in the list (but is alluded to a bit in the report) and is needed to put the info into context is where did the contamination occur or where was the risk reduction step missed. What is the attributed source?

Source alone doesn’t matter, food alone doesn’t matter but putting those two data sources together allows for a concentration on where risk reduction efforts are needed.

Potatoes are the food on the list I have the most problem with. And it’s not because I have a soft spot for Idaho or Prince Edward Island. It’s because the outbreaks that place potatoes on the list are associated with potato dishes. It just happens that potato salad is consumed a lot, is prepared alongside other foods that carry risks by foodhandlers who might suck at hygiene. Potato dishes (mainly because of the additon of other foods) also create a great medium for pathogens. Potatoes aren’t on this list because potatoes are a particularly risky food.

The report says that over 40% of the included potato outbreaks were linked to foodservice or processing. 60% come from elsewhere (which probably includes community dinners, festivals, and in-the-home). Should I not eat potatoes, or should I not eat potato dishes? What about potato chips? 

That information matters when it comes to dedicating resources to address the risky foods. It’s not a potato problem, it’s not an FDA regulated-food problem. Food safety is a farm-to-fork, almost every food, food handling problem.

The Zoonoses Diaries: Caught at Cat town

 Vet school doesn’t leave much time for extracurricular activities (especially during second year classes), but I try my best to stay relatively well rounded throughout these four years of academic boot camp. One of my favorite weekend activities is Cat town, a tailgating area near the football stadium here at K-State. (Doug talked about it yesterday)  Each home football game has a different Vet med-associated club volunteer to help serve food at Cat town, and yesterday’s game against Tennessee Tech was CVMF’s day (Christian Veterinary Medical Fellowship).  As a CVMF member, I helped to set up and serve lunch to the tailgaters. In typical vet student fashion, some brought their pets to the event. One of my classmates has two beautiful black-capped caiques that are always a big hit at Vet med events, and we had them strategically placed at the t-shirt selling booth to attract people to support the second year class.

Now to defend myself, when serving I wore my food-serving plastic gloves in aseptic fashion. I didn’t touch my face with my fingers or sneeze into my hands. I wish there would’ve been hand sanitizer available before I put my gloves on, because serving food hygienically involves a combination of good hand washing and regular glove changes.  We only had one server touching food directly (handing out burger buns) and everyone else used a utensil such as a spoon, knife or tongs to serve food along with gloves. During the slower parts of the afternoon, I would take breaks to chat with people and often drift over to see the birds, Monty and Apple (right). They are very charming little creatures, so I took full advantage of holding them and kissing them (glove-free).  

Lo and behold, who shows up to Cat town but my food-safety boss Doug Powell. He eyes my classmate and I suspiciously as we hold the birds on our fingers and give them kisses on the beak, all while enjoying burgers and cake (pretty much doing everything the CDC recommends avoiding).  Amy and Sorenne got an especially close look at the birds. In the background Doug said, “Keep that Salmonella factory away from my baby.” There’s the Doug I know, always thinking about the potential pathogens.

Later in the afternoon I chatted with my classmate about her food safety practices with the birds. She goes on to tell me that she frequently consumes food around her birds, and has never had any sickness in the past that could be related to the birds. While feeding the birds potatoes salad from her own fork, she tells me that she may have gotten Salmonella from them in the past, but she’s been around them so much that her body may have developed a tolerance to the bacterium. She has never has them tested to see if they carry Salmonella in their feces, though most birds do.

I’m thankful that my classmate has never had any sickness related to her birds, but that may not be the case for the rest of the nation. The young, elderly and other immunocompromised individuals are most likely to contract a zoonotic disease when handling pets. Practicing good food safety habits such as washing your hands thoroughly and cooking your meat to the proper temperature can help reduce the risk of food borne disease. Also, don’t kiss animals to allow them to lick your face, especially not in front of your boss.

No baby shoes, no service at Burger King

Sorenne turns 8-months-old tomorrow. Being in Florida, Amy bought her some flip-flops. But that’s about it for shoes.

However, a Burger King manager took the no shirt, no shoes, no service policy to some extremes and threatened to call police on a mom because her 6-month-old baby wasn’t wearing shoes in the restaurant.

Seriously, who would want to put a six month old on the floor of a Burger King?

The video below explains:

Could video games be a key to food handler training effectiveness?

Food handler training, required or encouraged in various jurisdictions across North America has been demonstrated by multiple studies to have various results. Most of the published research has focused on looking at inspection results, but in 2000, researchers in Oregon (April 2009 issue of Foodborne Pathogens and Disease) explored food handler food safety knowledge.

During April–September 2000 researchers administered a 28- question survey distilled from a longer survey obtained from the Oregon Food Handler Certification Program with 407 food handlers from 67 randomly-selected restaurants.The researchers found that their participants averaged 68% on the test. Significant differences were observed between managers’ average test scores and those of line staff: 74% versus 67%, respectively, and those with Oregon food handler training scored 69%, while those without one scored 63%.

Meatloaf sang that two out of three ain’t bad, but in food safety training, retention-wise, it’s not great.

The researchers conclude that survey demonstrates a limited level of knowledge among foodhandlers about food safety and that analyzing knowledge and comparing concurrent restaurant inspection scores would strengthen the understanding of food safety in restaurants.  The results of the survey also emphasize the need for educational programs tailored to improve foodhandlers knowledge of foodborne diseases.

I’d add that it’s not like knowledge translates automatically into practice. Demonstrating knowledge change is interesting, but not nearly as important as behavior change.

Food handlers need some sort of basic training, but it’s up to their managers and organization to make sure they stay up-to-date and that they have some sort of ongoing reminders (like food safety infosheets.

Reuters reports on a strategy for training that might have some applications with food handlers — video game simulations.

Many businesses use serious videogames designed for the PC but Hilton Garden Inn (HGI) has taken the virtual training concept portable for the first time with "Ultimate Team Play".

Working with North Carolina-based game developer Virtual Heroes, HGI has created a videogame for Sony’s PSP (PlayStation Portable) that allows employees to practice their jobs before they have to interact with customers.

It has the potential to be pretty cool and useful especially if used to demonstrate the team-like nature of foodservice and risk identification, but if it’s pulled off cheaply it could look like Duck Hunt.

Food handlers don’t have time

Researchers at Kansas State published the results of a study of the barriers to food safety practices of food handlers.  Conducting focus groups with 159 food handlers, split into 2 groups, the researchers report that food handlers not only have a lack of food safety knowledge but also often a lack of understanding why employees should comply with food safety guidelines.

Yep. Totally.  So what do we do about it?

The recommendations the researchers provide are:
-Provide regular food safety training to their foodservice employees;
(sure, except training for knowledge change on it’s own doesn’t do much, as they state in their press release)
-Educate employees about the consequences of improper food handling to improve attitudes toward food safety; (we prefer to use “compel” instead of educate, education is too limiting).
Place signs about consequences of improper food handling in food production areas; (kind of like our food safety infosheets?)
And three food safety culture ideas — (at barfblog we’ve been talking about food safety culture for a while, as have Frank Yiannas and Chris Griffith):
Encourage food safety compliance with verbal reminders and praise;
-Be good role models;
-Incorporate food safety practices into employees’ daily routines to eliminate the perceptions that they do not have time to perform them.

Hey this is great — but what’s missing is the how. Just telling managers to make more time for food handlers isn’t very realistic. Food safety communications types, us included, need to get out and start testing food safety culture and measure behavior. And share the results so everyone can build on it.

I presented some similar findings of food handler barriers at IAFP 2007 and some qualitative data on food safety practices at food service (highlighting time pressures especially) at IAFP 2008. I don’t think the solution to time pressures is telling the industry to slow down, or more "education". I think we need to engineer processes and equipment (like self sanitizing knives), look to new tools (like using sanitizer during busy times, instead of handwashing) — and test them. If they work, and they don’t slow the kitchen down, it’s an easy sell.

Our research in food safety culture needs to move to show me, don’t tell me.

Food workers: If you’re sick, stay at home

The Delaware County Health Department and others in Indiana are starting to crack down on food establishments that lack a policy of excluding employees from work if they have one of five illnesses.

The Star Press reports that during recent inspections, the county health department instructed the following establishments to have an employee illness/infection control policy in place by January: Gene’s Lounge, Pilot/Subway in Daleville, McDonald’s in Daleville, Byrd’s Landing Bar and Grill, Cowan Elementary and High schools, Central High School, Daleville Elementary and High schools and Papa John’s on Madison Street.

Robert Murphy, manager of the Fazoli’s in Muncie, said,

"We have posted something in back that lets all employees know what the new policy is. It’s really a good idea to post it so everybody knows about it. The flu season will be coming up before you know it."

Keith Ramsey, manager of MCL Cafeteria at Muncie Mall, said,

"We are in business to serve good, wholesome-cooked food to nourish bodies. If people are sick, they need to stay home."

The state health department says food service operators might not be comfortable discussing "private" matters like diarrhea, vomiting and boils, but for the spread of disease to be prevented, illnesses and symptoms must be discussed.