عوامل ایمنی و بهداشتی موثر بر مدیریت بخش تغذیه در بیمارستان‌های تامین اجتماعی با رویکرد مدل‌سازی معادلات ساختاری
محورهای موضوعی : -مدارک پزشکیعیسی فتحی 1 , امیراشکان نصیری پور 2 , نادر خالصی 3 , رضا زیاری 4
1 - دانشجوی دکتری رشته مدیریت خدمات بهداشتی و درمانی، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
2 - دانشیار گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - دانشیار گروه مدیریت خدمات بهداشتی و درمانی، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
4 - استادیار گروه اقتصاد، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
کلید واژه: سازمان تامین اجتماعی, ایمنی و بهداشت, مدل‌یابی معادلات ساختاری., بخش تغذیه بیمارستان,
چکیده مقاله :
مقدمه: با توجه به اهمیت عوامل ایمنی و بهداشتی در مدیریت بهینه بخش تغذیه در بیمارستان‌ها و مشخص نبودن میزان تاثیر این عوامل بر آماده سازی، تهیه و توزیع مواد غذایی سالم، این پژوهش با هدف تعیین و ارایه مدلی برای تبیین نقش و اهمیت مؤلفه‌های مورد نیاز در بیمارستان‌های تامین اجتماعی انجام شد. روش پژوهش: این مطالعه از نوع کمی کیفی بود. جامعه پژوهش عبارت بودند از مدیران بیمارستان‌ها، کارشناسان بهداشت محیط و کارشناسان تغذیه.ابزار گرد آوری داده‌ها فرم اطلاعاتی، چک لیست معاونت درمان تامین اجتماعی که با روش مشاهده مستقیم و مصاحبه تکمیل گردید. داده‌ها با استفاده از پرسشنامه‌ای شامل 15 سوال در 3 حیطه گردآوری شد. از نرم‌افزار SPSS و نرم‌افزار AMOS با رویکرد مدل سازی معادلات ساختاری مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: سه بعد ایمنی و بهداشتی، نظارت و کنترل و منابع انسانی، شناسایی شد. برازش به دست آمده بسیار نزدیک به یک بود که بیانگر قوت تک بعدی بودن مدل بود. بر اساس تحلیل عاملی تأییدی، مولفه‌های نگهداری مواد غذایی در دمای مناسب و شرایط نامناسب نگهداری مواد اولیه به ترتیب با ضرایب 0.753 و 0.545 بیشترین و کمترین تأثیر را در میان عوامل ایمنی و بهداشتی داشتند. نتیجه‌گیری: به منظور مدیریت بهینه بخش تغذیه نگهداری مواد غذایی در دمای مناسب در بیمارستان‌ها از اهمیت ویژه‌ای برخوردار می‌باشد و عنایت به این موضوع در کنار سایر عوامل می‌تواند مورد توجه مدیران بیمارستان‌ها،کارشناسان بهداشت و هم‌چنین کارشناسان تغذیه قرار گیرد.
Introduction: this study done to determine and provide a model for explaining the role and importance of the components needed In Social Security Hospitals due to importance of safety and health factors in the optimal management of nutrition part in hospitals and the lack of clarity on the impact of these factors on the preparation, production and distribution of healthy food. Methods: type of this study was qualitative - quantitative. The research population consisted of managers of hospitals, environmental health experts and nutrition experts. The data collection tool was an information form, that was a Social Security treatment checklist that completed by direct observation and interviewing. Data collected using a questionnaire including 15 questions that gathered in three areas. Use of SPSS software and AMOS Software analyzed with approach of modeling structural equations. Results: In this study, 3 aspects identified that included safety and health, monitoring and control, and human resources. Obtained Fitness was very close to unit, indicated the strength of the model's one dimensional. Based on the confirmatory factor analysis, "good food storage" in proper temperature and " Inappropriate storage conditions for raw materials "had the highest and the least effect among safety and health factors with coefficients of 0.753 and 0.554 , Respectively . Conclusion: In order to better manage of nutrition section in hospitals, while emphasizing on issues of health and safety, it is necessary to consider other influential factors and this will be applied in the future planning of the managers of social security hospitals.
1- Notermans S, Gallhoff G, Zwietering MH, Mead GC. Identification of critical control points in the HACCP system with a quantitative effect on the safety of food products. Food Microbiologyو 1995; 12(Supplement C): 93-8.
2- Sadeghifar J, Tofighi S, Hamouzadeh P, Raad Abadi M, Roshani M, Salimi M, et al. The compliance status of HACCP implementation requirements in nutrition departments of the selected hospitals of Tehran University of Medical Sciences. Jundishapur Journal of Health Sciencesو 2012; 4(3): 15-24. ]Presian[
3- Organization WH. Food safety and foodborne illness. Fact sheet 237. World Health Organization, Geneva Available at: http://www who int/mediacentre/factsheets/fs237/en/ Accessed; 2012: 10.
4- Lynch M, Painter J, Woodruff R, Braden C. Surveillance for Foodborne-disease Outbreaks: United States, 1998--2002: US Department of Health and Human Services, Centers for Disease Control and Prevention (CD); 2006.
5- Choi J, Norwood H, Seo S, Sirsat SA, Neal J. Evaluation of food safety related behaviors of retail and food service employees while handling fresh and fresh-cut leafy greens. Food Control, 2016; 67: 199-208.
6- Miokovic B, Njari B, Kozacinski L, Cvrtila Z. Application of HACCP in the control of the microbiological survey of meals in restaurants. Veterinarski Arhiv J, 2001; 71(2): 75-84.
7- Naing NN, Zain MM, Abdullah N. A study on reliability of questionnaire on knowledge, attitude and practice (KAP) of food handlers towards foodborne diseases and food safety. International Medical Journal, 2007; 14(4): 285-1
8- Okojie O, Wagbatsoma V, Ighoroge A. An assessment of food hygiene among food handlers in a Nigerian university campus. The Nigerian postgraduate medical journal, 2005; 12(2): 93-6.
9- Kramer J, Scott W. Food safety knowledge and practices in ready-to-eat food establishments. International journal of environmental health research, 2004; 14(5): 343-50.
10- Christison C, Lindsay D, Von Holy A. Microbiological survey of ready-to-eat foods and associated preparation surfaces in retail delicatessens, Johannesburg, South Africa. Food Control, 2008; 19(7): 727-33.
11- Familian A. Survey of quality improvement with assessing the HACCP critical factors in the industries in Lord Macaron. Iran University of Science and Technology, School of Industrial Engineering; 1998. ]Presian[
12- Ghavamsadri M, Derakhshni K. Management of food sector: guide for Food. Preparation centers Iran: Baraye farad; 2004: 21-3. ]Presian[
13- Guallar C, Ariza J, Dominguez A, Peña C, Grau I, Verdaguer R, et al. An insidious nosocomial outbreak due to Salmonella enteritidis. Infection Control & Hospital Epidemiology, 2004; 25(1): 10-5.
14- Farhadfar A. Nutrition sector review selected hospitals of Isfahan on HACCP prerequisite enforcement system. J Hosp, 2007; 19: 22-9. ]Presian[
15- Taylor E. A new method of HACCP for the catering and food service industry. Food Control, 2008; 19(2): 126-34.
_||_1- Notermans S, Gallhoff G, Zwietering MH, Mead GC. Identification of critical control points in the HACCP system with a quantitative effect on the safety of food products. Food Microbiologyو 1995; 12(Supplement C): 93-8.
2- Sadeghifar J, Tofighi S, Hamouzadeh P, Raad Abadi M, Roshani M, Salimi M, et al. The compliance status of HACCP implementation requirements in nutrition departments of the selected hospitals of Tehran University of Medical Sciences. Jundishapur Journal of Health Sciencesو 2012; 4(3): 15-24. ]Presian[
3- Organization WH. Food safety and foodborne illness. Fact sheet 237. World Health Organization, Geneva Available at: http://www who int/mediacentre/factsheets/fs237/en/ Accessed; 2012: 10.
4- Lynch M, Painter J, Woodruff R, Braden C. Surveillance for Foodborne-disease Outbreaks: United States, 1998--2002: US Department of Health and Human Services, Centers for Disease Control and Prevention (CD); 2006.
5- Choi J, Norwood H, Seo S, Sirsat SA, Neal J. Evaluation of food safety related behaviors of retail and food service employees while handling fresh and fresh-cut leafy greens. Food Control, 2016; 67: 199-208.
6- Miokovic B, Njari B, Kozacinski L, Cvrtila Z. Application of HACCP in the control of the microbiological survey of meals in restaurants. Veterinarski Arhiv J, 2001; 71(2): 75-84.
7- Naing NN, Zain MM, Abdullah N. A study on reliability of questionnaire on knowledge, attitude and practice (KAP) of food handlers towards foodborne diseases and food safety. International Medical Journal, 2007; 14(4): 285-1
8- Okojie O, Wagbatsoma V, Ighoroge A. An assessment of food hygiene among food handlers in a Nigerian university campus. The Nigerian postgraduate medical journal, 2005; 12(2): 93-6.
9- Kramer J, Scott W. Food safety knowledge and practices in ready-to-eat food establishments. International journal of environmental health research, 2004; 14(5): 343-50.
10- Christison C, Lindsay D, Von Holy A. Microbiological survey of ready-to-eat foods and associated preparation surfaces in retail delicatessens, Johannesburg, South Africa. Food Control, 2008; 19(7): 727-33.
11- Familian A. Survey of quality improvement with assessing the HACCP critical factors in the industries in Lord Macaron. Iran University of Science and Technology, School of Industrial Engineering; 1998. ]Presian[
12- Ghavamsadri M, Derakhshni K. Management of food sector: guide for Food. Preparation centers Iran: Baraye farad; 2004: 21-3. ]Presian[
13- Guallar C, Ariza J, Dominguez A, Peña C, Grau I, Verdaguer R, et al. An insidious nosocomial outbreak due to Salmonella enteritidis. Infection Control & Hospital Epidemiology, 2004; 25(1): 10-5.
14- Farhadfar A. Nutrition sector review selected hospitals of Isfahan on HACCP prerequisite enforcement system. J Hosp, 2007; 19: 22-9. ]Presian[
15- Taylor E. A new method of HACCP for the catering and food service industry. Food Control, 2008; 19(2): 126-34.