Handler Hygienic Practices and Aerobic Plate Counts of Blenderized Whole Food Tube Feedings among Selected Tertiary and Specialty Hospitals in the National Capital Region, Philippines

Michelle Leslie C. Quiambao-Pablo,1 Cecile Leah P. Tiangson-Bayaga,1 Ernani R. Bullecer2
and Alonzo A. Gabriel1

1 Department of Food Science and Nutrition, College of Home Economics,
University of the Philippines Diliman
2 Department of Nutrition, College of Public Health,
University of the Philippines Manila

Objective. This work presents an updated and broad documentation of current practices of blenderized whole food tube feed (BTF) handlers (n=40) in some tertiary (n=8) and specialty (n=2) hospitals in the National Capital Region, Philippines.

Study Design. Descriptive study

Methods. Survey questionnaire and checklists which reflect processes and practices on BTF production were developed and pre-tested. These tools were then administered to 40 respondents from 8 tertiary and 2 specialty hospitals in the National Capital Region, Philippines. Observations were also recorded concerning BTF handling and administration as well as the sanitation of the preparation facility. The study further conducted additional interviews, and on-the-job observations with the same group of responses and actual demonstration made in the documentation phase.

Results. Not all of the participating BTF handlers were observed to follow even simple personal and workplace hygienic practices. Moreover, not all BTF handlers had previous exposures to food safety systems training, and all test hospitals have yet to establish hazard analysis critical control point (HACCP) plans for BTF. The absence of accredited raw ingredient suppliers for the majority of th BTF facilities, failure to always wash raw materials prior to preparation, and the use of soft-boiled whole eggs were identified as sources of potential microbiological hazards. Total plate count was established to be as high as log10 7.19 CFU-mL-1. Ninety-three percent of the BTFs had plate counts exceeding the acceptable standard limit.

Conclusion. The microbiological quality of the BTFs analyzed was attributed to the observed poor hygienic practices, as well as the inherent microflora of BTF ingredients. Familiarity with good manufacturing practices (GMPs), good hygienic practices (GHPs), and HACCP is recommended to improve the microbiological quality of BTFs. The results of this work may be used as basis for advancing efforts to further improve BTF safely, especially that country had just recently ratified the Philippine Food Safety Act of 2013.

Key Words: enteral nutrition; blenderized whole food tube feeds; enteral feed preparation; food handling practices