Prevention of Foodborne Illness

Foodborne Illness and Kitchen Safety


At the end of the class, you will be able to:

1.      Shop for, store and handle foods in a safe way.

2.      Prevent food illnesses and kitchen accidents.



Many nursing assistants and home health aides shop for patients. Many also cook for patients. It is important for all of these health care people to know about kitchen and food safety. This class will help you to learn about this role.


A Safe Kitchen


Kitchens and bathrooms are probably the most dangerous rooms in a house. Many people fall in bathrooms because the floors are often wet. Some of the other things that happen in kitchens are:


  • Fires
  • Burns
  • Food illnesses


Some of the things that you should do in the kitchen to keep it safe are:


  • Keep the kitchen clean
  • Make sure that everything is in its place
  • Put things in a place where you can reach them and you do not have to climb up to get things
  • Clean up spills
  • Do NOT rush to do things. Take your time. Fires, burns, slips, falls and other accidents can happen when you are in a rush and not thinking.
  • Make sure that the oven, the stove and all electric is off when you are done using it.


A mop and a reaching tool should be used by people that use a wheelchair and others that can not bend over. This will help them to clean up spills and to pick up things that have dropped on the floor.



Food Safety




Be careful when you buy foods.


  • Buy frozen foods that are well frozen.
  • Pick meat that is in the bottom of the meat case where the temperature is the coldest.
  • Buy things that are well sealed and not dripping.
  • Look at the dates. Look at the “use by” or “sell by” date. Do NOT buy things after this date.
  • Buy cans that do NOT with have dents.
  • Buy cans that are NOT puffy and bulging.
  • Buy things in glass jars that do NOT have cracks.




Cans and glass jars that are not in good shape may have dangerous germs that can make you sick. Do NOT buy them.









When you are shopping, pick out cold, cooked and frozen things last. Shop for things that have to be hot or cold LAST. For example, pick out paper items, cans, and cleaning things FIRST. Then get milk, eggs, ice cream and meat right before you are ready to check out of the store.


Keep all the meat, chicken and fish away from the other things in your cart. Make sure that the store person packs these things in different bags. Do NOT let them put fish with paper plates and things like that. Put fruits and other fresh things in plastic bags in order to keep them clean, safe and away from meat and fish drips.




Wash your hands very well for at least 30 seconds before and after you touch any food.


Cans must be kept in a cool and dry place. Do NOT keep any food cans for more than one year. Throw them out if they have not been used in one year. 


Put cold and hot foods away right away after you get home from the store. Put them in the refrigerator or freezer within one (1) hour, especially if it is hot outside. Do not ride around in the car doing other things after you have bought food. Get it home and put away as soon as possible.







Wrap meat, chicken, fish and other items in freezer bags, wraps or foil before they go into the freezer. Label and date them all.


Keep the refrigerator clean and lean! Clean up all spills right away. Wash the inside of the refrigerator with warm soapy water and then rinse it off. You should also use a solution of 2 tablespoons of household bleach to 1 gallon of warm water. You can keep odors out with a small box of baking soda.


Keep the temperature of the refrigerator between 36 and 38 degrees. 

Keep the door closed if it loses power as can happen with a bad  storm. Cook and serve foods within a few hours if you cannot keep them cold. Throw them out if they do not stay cold. 








Keep meat and fish away from other foods. Use plates, plastic bags, plastic or foil wrap or containers with covers to keep the juices and drips from meat and fish away from other foods.






The temperature of the freezer must be at or below 0 degrees in order to keep foods frozen and safe.


The freezer door must also be kept closed if you lose power or it fails to work right. If the food cannot be kept cold, cook and serve the food within a few hours or throw it out.


Do NOT refreeze foods that have thawed out.










Many people get sick when food is not handled and kept in the right way. Sick people and the elderly are at even greater risk than others who are young and healthy.


Keep food safe by doing these things. 



  1. Use the F I F O method of food storage:


F - First

I  - In

F - First

O - Out


  1. Use the older foods first !! The first things that you put in are the first things that must come out and be used.


  1. Thaw frozen foods out in the refrigerator. Do NOT leave these foods out in room air. Do not put these foods on the counter. Bacteria grows very fast in room air. It gets too warm when it is left out. When you want to use these foods, take it out and either put it in the refrigerator for 24 to 36 hours before cooking it or use the “thaw” setting of your microwave oven. Then, cook the food right away.


  1. Keep all food work areas VERY CLEAN.


  1. Wash your hands very well for at least 30 seconds before and after you touch food. Also, wash your hands very well after you go to the bathroom.







  1. Use different cutting boards for meats, vegetables, fruit, cooked foods and raw foods. Wash them with warm, soapy water and then wash it again with 2 to 3 teaspoons of household bleach in a quart of warm water. Rinse with plain hot water.







  1. Do NOT stop the cooking process once you have started it. Finish the cooking.


  1. Preheat the oven before you put food into it.


  1. Stuff meat, turkey and chicken right before you are ready to cook it.


  1.  Serve fresh, cooked foods that you have bought in the store within 2 hours.


  1. Refrigerate all “left over” food right after the meal is done. Do NOT let the food “sit out to cool”. Split large amounts of food into smaller parts and then put the food into the refrigerator so that it cools off as fast as possible.





If you are storing cooked stuffed foods, remove the stuffing from the food and store separately.









In addition to doing the things above, do these things to avoid getting sick from eggs.


  1. Buy only Grade A or Grade AA eggs that are clean and do NOT have shells that are cracked.


  1. Make sure that they are fresh. Check the carton for the date. 


  1. Throw out any eggs that have an odor or a color that does not look right.


  1. Cook eggs right away, or put them in a container, or throw them out if you break or crack them by mistake. If you do not use them right away, use them within 2 days.


  1. Keep eggs frozen until you are ready to use them or throw them out if they freeze by accident. Throw them out if the shell is cracked.


  1. If you are cooking something that needs either egg whites only or egg yolks only and not a whole egg, you must cover the left over yolks with cold water before putting them in the refrigerator to use later. Whites can just be put in a small container so you can use them in the future. Use these left overs within 4 days or throw them out.


  1. Boil and fry eggs until both the yolk and the white parts are firm. They must be cooked to 160 degrees or more. Soft boiled eggs are NOT safe. Raw eggs are NOT safe.


  1. If you are making an egg dish, make sure that it is completely cooked by placing a knife into the center. If the knife comes out clean then you know that the egg dish is cooked. If it has some soft egg on it, it is NOT cooked. Cook it longer.


  1. Serve cooked egg dishes right away after cooking or refrigerate it at once.





10. Do NOT leave eggs out in room air for more than 1 hour.










Fresh fruits and vegetables are not a big problem in terms of illness, but you must still handle them in the right way.


1.      Buy them and eat them only when they look fresh


2.      Buy them and use them only when they do not have any odor


3.      Buy them and use them only when that do not have a bruise


4.      Buy them and use them only when they have no mold or slime


5.      Buy only what you need. Do NOT stock up on these fresh foods


6.      Put them in the “crisper” part of the refrigerator where the moisture is a little higher than other places


7.      Keep all cut fruits and vegetables covered


8.      Wash all fruits and vegetables in clean drinking water just before eating them. Do this even when you do not eat the outside of the fruit, like an orange.


9.      If you eat the skins of thinks like a potato or carrot, scrub them very well.


10.Wash your hands and the knife or peeler before and after touching fresh fruit and vegetables.











Every year, about 24 to 81 million people in the United States get sick from food. About 9,000 people die from it every year.


Anyone can get sick from the bacteria, or germs, in food but some people are at greater risk than others for this illness.


The old, very young children, pregnant women and people with a weak immune system get more food diseases than others. People with AIDS, cancer, and some medicines are also at risk.


There are many different food illnesses that result from a lot of different germs that are found in food. 




You must follow all of the rules above plus these things in order to prevent food illnesses.  




  • Buy only pasteurized dairy products. Pasteurization kills germs.


  • Use egg substitutes when making egg nog, Caesar salad, chocolate mousse, custard and home made mayonnaise.


  • Marinate food in the refrigerator, NOT on the counter top. Throw away all left over juices. NEVER use it again. Do NOT even use the left overs to baste food while it is being cooked.


  • Make sure that the food in a microwave turns around, or it is turned by you, in order to make sure that it is completely cooked. Let the food stand for 2 to 5 minutes to make sure that it is completely cooked.







  • Always cook in an oven that is at 325 degrees or more.


  • Clean your can opener with soap and water after every use.











  • Store left overs in covered dish. Heat all left overs until they are hot. Eat them within 3 days or throw them out.


  • Never leave any cooked or uncooked food out of the refrigerator for more than one hour before you eat it.


  • Cook all meats and fish to at least 160 degrees or more. This is needed to kill the germs in food.








  • Do NOT eat rare or medium rare meats. It should be gray or brown in color, NOT pink.






  • Do NOT eat raw fish or raw shellfish like clams. Fish should flake easily with your fork when it is cooked enough.




  • Do NOT spread germs from raw food to other food. Wash your hands, utensils, cutting boards and counters before and after each food prep step.






The signs of food illness are:


  • Nausea
  • Vomiting
  • Diarrhea


These things can start within a few hours after eating the food or they can begin one full day after eating the food. Many people think that they just got an “upset stomach”. They may not think that they are sick from the food.


If you think that you, or your patient, might have a food illness contact the doctor right away because it could be very serious, especially if the person is weak and has another problem, like AIDS/HIV. It can lead to big problems and even death.


You should also do these things.


  1. Keep the bad food but mark it with a warning to make sure that nobody else in the house eats it. The food may have to be looked at closely to find out exactly what kind of germs were in it.


  1. If the person ate the food in a public place, call the owner and report it. Also call the local health department.


  1. Have the person drink lots of fluids so that they do not get  dehydrated from any vomiting or diarrhea.









People with physical problems, ill people and older people often need help in the kitchen with their meals. They may also need help with shopping for food and food storage. Everyone needs a complete and good diet. Many people also need a special diet. Special diets often take more time and energy than regular diets. Old people and sick people may not have the strength and physical ability to take care of their meals.


  • An old person may lose their ability to smell, hear and see.
  • Some old people may not want to throw food away in order to save them money. This could be a big problem. They may eat old food that makes them sick.



When people get old they:


  1. have less acid in their stomach than they did when they were young. Acid helps to kill any germs that may be in the food they eat. They may get a food illness because they do not have enough acid. The same food may not make a young person sick but it may make an old person sick.


  1. can not fight off germs as well as they did when they were young. This makes them, and other people like AIDS patients, at high risk for food illness, more than those without these problems have. 



Food poison and food illness can make a young and healthy person “sick” for a few days. The same illness can make the older person and the ill person very sick for a long time. Some die from it.





Poor sight is a big problem when it comes to food safety. A person may not be able to keep the kitchen clean because they can’t see how dirty it is. It may stop the person from seeing the signs of bad food, mold and dirt.


When a person can not hear well, they may not be able to hear a timer ring off. They may not hear that the pot is boiling over. This can lead to fires and burns.


Also, a person may not know that things are burning or that the food smells rotten if they do not have a good sense of smell.




Also, some people do not think as well as others. When they are cooking they may forget that they have something on the stove. It is very important that everyone is alert and safe in the kitchen.








Microwave ovens are a great new tool. They are very nice and they let us cook and heat things up very quickly but they can cause injury, like burns and food illness. They can be a great place for food germs to live, grow and spread if they are not kept clean.


Do these things.


  1. Open food and drink wrappers AWAY from your face after cooking so that you do not get a burn from steam and heat. Food and drinks may feel cool to the touch on the surface, but, they may still be VERY hot in the middle. Be careful.


  1. Test the temperature of the food or drinks before giving it to the person to eat.


  1. Use dishes that are made for the microwave. Others may cause the food or drink to leak or burst apart.


  1. Keep it clean and germ free.





Food illness can be prevented. Wash your hands before and after touching any food. Store foods in the right way. Cook meals in a safe manner. Keep the kitchen and food area clean and tidy.





Acheson, David W. K. MD and Robin Levinson (1998). Safe Eating. Dell Publishing Company.


United States Department of Health and Human Services. (2010). “Food Safety”. [online].

Copyright © 2010 Alene Burke