الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hospital food services and patients’ nutrition are essential components of health care and food services department has been considered as one of the main departments of the hospital. These services can have a major influence on the nutritional intake of hospitalized patients who are vulnerable and -#119;-#104;-#101;-#114;-#101; the possibility for malnutrition is well recognized. br A large proportion of hospital patients depends upon hospital food as their only source of nutrition. Therefore, provision of acceptable food for patients is essential and it is the main factor in ensuring that patients have adequate nutrition to recover -#102;-#114;-#111;-#109; their illness br Moreover, the matter of food safety in hospitals is considered a great challenge due to the countless potential risks of hospital food -#102;-#114;-#111;-#109; preparation to the patient’s tray. br In addition, patient’s opinion of hospital food services is one of the factors that contribute to a successful hospital food services. Improved hospital food services can be achieved by identifying patients’ expectations, perceptions and how they want the service to be provided. br Therefore, the current study was conducted and aimed to study food services for inpatients in Sohag University Hospital, identify knowledge and compliance of food services employees with hygienic practices of food handling, determine inpatients’ satisfaction towards the provided food services and points of dissatisfaction and determine whether hospitalized patients receiving nutritional advice related to their disease condition provided by health services providers in the hospital or not. br This study is a cross sectional hospital based study conducted in Sohag University Hospital in the kitchen concerned with inpatients food supply to assess inpatients food services and in Internal medicine department, general surgery department, obstetrics and gynecology department in Sohag University Hospital. br Data was collected by using a check list filled through direct observation of the kitchen concerned with inpatients food once every 2 weeks during the study period and through asking the concerned staff and by anonymous questionnaires filled through examining medical files of the studied inpatients and personal interviews with them for assessing their satisfaction towards the provided food services and with employees of inpatients’ food services department concerned with inpatients food handling and domestic workers helping in inpatients’ food services for determining their knowledge and compliance with hygienic practices of food handling. br The findings of this study revealed a number of deficiencies -#119;-#104;-#101;-#114;-#101; assessment of different aspects of food services in Sohag University Hospital pointed to obvious gaps as regards facilities, food hygiene, equipment, personal behavior and sanitation. br In addition, findings revealed also defective staffing of food services department with no role in menu planning, nutritional counseling and no contact with patients to identify preferences and complaints. br Results also showed lack of communication between treating physicians and dietary staff, negligence of nutritional assessment and screening on admission and lack of attention to food type determination and documentation by most of the treating physicians in the hospital. br Moreover, results of the current study revealed defective food safety knowledge and inadequate practices of some of the studied employees -#119;-#104;-#101;-#114;-#101; 48.1% and 42.6% had scores less than 50% in knowledge and practices respectively with significant effects of their educational level and work activity on both knowledge and compliance with hygienic practices of food handling and a strong highly significant positive association between overall knowledge and practice scores (r = 0.8). br None of the employees reported that they receive initial health education or attend any training courses on food hygiene and food borne diseases. br Of the studied inpatients 15.7% reported that they don’t receive 3 meals per day and 31.4% weren’t satisfied by meal timing. Only 39.6 % of the respondent inpatients were advised by the treating physician about the appropriate diet while 60.4% reported that they weren’t advised about diet appropriate for their health condition. None of the respondents reported that they have been asked about their preferred food. br The prescribed food type for the respondents was only documented in 4.7% of the examined files. On the other hand, no food type was documented in 95.3% of the examined files. Body weight, body height, BMI measurements on admission, follow up body weight measurement and any other data about nutritional risks screening on admission were found to be not documented at all the examined files. br 39.2% of the studied inpatients didn’t eat the provided hospital food and all of them get food -#102;-#114;-#111;-#109; outside the hospital due to a variety of reasons -#119;-#104;-#101;-#114;-#101; about fourth (24.6%) of respondents reported that they felt hungry between meals, 18.7% reported that the amount of hospital food was inadequate, the unpalatable way of cooking was the reason why 16.3% of them got food -#102;-#114;-#111;-#109; outside the hospital. Of the respondents 14.2% reported that they didn’t like hospital food, 8.8% reported that hospital food was not suitable for their condition, 6.6% wanted other food types, 6.1% didn’t have appetite and 2.5% of them brought food -#102;-#114;-#111;-#109; outside the hospital because of domestic workers were portioning and serving food. br Moreover, the satisfaction rate among the group eating hospital food was 64.2% referring to inadequate food services in the hospital. Different aspects of hospital food services were significantly associated with inpatients overall satisfaction with food services including served food quality, staff/service issues and hot food factors, food quantity and physical environment respectively. br Based on the results of the present study, it is recommended that food preparation and portioning should be in one well prepared, more sanitary area inside the hospital, continuous education and training programs should be provided on regular basis to food services employees, dietitians specialized in clinical nutrition should be included in the staffing of food services department, food suitable for inpatients health problems should be provided. br br Conclusions br This study concluded that: br • Provision of adequate safe food for inpatients meeting their needs and expectations, with monitoring and improving their nutritional status is a complex multidisciplinary process depending on many factors and require close connection between clinical and catering staff and these goals are not reached without qualified trained employees receiving continuing regular education. br • Adoption of food safety standards, prerequisite programs and the Hazard Analysis and Critical Control Point (HACCP) plans in food services department for hospitalized patients is a necessity for the provision of safe food br • Clinical nutrition staff have an essential role in providing food meeting inpatients needs and must be included in the staffing of food services department. br • Continuous training and education of food services employees is very important to make food services employees adopt safe food handling practices. br • Educating inpatients about their nutritional needs and considering their preferences, perceptions, needs and complaints is essential to guarantee the provision of effective successful food services with high quality. br RECOMMENDATIONS br Recommendations br Based on the results of the present study, it is recommended that: br 1-As the preparation area is away -#102;-#114;-#111;-#109; portioning area, food is more liable to be contaminated and temperature of food is affected during transport so food preparation and portioning should be in one well prepared, more sanitary area inside the hospital. br 2- Implementation of prerequisites programs to control hazards associated with the food services environment (the establishment, infrastructure, personnel and equipment), a step needed prior to the implementation of HACCP and which is essential for food safety. br 3- Food temperature and food protection -#102;-#114;-#111;-#109; contamination during transport, storage and serving should be taken into consideration. br 4- Provision of protective closing and gloves for food services employees. br 5-Food services department should be more organized with predetermined clear suitable job descriptions for employees. br 6- Strict continuous follow up and supervision on the process of food preparation, portioning and distribution of meals to patients as regards sanitation and food hygiene and meals timing. br 7- Regular inspection of food services employees for identifying and excluding sick employees and provision of sufficient number of employees to allow for exclusion of sick employees. br 8- Provision of continuous education and training programs on regular basis to food services employees regarding food hygiene, food borne diseases and safe food handling practices. br 9- Provision of dietitians specialized in clinical nutrition for proper menu planning, determination of nutritional needs for different patients, nutrition education and counseling for inpatients during hospitalization and on discharge. br 10-Enhancing patients’ satisfaction through providing food suitable for their health problems and asking them about their food preferences and the deficiencies they observed in hospital food services. br 11- Domestic workers should not be involved in food services for inpatients and tray service employees should be available. br 12- Medical staff should focus on the role of inpatients’ nutrition and the importance of implementation of on admission nutritional screening and nutritional counseling for inpatients. br 13- Attention should be paid for determining and documenting food type prescribed by the treating physician.