A lot, it seems!
When The Lantern Project decided to explore soft eggs in aged care, who would have thought about the complexities, variance and struggles residential facilities face?
We found that one risk averse person can affect the outcome for residents. And there are many points between the hen and resident where risk aversiveness can creep in.
The risk of salmonella on clean, uncracked eggs from A grade producers is very small, however can have major consequences. The Australian Egg Corporation (AECL) suggested about 1 in 13,000 clean, uncracked eggs may be infected with salmonella. When you receive a cracked egg, there are many opportunities for infection to occur, including from transport, handling, storage, the air, etc. Risk increases to 1 in 1,300 eggs.
Recommended advice is do not use cracked or dirty eggs. Throw them out and the container they came in. Thoroughly wash hands after touching eggs and clean/sanitise all surfaces the eggs and container have touched.
The egg yolk has no antimicrobial properties and is susceptible to Salmonella. As a whole egg, the yolk is protected by the shell, membrane and white. When eggs are not cooked to a time and temperature to kill the salmonella, it may cause a salmonella outbreak. The infected egg can affect the whole batch of egg product that is cooked at the one time.
According to the AECL, there are always food handling issues with salmonella outbreaks. From my own research and questioning kitchen staff, there is not the realisation of the significance of washing hands thoroughly after touching eggs, egg products and egg containers.
The same goes for anything else the infected egg and now infected hands touch – bench, preparation boards, equipment, utensils, gloves, clothing, dish cloths, tea towels. Washing hands thoroughly with hot soapy water before and after handling eggs will reduce risk. Wearing gloves is not a substitute for good hand washing practice.
Other food products, such as fruits and salad, can also become infected by coming in contact with hands, equipment and surfaces the infected egg has touched. Thorough cleaning and sanitisation of all surfaces that eggs, egg product and containers have touched is essential.
Raising staff awareness and effective training, ongoing reminders and poster displays will help to mitigate the food handling risk.
Some providers spoken to feel conflict between their obligation to keep residents safe, and allowing them to exercise choice about their food preferences. Providers must consider:
Quality of Care Principles 2014 – providers are to actively work to provide a safe and comfortable environment with health promoted and achieved at the optimum level. Residents are enabled to exercise choice and control over their lifestyle.
State & Territory Health Departments – has recommendations (not enforceable) on food safety. Eg on reducing Salmonella for “at risk groups”, Qld Health recommends using pasteurised egg or egg products.
FSANZ Standard 3.3.1 – a requirement for aged care providers to have a Food Safety Program in place because potentially hazardous food is served to vulnerable populations.
Food Safety Program – specific to each facility and details how hazardous foods, including eggs, will be managed. Assessed for compliance at the state and territory government level.
Many residents love soft cooked eggs. Many providers would like to give eggs to their residents just the way they like them. Solutions I have seen and heard that are working well include:
Some managers find innovative solutions and choose to manage the risk through their Food Safety Program. Other managers aim to reduce their risk by reducing hazardous foods at their facility and don’t allow soft eggs at all.
In conclusion, there is nothing to stop you serving soft cooked eggs to your residents. Your residents will increasingly expect it. The Salmonella risk is small but the consequences can be severe. While safe food handling will go a long way to mitigate the risk, ongoing training and reminders to staff about the hazards of eggs is essential.