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BMC Health Services Research
Research article

BioMed Central

Open Access

Food safety in hospital: knowledge, attitudes and practices of nursing staff of two hospitals in Sicily, Italy
Cecilia Buccheri1, Alessandra Casuccio2, Santo Giammanco1, Marco Giammanco1, Maurizio La Guardia1 and Caterina Mammina*3
Address: 1Division of Physiology and Human Nutrition, Department of Medicine,Pneumology, Physiology and Human Nutrition, University, Via A. Elia, 90127 Palermo, Italy, 2Department of Clinical Neurosciences, University, Via L. Giuffrè, 90127 Palermo, Italy and 3Department of Hygiene and Microbiology "G. D'Alessandro", University, Via del Vespro 133, 90127 Palermo, Italy Email: Cecilia Buccheri - cebucc@libero.it; Alessandra Casuccio - casuccio@unipa.it; Santo Giammanco -giammanc@unipa.it; Marco Giammanco - giammanco@unipa.it; Maurizio La Guardia - laguamau@unipa.it; Caterina Mammina* - diptigmi@unipa.it * Corresponding author

Published: 3 April 2007 BMC Health Services Research 2007, 7:45 doi:10.1186/1472-6963-7-45

Received: 5 January 2007 Accepted: 3 April 2007

This article is available from: http://www.biomedcentral.com/1472-6963/7/45 © 2007 Buccheri et al;licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background: Food hygiene in hospital poses peculiar problems, particularly given thepresence of patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. Moreover, in nosocomial outbreaks of infectious intestinal disease, the mortality risk has been proved to be significantly higher than the community outbreaks and highest for foodborne outbreaks. On the other hand, the common involvement in the role of food handlers of nurses ordomestic staff, not specifically trained about food hygiene and HACCP, may represent a further cause of concern. The purpose of this study was to evaluate knowledge, attitudes, and practices concerning food safety of the nursing staff of two hospitals in Palermo, Italy. Association with some demographic and work-related determinants was also investigated. Methods: The survey was conducted, by using asemi-structured questionnaire, in March-November 2005 in an acute general hospital and a paediatric hospital, where nursing staff is routinely involved in food service functions. Results: Overall, 401 nurses (279, 37.1%, of the General Hospital and 122, 53.5%, of the Paediatric Hospital, respectively) answered. Among the respondents there was a generalized lack of knowledge about etiologic agentsand food vehicles associated to foodborne diseases and proper temperatures of storage of hot and cold ready to eat foods. A general positive attitude towards temperature control and using clothing and gloves, when handling food, was shared by the respondents nurses, but questions about cross-contamination, refreezing and handling unwrapped food with cuts or abrasions on hands were frequentlyanswered incorrectly. The practice section performed better, though sharing of utensils for raw and uncooked foods and thawing of frozen foods at room temperatures proved to be widely frequent among the respondents. Age, gender, educational level and length of service were inconsistently associated with the answer pattern. More than 80% of the respondent nurses did not attend any educational course onfood hygiene. Those who attended at least one training course fared significantly better about some knowledge issues, but no difference was detected in both the attitude and practice sections. Conclusion: Results strongly emphasize the need for a safer management of catering in the hospitals, where non professional food handlers, like nursing or domestic staff, are involved in food service...
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