Section 250.1610  Dietary Department Administration

a)         Organization

            There shall be an organized department of dietetics, and a well defined plan of operation designed to meet the needs of the patients whether the services are centralized, decentralized or provided under contractual agreement.

b)         Staffing:  Dietetic Service Director

            The dietetic department shall be directed by a full-time person who is qualified by dietetic and food service management training and experience, preferably a registered dietitian, whose responsibilities shall include, but are not limited to, the following:

1)         developing written policies and procedures to include but not necessarily be limited to:

A)        responsibilities and authority for the operation;

B)        standards of nutritional care for all regular and therapeutic diets including supplemental feedings;

C)        medically prescribed diet orders and alterations in diets or diet schedules such as holding trays, late trays, and times for accepting diet changes;

D)        patient tray identification;

E)        food preparation, storage and service;

F)         personal hygiene;

G)        sanitation and safety;

H)        ancillary dietetic services including food storage preparation and service in kitchens and dining areas on patient care units; formula supply; vending operation; and ice making;

I)         conferences--departmental and interdepartmental, clinical, executive and/or administrative;

J)         training programs for personnel; and

K)        patient education programs.

2)         planning menus for all general and therapeutic diets in accordance with the current recommended Daily Dietary Allowances of the Food and Nutrition Board, National Research Council, and in accordance with the principles of good dietetic management;

3)         planning, organizing, directing, controlling and evaluating all management aspects of the dietetic services including such things as budget and/or interpretations of financial reports; purchasing and/or requisitioning food, dietetic supplies and equipment, food costs, food storage; food preparation; food service; safety; sanitation; record keeping; personnel scheduling and evaluating;

4)         planning, implementing and/or conducting education programs for orientation, on-the job training, in-service and continuing education on a regular, routinely scheduled basis for all dietary and other appropriate personnel, and staff development sessions for all professional staff;

5)         administering all the nutritional aspects of patient care including, but not necessarily limited to:

A)        taking nutrition histories and recording in patients' medical charts;

B)        interviewing patients regarding food habits;

C)        giving diet counseling to patients and their families; encouraging patient participation in planning their own diets;

D)        participating in appropriate ward rounds and conferences, or by other methods; sharing specialized knowledge with medical and nursing staffs and other appropriate interdisciplinary team members involved in the care of the patient;

E)        consulting with patient care team(s).

c)         Consultation

1)         When the full-time dietetic service director, for legitimate, documented reasons, is not a qualified registered dietitian or qualified nutritionist, the hospital shall employ a qualified registered dietitian on a part-time (minimum of 20 hours per week) or on a consulting basis. The hours of consultation in the hospital shall be dependent upon the size, needs and complexity of the hospital and dietetic service but in no case shall there be less than a minimum of eight hours of consultation per month.

2)         If consultant dietetic services are used, the consultant's visits are to be at appropriate times and of sufficient duration and frequency to provide continuing liaison with medical, nursing and patient care teams; to advise the administrator; to give patient counseling; to give guidance to the director and staff of the dietetic service; to approve all menus and administrative nutritional aspects of patient care; to participate in development and/or revisions of dietetic policies and procedures; and to assist with planning and conducting orientation, in-service and continuing education programs for dietary and other appropriate personnel.

d)         Staff

1)         There shall be sufficient number of properly trained and supervised dietary personnel, including a clinical dietitian(s) where warranted, competent to carry out all the functions of the dietetic service in an efficient, effective manner.

2)         Dietary personnel shall be so scheduled on duty that the dietary department is open, and in service, a minimum of 12 hours a day.

e)         Health and Hygiene

1)         Personnel shall be in good health; free of infections or communicable disease; and free of boils, infected wounds, sores or lesions.  Persons suspected of having a communicable, contagious or infectious disease shall be subject to the measures outlined in the Department's current Regulations for the Control of Communicable Diseases (77 Ill. Adm. Code 690)" and the Department's current "Food Service Sanitation Rules and Regulations".

2)         The outer clothing of all employees shall be clean and street clothing shall not be worn as outer clothing by employees while engaged in the preparation and serving of food.

3)         Employees shall wear hair nets, headbands or other effective hair restraints to prevent the contamination of food or food-contact surfaces.

4)         Employees shall thoroughly wash their hands and exposed portions of their arms with soap and warm water before starting work; during work as is necessary to keep them clean; and after smoking, eating, drinking or using toilet.  Employees shall keep their fingernails clean and trimmed.

5)         Except where tasting food is part of the job, employees shall consume food only in designated dining areas.  An area shall not be designated as a dining area if consuming food there might result in contamination of other food, equipment, utensils, or other items needed protection.

6)         Employees shall not use tobacco in any form while engaged in food preparation or service, nor while in equipment or utensil washing or food preparation areas. Employees shall use tobacco in any form only in designated areas.  An area shall not be designated for that purpose if the use of tobacco there might result in contamination of food, equipment, utensils, or other items needing protection.

7)         Employees shall handle soiled tableware in a way that avoids contamination of their hands.

8)         In the event food service employees are assigned duties outside the dietetic service, these duties do not interfere with the sanitation, safety, or time required for dietetic work assignments.

9)         Employees shall maintain a high degree of personal cleanliness and shall conform to good hygienic practices.