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Policies and Procedures

Food, Formula and Enteral feed preparation – Food Safety

  • 1. Overview/Procedure description

    To provide guidance for staff on the process of formula preparation and provision of enteral feeds for patients to ensure that the RCH operates in accordance with the Food Safety Standards.

    2. Related Policy

    Legislative Compliance

    Related Procedure

    Food Safety - Food brought into RCH from external sources for consumption by Parents and Carers Procedure

    Food Safety - Food brought into RCH from external sources for consumption by patients Procedure

    3. Definition of terms

    Hazard Analysis and Critical Control Points (HACCP) protocol is a risk management system that identifies, evaluates and controls hazards related to food safety throughout the food supply chain.

    Enteral feeding refers to the delivery of a nutritionally complete feed via an enteral tube directly into the stomach, duodenum or jejunum and includes nasogastric tubes (NGT), nasojejunal tubes (NJT’s), percutaneous endoscopic gastrostomies (PEG’s), and percutaneous endoscopic jejunostomies (PEJ’s).

    4. Procedure Details

    The Royal Children's Hospital (RCH) Food Services department operates under a HACCP Food Safety Policy and takes all reasonable precautions to fulfill our "due diligence" responsibilities to provide safe food and formula to our children.

    The RCH food business is classified as a class 1 food service premise whereby food and formula preparation is undertaken using strict HACCP (Hazard Analysis and Critical Control Points) controls due to the fact that it is served and consumed by at risk, vulnerable children.

    The RCH has a duty of care to its consumers (patients and families) as outlined in the following legislation; Victorian Food Act 1984 and in the Food Standards Australia New Zealand Act 1991 to ensure all food is safe, nourishing and suitable. Pamphlets are available in the ward pantries to provide to families outlining the Food from Home policy for patient use and Food from Home policy for parent use. 

    The Food Safety Program has the following requirements:

    • All formula must be prepared in the central formula room. Formula is NOT to be prepared on the wards as this may lead to a high risk of feed contamination and food they are not a sterile environment and are not equipped for the safe preparation of infant formula. 
    • Use of a blenderised or pureed diet administered via an enteral tube is not recommended and CANNOT be undertaken  during a patient’s admission to hospital for the following reasons:
      • It is nutritionally incomplete in macro and micro components,
      • It is microbially unsafe hence unsuitable to hang in the warm hospital environment for feed delivery
      • It cannot be stored in the ward patient fridge as this is a direct breach of compliance with the RCH Food Safety Program and potentially places other ward patient’s food safety at risk
    • Home prepared food cannot be stored in the ward pantry or formula room fridges as this is in breach of our Food Safety Program. If necessary, these foods should be transported in a suitable insulated container (eg esky ) with icepacks and consumed immediately upon arrival. The ward patient pantry fridge and ward formula fridge is for hospital provided patient provisions only. These fridges cannot be used to store food from home or other external sources as doing so will place patient food safety at risk and breach the RCH Food Safety Program.  Only packaged shop brought food for single use only that is unopened (sealed by the manufacturer), custards and drinks can be stored in the patient fridges on the ward for patient use. All other items not complying with this will be discarded. Non-perishable food items (such as crackers, crisps etc) can be stored in the patient room as they do not require refrigeration.
    • Parent lounge fridges cannot be used to store patient food as they are not monitored for temperature or contents, placing patient food safety at risk.
    • Parents / carers who choose to use their own brand of a nutritionally complete formula not stocked by RCH, are to bring an unopened tin to the central infant formula room for formula room staff to prepare the feeds in a clean environment. These feeds cannot be prepared on the ward as outlined above.

    Failure to comply with our Food Safety Program places the child at risk of a food safety breach and at significant risk of food poisoning and diarrhoea, and also jeopardizes the RCH Food Service Licence.

    5. References

    Victorian Food Act 1984

    Food Standards Australia New Zealand Act 1991  

    6. Contacts

    Manager, Department of Nutrition and Food Services

    Food Safety Officer, Department of Nutrition and Food Services