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  • Posted: January 8th, 2012 - 11:46am by Doug Powell

    Florida has only a few restaurants with flawless inspection scores, and chefs who run them offer some tough advice: Hire outside inspectors, treat the ice machine as a potential felon and become fanatical about details that others overlook.

    Mark Brown, executive chef of The Sanctuary Golf Club on Sanibel Island, one of just a half-dozen kitchens to earn perfect inspection scores this past autumn, told Richard Mullins of Tampa Bay Online, "Are the Coke machine nozzles clean? Is the ice machine maintained? Are the trash cans clean? Because when you drag them through a kitchen, they're a great way to transport waste and disease. This is something you have to train on every single day, over and over. … My first year here, I think the staff was ready to hang me."

    To avoid that fate, the most rigorous restaurant operators get out front of the health department inspections. They contract private companies for extra inspections, with standards much tougher than the government's.

    "The good restaurants know the most important thing is to make the customer happy," said Beth Cannon, associate director of quality assurance for the inspection company Steritech Group Inc.

    While some restaurants refrigerate soup in 5-gallon buckets, Brown said that's far too large a container to cool down enough to prevent bacteria growth. So his chefs seal and date soup in small bags, and soak them in ice water before storage in the refrigerator.

    With potentially risky items like oysters, his kitchen keeps records on every one for a year, so any problems can be tracked back to a particular harvester.

    Cross-contamination happens in even the smallest instances.

    For instance, if a dish-washing employee sprays off plates, loads them in the dishwashing machine and then forgets to wash his hands when unloading the machine, he'll track potential illnesses to the clean plates.

    If a kitchen worker stacks boxes of vegetables on the floor, those boxes will track germs from the floor into the refrigerator.

    If a chef prepares patties of raw hamburger, even while wearing gloves, and wipes his hands on his apron, he can track potential bacteria and germs into the "hot" side of the kitchen when grilling burgers.

    If a salad chef accidentally touches his nose and then grabs a head of lettuce, he can potentially transfer hepatitis A.
    Training a kitchen full of employees on all the right practices isn't simple, particularly with the high turnover in the restaurant industry.

    Five Guys uses Steritech for periodic inspections, but it also employs "mystery eaters" to review each location at least twice a week, grading everything from the bathroom floors to the quality of the fries, said Jo Jo Jiampetti, a regional vice president for Five Guys in Tampa.

    "You have to teach every day what the standards are, and hold everyone accountable."

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  • Posted: October 15th, 2009 - 1:31pm by Doug Powell

    A British study by the London School of Hygiene and Tropical Medicine concluded that people are more likely to wash their hands properly after using the toilet if they are shamed into it or think they are being watched.

    As part of a flood of handwashing information for today’s World Handwashing Day, the study, published in the American Journal of Public Health found that with no reminders, 32 percent of men and 64 percent of women used soap.

    The observational study reported on the behavior of people using toilets at motorway service stations in Britain over 32 days.

    When prompted by an electronic message flashing up on a board asking: "Is the person next to you washing with soap?," around 12 percent more men and 11 percent more women used soap.

    Other messages flashed on the electronic boards included:

    • Water doesn't kill germs, soap does; and,
    • Don't be a dirty soap dodger.

    The message that produced the strongest positive response was: "Is the person next to you washing with soap?"

    The researchers also noted "intriguing differences" in the behavior of men and women: While women responded to simple reminders, men tended to react best to messages that invoked disgust, such as:

    • Don't take the loo with you -- wash with soap, and
    • Soap it off or eat it later.

    I like the last one.

    We’ve undertaken both shock and shame attempts at handwashing messages (below). Results pending.

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  • Posted: September 4th, 2009 - 6:21am by Doug Powell

    Food safety researcher and talk-show host Jon Stewart got it right back in 2002 when he said,

    “If you think the 10 commandments being posted in a school is going to change behavior of children, then you think “Employees Must Wash Hands” is keeping the piss out of your happy meals. It's not.”

    Instead, getting college students to wash hands, halt disease, requires giving them proper tools and spreading the word in ways that get attention: the path to poor hand sanitation is paved with good intentions, according to researchers from Kansas State and North Carolina State Universities.

    As college campuses prepare for an expected increase in H1N1 flu this fall, the researchers said students' actions will speak louder than words.

    "Many students say they routinely wash their hands," said Douglas Powell, an associate professor of food safety at Kansas State University. "But even in an outbreak situation, many students simply don't."

    In February 2006, Powell and two colleagues — Ben Chapman, an assistant professor at North Carolina State University, and research assistant Brae Surgeoner — observed hand sanitation behavior during an outbreak. What was thought to have been norovirus sickened nearly 340 students at the University of Guelph in Canada.

    Hand sanitation stations and informational posters were stationed at the entrance to a residence hall cafeteria, where the potential for cross-contamination was high. The researchers observed that even during a high-profile outbreak, students followed recommended hand hygiene procedures just 17 percent of the time. In a self-reported survey after the outbreak had subsided, 83 of 100 students surveyed said they always followed proper hand hygiene but estimated that less than half of their peers did the same.

    The results appear in the September issue of the Journal of Environmental Health.

    Powell said that in addition to providing the basic tools for hand washing – vigorous running water, soap and paper towels — college students, especially those living in residence halls, need a variety of messages and media continually encouraging them to practice good hand hygiene.

    "Telling people to wash their hands or posting signs that say, 'Wash your hands' isn’t enough," said Ben Chapman, an assistant professor at North Carolina State University. "Public health officials need to be creative with their communication methods and messages."

    Most students surveyed perceived at least one barrier to following recommended hand hygiene procedures. More than 90 percent cited the lack of soap, paper towels or hand sanitizer. Additional perceived barriers were the notion that hand washing causes irritation and dryness, along with just being lazy and forgetful about hand washing. Fewer than 7 percent said a lack of knowledge of the recommended hand hygiene procedures was a barrier.

    "Providing more facts is not going to get students to wash their hands," Powell said. "Compelling messages using a variety of media – text messages, Facebook and traditional posters with surprising images — may increase hand washing rates and ultimately lead to fewer sick people."

    University students’ hand hygiene practice during a gastrointestinal outbreak in residence: What they say they do and what they actually do
    01.sep.09
    Journal of Environmental Health Sept. issue 72(2): 24-28
    Brae V. Surgeoner, MS, Benjamin J. Chapman, PhD, and Douglas A. Powell, PhD
    http://www.neha.org/JEH/2009_abstracts.htm#University_Students%92_Hand_Hygiene_Practice_During_a_Gastrointestinal_Outbreak_in_Residence:_What_They_Say_They_DO_and_What_They_Actually_Do
    Abstract
    Published research on outbreaks of gastrointestinal illness has focused primarily on the results of epidemiological and clinical data collected postoutbreak; little research has been done on actual preventative practices during an outbreak. In this study, the authors observed student compliance with hand hygiene recommendations at the height of a suspected norovirus outbreak in a university residence in Ontario, Canada. Data on observed practices was compared to post-outbreak self-report surveys administered to students to examine their beliefs and perceptions about hand hygiene. Observed compliance with prescribed hand hygiene recommendations occurred 17.4% of the time. Despite knowledge of hand hygiene protocols and low compliance, 83.0% of students indicated that they practiced correct hand hygiene during the outbreak. To proactively prepare for future outbreaks, a current and thorough crisis communications and management strategy, targeted at a university student audience and supplemented with proper hand washing tools, should be enacted by residence administration.

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  • Posted: September 1st, 2009 - 10:09pm by Ben Chapman

    Playing the calm, cool Danny Glover to Doug's crazed Mel Gibson, I wanted to contribute to the food safety month discussion.

    I’m not a fan of causes of the month; either an issue is important year-round or it’s not. Food safety month, established sometime in the mid-90s (thanks Google news archives), is supposed to be an awareness-raising time. The goal is to focus consumer food safety communication efforts and coordinate messages.  But does this even work?

    Liz Redmond and Chris Griffith published research in 2006 that showed even targeted, specific social media messages (which isn’t really what is seen in the many food safety month press releases) may impact practices right after the audience is exposed to them, but behavior changes were not sustained 4-6 weeks after being exposed:

    Results suggested that “one-off” food safety interventions developed and implemented using a social marketing approach may result in a short-term improvement of consumer food safety behaviors.

    The unfortunate part about food safety month is that messages get recycled from previous years (sometimes with updated temperatures, sometimes not). It appears that contrary to CDC’s FoodNet report suggestions on enhanced measures, folks are just throwing the same messages year after year. The majority of messages focus on what consumers can do in their home, but few stories exist about what industry, regulators and researchers are doing to address food safety risks. If food safety is a farm-to-fork problem (kind of what HACCP is built on, addressing risks at different points) then our food safety messages need to be farm-to-fork.

    Over a decade of food safety months and we've got the same annual estimate of foodborne illness incidents. If there’s no measurable impact, why bother?

    Let's get rid of the one-off consumer-focused message blitz that is food safety month.

    The best campaign idea I have for food safety month 2009 is a funeral of sorts. The campaign would be focused on lamenting the demise of food safety month and the birth of “Every month is food safety month”.  We can have a New Orleans jazz-type funeral (because they really do them up right with the parade and all) with the cook, chill, clean, separate motto being pulled behind in an elaborate horse-drawn carriage. It will be a somber event for some, but others will rejoice in shedding the tactics that may result in only short-term behavioral changes. New messages and mediums are needed to really affect foodborne illness incidents.

     

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  • Posted: May 27th, 2009 - 10:42pm by Doug Powell

    At some point while endlessly bitching at Chapman to finish his damn thesis and produce some papers, I realized, I wasn’t so good at closing the deal myself.

    I could say I like blogging, being quoted in media, the immediacy of it all, but I also realized I needed the credibility of peer-reviewed publications.

    So after grappling with divorce, the angst of children lost, the joy of remarriage and once again the commitment to an ideal, another kid, I decided that while I was bitching at Chapman, I better take care of my own shop.

    So, with some pride, I announce the first of about a dozen peer-reviewed papers that are going to appear this year.

    Designing effective messages for microbial food safety hazards, which will appear in an upcoming issue of Food Control, by Douglas Powell, Casey Jacob and Lisa Mathiasen, was started by Lisa back in 2003. I told her it was going to be published and she said, “about time.”

    Casey did some excellent improvements, and the thing is coming out.

    Here’s the abstract; I’ll post the full paper info when it’s published.

    Despite numerous food safety information campaigns and educational efforts, microbial foodborne illness remains a significant source of human disease. New food safety messages transmitted using new media are required to enhance food safety from farm-to-fork. A review of the literature reveals that targeting a segment of the population and understanding knowledge, attitudes, and perceptions of the individuals comprising that segment can lead to successful communication of food safety messages. Messages found to be effective are relevant to the target audience, contain reliable information, are rapidly distributed at appropriate times, and are repeated. Those containing information that is easily received and understood have also been found effective. The use of media commonly accessed by today’s consumers is also valuable. Evaluation of the effect of all aspects of food safety messages and media, as measured through observation of recipients’ actions, is required to validate the effectiveness of food safety communications.

    And I’m in love with my partner, cause she’s the meanest editor I’ve ever had.

    And vice-versa.

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  • Posted: May 6th, 2009 - 11:26am by Doug Powell

    Megan Hardigree, a research associate at Kansas State University working on hand hygiene, writes that this year, Cinco de Mayo wasn’t just a holiday to celebrate the Mexican army’s victory over the French in the Battle of Puebla (yesterday) or a song by the band, Cake. It was also a day to celebrate the launch of the World Health Organization’s (WHO) newest hand hygiene campaign: Save Lives: Clean Your Hands.

    The aim of Save Lives: Clean Your Hands is to stop the spread of infection by increasing hand hygiene of healthcare workers. This is said to be the next step of the original, Clean Care is Safer Care, from 2005. The initiative persuades individuals to join the movement with gain-framed messages (they apparently encourage positive behavior) such as “Help stop hospital acquired infections in your country” and “Make patient safety your number one priority.”

    To help support this initiative, WHO has accompanied the promotion with a variety of tools and resources to aid healthcare facilities in promoting and enforcing better hand hygiene. These tools include: tools for system change, tools for training and education, tools for evaluation and feedback, tools as reminders in the workplace, and tools for institutional safety climate. My personal favorite, mostly because of the fun diagram, is in the “tools as reminders in the workplace” which includes “My 5 Moments for Hand Hygiene:”

    • before touching a patient;
    • before clean/aseptic procedures;
    • after body fluid exposure/risk;
    • after touching a patient; and,
    • after touching patient surroundings.

     “Be a part of a global movement to improve hand hygiene, “ says WHO.

    Now to evaluate whether any of these messages actually compel people to wash their hands.
     

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