title: [Evaluation of policies in the procedures for food handling to prevent nosocomial infections in general hospitals and public institutions of health in Mexico].
abstract: OBJECTIVE
  To evaluate the implementation and proper use of policies and procedures for food handling to prevent nosocomial gastrointestinal infections in major General Hospitals and Public Institutions of Health in Mexico.
  
  
  METHODS
  We performed a cross-sectional study of food services in 54 second-level general hospitals from these institutions: Mexican Institute of Social Security (IMSS), Institute of Security and Social Services for State Workers (ISSSTE), and the Ministry of Health (SESA). A questionnaire was made to identify risk factors for food contamination. In the statistical analysis, we determined the relative frequency of food handling complying with the norm; a qualitative analysis was performed using an intentional non-probabilistic sampling, targeting department heads, managers, and operational staff. The qualitative variables were verified through non-parametric tests.
  
  
  RESULTS
  From 54 hospitals evaluated, 81% had procedure and operation manuals, 35% prepared and stored food according to NOM-251-SSA1-2009, 52% performed ongoing training, 62% had a record of microbiological analysis done to staff and 81% done to foods, and 31% had first in first out (FIFO) temperature control systems.
  
  
  CONCLUSIONS
  Second-level health institutions in Mexico have deficiencies in the implementation of norms and procedures to handle, store, and prepare food that can lead to gastrointestinal outbreaks of nosocomial infections in patients, health staff, and visitors. In order to ensure the quality of food preparation for distribution and consumption in hospitals, it is necessary that food services comply with current norms and regulations, updating policies and procedures, and training their staff continuously.
authors.affiliation: Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.; Epidemiología Hospitalaria y Control de Calidad de la Atención Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Villanueva Martínez
authors.affiliation: Epidemiología Hospitalaria y Control de Calidad de la Atención Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.
authors.forename: Alejandro Ernesto
authors.initials: AE
authors.lastname: Macías-Hernández
authors.affiliation: Epidemiología Hospitalaria y Control de Calidad de la Atención Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.
authors.forename: Alethse
authors.initials: A
authors.lastname: de la Torre-Rosas
authors.affiliation: Epidemiología Hospitalaria y Control de Calidad de la Atención Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F.
authors.forename: Carlos
authors.initials: C
authors.lastname: Polanco González
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005511:Food Handling / Q000592:standards*; D006268:Health Facilities / Q000592:standards*; D006769:Hospitals, General / Q000592:standards; D006801:Humans; D008800:Mexico; D017150:Public Sector