LTC Regulations: F441, Infection Control

Any nursing employee preparing or serving food must follow F371, including the portion about no bare hand contact with food.

However, when nursing employees are assisting residents with meals, F441, Infection Control, comes into play. The important aspects of F441 related to meal service concern hand hygiene.

The SOM states: "Hand hygiene is a general term that applies to washing hands with water and either plain soap or soap/detergent containing an antiseptic agent; or thoroughly applying an alcohol-based hand rub (ABHR).

It also states: "Hand washing refers to washing hands with plain (i.e. nonantimicrobial) soap and water."

F441 specifies when hand hygiene must occur. It also specifies when hand hygiene must include hand washing.

For example, hand washing must occur when hands are visibly soiled. Hand washing must also occur before and after eating or handling food. Hand hygiene can include using an ABHR.

F441 defines when nursing employees must wash their hands and when they can use an ABHR.

According to F371, they still cannot touch food with bare hands. If they use gloves, the gloves become contaminated as soon as they touch anything else, just as if they were dining service employees.

Nursing employees using gloves in the dining room really is not practical. They would be changing gloves and washing hands almost constantly. A better approach is a combination of completing as much food handling as possible in the kitchen by dining service employees and using utensils in the dining room.

For example, if toast is buttered in the kitchen as it is being made, that saves a step in the dining room. A fork can then be used to hold the toast in place while a knife is used to spread the jelly in the dining room. Deli papers can also be used, but they are a single use item.

What are you doing to avoid bare hand contact with food while residents are being assisted?