≥ 92% of participants will know how to handle food safely.
≥ 92% of participants will know how to handle food safely.
After completing this continuing education course, the participant will be able to meet the following objectives:
If you work in a healthcare facility, food safety and diet is primarily done by another department. If you work in assisted living or home care, you may have a bigger responsibility for food safety. Diseases, metals, and poisons in food are called foodborne illness. These illnesses can cause harmful symptoms and death. The symptoms can be immediate or can happen after a long time. A foodborne illness that happens quickly after eating the food is sometimes called food poisoning. Foodborne illness symptoms include upset stomach, diarrhea, vomiting, fever, stomach cramps. Notify your supervisor if you see these problems because the person may need to see a doctor. Food can have metals and poisons that do not cause problems immediately but can build over time. Buy food from a trustworthy source to avoid metals and poisons.
Children and older people are more likely to be harmed by bad food. They also dehydrate more quickly. Older people may have problems getting food or may not know how to cook. Their sense of taste, smell, or vision can be bad, so they may not understand the food can be harmful to their health.
Safe handling of food stops illness. Washing your hands and keeping surfaces clean is very important. Sometimes food is obviously spoiled. But sometimes, metals, poison, and bacteria that can cause illness cannot be seen, smelled, or tasted.
Perishable foods are likely to spoil, decay, or become unsafe to eat if not refrigerated. Meats and cooked leftovers are examples of perishable foods. The FoodKeeper App, developed by FoodSafety.gov, can provide help with recommendations on storing food safely. This app can be downloaded here. It is not safe to store perishable food for more than an hour in areas where the temperature is over 90°F, or 32.2°C.
Non-perishable foods do not have to be refrigerated and are good for a long time. Some non-perishable food must be refrigerated after opening, like mayonnaise or salad dressing. The label will tell you if the open container needs to be refrigerated.
Molds are fungi that can live on foods that are plant or animal. Some molds cause allergic reactions and respiratory problems. Molds may not be visible. Even when you can see the mold, there are probably threads of the mold growing deep into the food that cannot be seen. Mold you can see can look like:
Do not smell mold because it can cause breathing trouble. When food is moldy, throw it away in a plastic bag or wrap to keep animals and children from getting into the harmful food. Clean the area and food around the area where the moldy food was found. Mold spreads quickly in fruits and vegetables.
|Luncheon meats, bacon, or hot dogs||Discard||Foods with high moisture content can be contaminated below the surface. Moldy foods may also have bacteria growing along with the mold.|
|Hard salami and dry-cured country hams||Use. Scrub mold off the surface.||It is usual for these shelf-stable products to have surface mold.|
|Cooked leftover meat and poultry||Discard||Foods with high moisture content can be contaminated below the surface. Moldy foods may also have bacteria growing along with the mold.|
|Cooked casseroles||Discard||Foods with high moisture content can be contaminated below the surface. Moldy foods may also have bacteria growing along with the mold.|
|Cooked grain and pasta||Discard|
(not cheese where mold is part of the processing)
|Use. Cut off at least 1 inch around and below the mold spot (keep the knife out of the mold itself so it will not cross-contaminate other parts of the cheese). After trimming off the mold, re-cover the cheese in fresh wrap.||Mold generally cannot penetrate deep into the product.|
|Cheese made with mold|
(such as Roquefort, blue, Gorgonzola, Stilton, Brie, Camembert)
|Discard soft cheeses such as Brie and Camembert if they contain molds that are not a part of the manufacturing process. If surface mold is on hard cheeses such as Gorgonzola and Stilton, cut off mold at least 1 inch around and below the mold spot and handle like hard cheese.||Molds that are not a part of the manufacturing process can be dangerous.|
(such as cottage, cream cheese, Neufchatel, chevre, Bel Paese, etc.) Crumbled, shredded, and sliced cheeses;(all types)
|Discard||Foods with high moisture content can be contaminated below the surface. The cutting instrument can contaminate shredded, sliced, or crumbled cheese. Moldy soft cheese can also have bacteria growing along with the mold.|
|Yogurt and sour cream||Discard|
|Jams and jellies||Discard||The mold could be producing a mycotoxin. Microbiologists recommend against scooping out the mold and using the remaining condiment.|
|Fruits and vegetables, FIRM|
(such as cabbage, bell peppers, carrots, etc.)
|Use. Cut off at least 1 inch around and below the mold spot (keep the knife out of the mold itself so it will not cross-contaminate other parts of the produce).||Small mold spots can be cut off FIRM fruits and vegetables with low moisture content. It is difficult for mold to penetrate dense foods.|
|Fruits and vegetables, SOFT|
(such as cucumbers, peaches, tomatoes, etc.)
|Discard||SOFT fruits and vegetables with high moisture content can be contaminated below the surface.|
|Bread and baked goods||Discard||Porous foods can be contaminated below the surface.|
|Peanut butter, legumes, and nuts||Discard||Foods processed without preservatives are at high risk for mold.|
Buying small amounts of food and using food quickly can help prevent foodborne illness. Buy from a reliable place. The government has a labeling process enforced by the United States Department of Agriculture (USDA). Labeling is required to educate the buyer about the product. When shopping, select refrigerated or frozen food after you are done shopping for non-perishable food. Do not buy meat that has a torn or leaking package. Do not buy dented, rusted, or swollen cans. Do not buy damaged containers. The food inside may be spoiled. Check expiration dates. Discount stores and on-sell food items may be close to expiring. They are cheap and can be eaten but cannot be kept long. The definition of labels are (100+ Non-Perishable Foods - Foods That Don't Expire for a Long Time, 2021):
Fish and shellfish are easily contaminated with metals and poisons if caught in a place where the water is contaminated. Find out if fish or shellfish came from a safe place if not bought in a place that follows USDA food requirements. Do not fish in water where manufacturing waste, sewage, fertilizer, and pesticide runoff happens. Raw fish and shellfish can have bacteria even if bought in a reliable place. Some raw fish (sushi) are poisonous to eat if not prepared correctly.
Do not pick and eat wild mushrooms or berries without knowing which ones are safe and which ones are poisonous. Raw milk is more likely to be contaminated than pasteurized milk products bought in a store. Do not harvest wild shellfish if the shellfish is not entirely submerged all the time. The shellfish that is out of the water for parts of the day is bad.
Bacteria grow in warm moist places. Refrigeration slows bacteria growth but does not stop it. Refrigerate perishable food within 2 hours of buying. Refrigerate perishable food if it is too hot. The temperature of the refrigerator and freezer has factory settings and resets. They can be adjusted. The refrigerator should be set at 40°F or 4.4°C. The freezer should be set at 0°F or -17.7°C (Basics for Handling Food Safely, 2015). Wrap meats tightly to avoid leaking.
Proper non-perishable storage is in a cool, dark, dry area. The worst places to store non-perishable food is under a sink, near the stove, or in the garage because these places are more likely to be moist and have temperature changes that damage the food. Cans should be stored in temperatures less than 90°F or 32.2°C and above freezing (100+ Non-Perishable Foods - Foods That Don't Expire for a Long Time, 2021).
Canned food is good for a long time. High acid food like tomatoes and fruits should be used within 18 months. Low acid food can keep for 2-5 years. Do not use cans if they are dented, rusted, or swollen. Many foods are safe to eat past their expiration date if stored properly. Do not use anything that looks or smells bad. Bad appearance includes mold, dark or oily appearance, water damage, or pest infestation. Non-perishable food that lasts a very long time, if kept in an airtight container in a cool, dry, dark place include (100+ Non-Perishable Foods - Foods That Don't Expire for a Long Time, 2021):
These short but safe time limits will help keep refrigerated food from spoiling or becoming dangerous to eat. Because freezing keeps food safe indefinitely, recommended storage times are for quality only (Basics for Handling Food Safely, 2015).
|Fresh, in shell||3 to 5 weeks||Do not freeze|
|Raw yolks & whites||2 to 4 days||1 year|
|Hard cooked||1 week||Does not freeze well|
|Liquid pasteurized eggs, egg substitutes|
|Opened||3 days||Does not freeze well|
|Unopened||10 days||1 year|
|Refrigerate after opening||2 months||Do not freeze|
|Frozen Dinners & Entrees|
|Keep frozen until ready to heat||—||3 to 4 months|
|Deli & Vacuum-Packed Products|
|Store-prepared (or homemade) egg, chicken, ham, tuna, & macaroni salads||3 to 5 days||Does not freeze well|
|Hot dogs & Luncheon Meats|
|1 week||1 to 2 months|
|2 weeks||1 to 2 months|
|3 to 5 days||1 to 2 months|
|2 weeks||1 to 2 months|
|Bacon & Sausage|
|Bacon||7 days||1 month|
|Sausage, raw — from chicken, turkey, pork, beef||1 to 2 days||1 to 2 months|
|Smoked breakfast links, patties||7 days||1 to 2 months|
|Hard sausage — pepperoni, jerky stick||2 to 3 weeks||1 to 2 months|
|Summer sausage labeled "Keep Refrigerated"|
|Opened||3 weeks||1 to 2 months|
|Unopened||3 months||1 to 2 months|
|Corned beef, in a pouch with pickling juices||5 to 7 days||Drained, 1 month|
|Ham, canned labeled "Keep Refrigerated"|
|Opened||3 to 5 days||1 to 2 months|
|Unopened||6 to 9 months||Do not freeze|
|Ham, fully cooked|
|Vacuum sealed at the plant, undated, unopened||2 weeks||1 to 2 months|
|Vacuum sealed at the plant, dated, unopened||"Use-By" date on the package||1 to 2 months|
|Whole||7 days||1 to 2 months|
|Half||3 to 5 days||1 to 2 months|
|Slices||3 to 4 days||1 to 2 months|
|Hamburger, Ground & Stew Meat|
|Hamburger & stew meat||1 to 2 days||3 to 4 months|
|Ground turkey, veal, pork, lamb, & mixtures of them||1 to 2 days||3 to 4 months|
|Fresh Beef, Veal, Lamb, Pork|
|Steaks||3 to 5 days||6 to 12 months|
|Chops||3 to 5 days||4 to 6 months|
|Roasts||3 to 5 days||4 to 12 months|
|Variety meats — tongue, liver, heart, kidneys, chitterlings||1 to 2 days||3 to 4 months|
|Pre-stuffed, uncooked pork chops, lamb chops, or chicken breasts stuffed with dressing||1 day||Does not freeze well|
|Soups & Stews|
Vegetable or meat added
|3 to 4 days||2 to 3 months|
|Chicken or turkey, whole||1 to 2 days||1 year|
|Chicken or turkey, pieces||1 to 2 days||9 months|
|Giblets||1 to 2 days||3 to 4 months|
|Cooked Meat and Poultry Leftovers|
|Cooked meat & meat casseroles||3 to 4 days||2 to 3 months|
|Gravy & meat broth||3 to 4 days||2 to 3 months|
|Fried chicken||3 to 4 days||4 months|
|Cooked poultry casseroles||3 to 4 days||4 to 6 months|
|Poultry pieces, plain||3 to 4 days||4 months|
|Poultry pieces in broth, gravy||3 to 4 days||6 months|
|Chicken nuggets, patties||3 to 4 days||1 to 3 months|
|Other Cooked Leftovers|
|Pizza, cooked||3 to 4 days||1 to 2 months|
|Stuffing, cooked||3 to 4 days||1 month|
Wash your hands with warm water and soap for 20 seconds before and after handling food. Fresh food and vegetables should be washed to remove pesticides and dirt. Keep raw meat and their juices away from other food. After cutting raw meats, wash the cutting board, utensils, and countertops with hot, soapy water. Marinating meat should be placed in a covered dish and kept in the refrigerator.
The refrigerator allows slow, safe thawing of frozen food items. Make sure thawing meat and poultry juices do not drip onto other food. Frozen food can be put in cold tap water in a leak-proof container or plastic bag for faster thawing. Be sure to change the water every 30 minutes. The microwave can also be used for thawing. The food should be cooked immediately after thawing (Basics for Handling Food Safely, 2015). Meat and poultry defrosted in the refrigerator may be refrozen before or after cooking. Do not refreeze if thawed another way; cook before refreezing (Basics for Handling Food Safely, 2015).
Cook the food thoroughly to kill bacteria and parasites. Cook food at the recommended sage internal temperature (Table 3). Use a meat thermometer to check the internal temperature if needed. Do not eat cooked meat if there is blood when cut. If you see blood, cook the meat more. Some people prefer rare beef or raw seafood. That is a choice, but there is a risk of infection, parasites, and poisoning. Pork and chicken are likely to have parasites if not thoroughly cooked. Refrigerate cooked food promptly. Cook or freeze fresh poultry, fish, ground meat, and variety meats within two days of purchasing. Use cooked leftovers within four days. Reheat leftovers to 165 °F (73.9 °C). Beef, veal, lamb, or pork should be cooked or frozen with 3-5 days. Fish and shellfish from a contaminated source are dangerous. Do not eat them because they are caught in a water source with a large drain off chemical or animal waste.
|Cook foods to the following safe internal temperatures as measured with a food thermometer:|
|Fresh ground beef, pork, lamb, veal||160°F|
|Beef, pork, lamb, and veal (roasts, steaks, chops)*||145°F|
|*as measured with a food thermometer before removing meat from the heat source. For safety and quality, allow the meat to rest for at least three minutes before carving or consuming. For reasons of personal preference, consumers may choose to cook meat and poultry to higher temperatures.|
|Ham, cook before eating*||145°F|
|Ham, fully cooked, to reheat||140°F|
|Poultry, whole, parts or ground||165°F|
|Egg dishes, casseroles||160°F|
|Leftovers, to reheat||165°F|
|Hot dogs, luncheon meats, bologna, and other deli meats||165°F or until steaming hot|
When serving food in a buffet style, hot food should be kept at a temperature of 140 F (60°C) or warmer and cold food should be kept at a temperature of 40°F (4.4ºC) or colder. To keep food hot, use chafing dishes, slow cookers, and warming trays. Food can be kept cold by nesting dishes in ice or replacing the cold dish often. Perishable food cannot be out for more than 2 hours at room temperature or 1 hour if the temperature is above 90°F (32.2ºC).
Hot food that is bought or delivered needs to be eaten within two hours. If that cannot happen, refrigerate the food.
Reheating food to a temperature that is not hot enough can cause foodborne illness. Reheat food thoroughly to a temperature of 165°F or until hot and steaming. Check microwave directions for cooking time and power level.
Throw out any food left out at room temperature for more than 2 hours or 1 hour if the temperature is above 90°F (32.2ºC).
Some people have special diets because of medical conditions. The most common are diabetic, cardiac, and renal diets. Special diets may also have limits on the amount of fluid. You should have access to a written list of foods and fluids that meet the special diet. If not, ask the supervisor or patient. Some patients need to have their fluid intake and urine output (I&O) measured. Tracking I&O is important because the nurses and doctors make decisions based on this information. If the I&O is not accurate, the patient may receive treatment or have treatment held back that can cause harm or death.
You are responsible for making accessible, providing, and recommending allowable foods and fluids from the list. You are never responsible for policing the patient's diet. Individuals have the right to choose not to follow the diet. A gentle reminder is allowable, but it is the patient's choice. Report non-compliance to your supervisor so they can educate the patient further or expect patient problems.
You enter a new homecare assignment for a 78-year-old person. When you enter, you notice the temperature in the home is very hot. The patient is in the living room with the windows open and a fan on the patient. You see a package of ground beef on the kitchen counter. The kitchen has no open windows and no fan. The ground beef is leaking bloody fluid and looks whitish gray. In discussion with the patient, you mention that the ground beef is not refrigerated and looks spoiled. The patient agrees with you but says there is no more meat in the house, and the patient cannot move around to put food in the refrigerator. You tell the patient the meat looks spoiled and recommend the meat be thrown away. The patient agrees, and you dispose of the meat. You call your supervisor about the situation. The RN makes an emergency visit to do a safety assessment and arrange meals. It is good that the patient agreed to throw away the meat. The patient may not have agreed because of the lack of funds to buy more food.