During the holidays, SNF staff across the country welcome an increased number of visitors with special treats to share with loved ones. While extra visitors and sweet treats add to the spirit of the facility at holiday times, they can also pose safety risks to residents. (Consider a yummy pumpkin roll with cream cheese frosting, left at room temperature for 48 hours in a resident’s room.) If you haven’t already done so, now is a good time to shore up your facility’s visitor food policy implementation. Here’s how:
1. Make the front desk the first stop.
“When family and friends sign in at the front desk, we make sure that all food and beverages are brought to the nurses’ station and that nursing is made aware of the food items. That said, about 80% of visitors comply, but about 20% think it doesn’t apply to them. This makes it tough,” shares Lynn Milligan, MSN-Ed, RN, C-NE, RAC-CT, director of education and employee health at Leahi Hospital in Honolulu, HI. “Out of caution, you should assume that not all visitors are reporting food—because they couldn’t find a nurse, they chose not to show a nurse, or they just assumed the food item was okay.”
2. Educate visitors on how outside food can impact resident safety.
“It’s important to remind visitors that resident diets may be restricted for any number of reasons,” stresses Milligan. A resident who has suffered a stroke or suffers from Parkinson’s disease may require an altered texture that enables swallowing, a diabetic resident may need sugars limited, a hypertensive resident may need low sodium, and a resident on dialysis may need a variety of restrictions.
Beyond dietary restrictions, it’s important to ensure that all outside food is labeled, dated, and kept at a safe temperature. All outside food should be thrown out after 72 hours. Not only does this protect the resident the food was intended for, it also protects other residents, such as a roommate who could stumble upon left-out food and choke, for example.
3. Be welcoming.
“At my facility, we have assigned staffing, and staff would notice an unusual visitor,” remarks Milligan. She suggests encouraging staff to welcome unfamiliar visitors in the hallway to help make sure they are following the policy. “A simple Hi. Who are you here visiting? Do you have any questions? goes a long way. Remember that infrequent visitors often need the most education.”
4. Remind staff starting in November.
“We find that food starts trickling into the facility around Thanksgiving,” says Milligan. She suggests a policy review at a November staff meeting. Additionally, she recommends printing out a policy reminder in the break room to keep the visitor food policy on the forefront of everyone’s mind.
5. Keep an eye out in resident rooms in the evening.
If food was left by a well-meaning visitor, it should be stored or thrown out as appropriate. “Ask CNAs to check for food left after visitors during evening rounds,” suggests Milligan.
6. As necessary, write the option for a waiver form into the policy.
“If a resident and/or their legal representative have been educated about a specific food item, that the resident shouldn’t have this, but the resident continues to choose to consume that item regardless, offer a waiver form that acknowledges this resident choice,” says Milligan. This will protect the facility and honor the resident’s choice.
“Food is often one of the last pleasures and decisions that a resident has control over, depending on their disease process,” says Milligan. When you enforce your facility’s policy, it’s important both to comply with regulation for resident safety and to do so in a way that honors the resident.
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