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PUREE DIETS and THICKENED LIQUIDS Improving Quality April 4, 2014 Utah Dietary Mangers S Why Are You Here Today S Improve quality of life!!! S Improve hydration. S Lower costs of thickened liquids. S Improve the diets offered at your facility. S Off work for a few hours and home early! What we want to Accomplish: S Learn more about puree food consistency. S Learn about thickened liquids tips & traps. S Learn about costs of thickeners. Who do we interact with? RESIDENT! Family Caretakers Nursing Dietary Manger Admin CNA’s Speech RD What is the best puree food texture? S All references state smooth and creamy. S All food does not puree to smooth and creamy. S Expectations from surveyors appear to vary with other survey observations. S Some residents WANT some texture to know it is real food. S Is a subjective area! How to Know the Best S Have a tasting system in place. S Know recipes reflect current practice. S Educate staff – the best recipe still may need work due to moisture content. S Residents eat and drink well. S Puree menu matches all regular menu components. Puree Principles S Serve food at the correct temperatures. S Food should be consistency of mashed potatoes and pudding. S No Weeping! S Liquid foods can be liquid (soup) S Use thickener as needed – powders change taste and content. S No sticky, gummy, chunks, large grains. Puree Prep Steps S Wash Hands. S Assemble clean and sanitized utensils. S Recipe/Directions. S Product: Cool if hot, Chilled if cold. S Number of puree portions S Portion food. S Process. Steps in Processing S Bowl filled to correct height. S Process for correct time. S Added ingredients: liquid. S Thickening agent. S Process S Taste S Scraping S Reheating/re chilling S Portion S Decorate or Garnish Specific Foods To Puree S Soup S Meats S Starch S Vegetables S Fruits S Desserts See It First S Textures add variety. S Plate placement can add color contrast. S Selling the food with staff explaining content. S Try different dishes, shapes, colors of serving plates, bowls and glasses. S Drizzle sauces and condiments for interest. Color and Placement S Color adds contrast. S May need some food coloring. S Try sauces and shapes. S Make puree garnishes: extra gelatin for cutouts, avocado, jelly, dessert sauces, condiments. S Try different dishes, bowls, glasses Know your equipment S Blenders, grinders, processors, blixers. S Caring for your equipment. S Purchase the right size of tool. Best Liquid Texture S Acceptable to resident S Tastes like liquids prepared S Looks like real liquid S Staff can prepare ahead of time S Does not continue to thicken S Blends well with many fluids, even hard to thicken nutrient dense items Thickened Liquids S Flavor is not altered. S Does not affect diabetes control. S Mixing parameters S Can be prepared in bulk for kitchens S Limits inventory and saves space Thickened Beverages' S Variety S Pre-Thickened S Powder S Gel’s Hydration S Cost of dehydration, under hydration S Increased nursing costs S Loss of revenue for the facility S Wound care S Causes of low fluid intake? S Not appealing. S Lack of Variety. Tricks & Traps S Tricks S Variety S Appearance S Prep ahead S Bulk S Traps S Under Mixing S Guessing over mixing S Sets Up S Serving Temperature Cost Information S Explanation of cost S Back Door costs S Powder Lowest costs. S Resident Appeal S Waste Costs S Pre-Thickened Highest cost. S Inventory cost and space S Gel-Thickener Thank you for coming S