INTRODUCTION

Department of Dietetics at Post Graduate Institute of Medical Education & Research has been functioning ever since the inception of Nehru Hospital in 1963, located on 3^rd Floor, 4^th Floor and 5^th Floor, Block-C, PGIMER. The department of Dietetics, PGIMER is a vital organization that carries multiple responsibilities related to patient’s nutritional needs for better medical outcomes.

Nutrition is a basic human need and a prerequisite to a healthy life. A proper diet is essential to meet the daily needs of humans to remain healthy and in disease free condition.

The main objective of the department of Dietetics is to provide normal and therapeutic diets/feeds as well as clinical services to the patients. Meal services are provided to all indoor patients of Nehru Hospital, Advanced Pediatric Center (APC), Advanced Eye Center (AEC), Advanced Cardiac Center (ACC) and Drug De-addiction Center (DDTC). Apart from this; department also runs Diet Clinic daily in New OPD, APC and ACC. Research work is also carried out by the Dietetics faculties in collaboration with other departments. Research papers are presented in National and International conferences and are published in journals of repute. This department has all ultra modern facilities like Fully Automatic Chapatti Making Machine, Walk in cold room, Dough kneading machine, potato peelers, Vegetable cutting machine, bulk cookers and Body fat analyzer for research purposes. The dietetics department aims to provide high level of nutritional care which is an integral part of the total patient care.

DEPARTMENT DIRECTORY

Location

 Department of Dietetics

The important functions of this department in PGI are grouped under:

1. Administrative:    Establishment, procurement, storage, accounts, record.
2. Educative:          Dietary instructions, cooking demonstration and follow up chart.
3. Therapeutics:     Clinical Services, Food processing, production and meal service management.

 Services Provided:-

1. Dietetics services for In-door patients
2. Education and Training
3. Institute Hospitality

CLINICAL SERVICES - Daily ward rounds are taken by the dieticians in their respective wards and diet is prescribed/implemented in consultation with the doctors. Individual diet counseling along with diet chart is provided to indoor as well as outdoor patients.

Clinical rounds –

• A standard protocol is prepared to maintain the quality of ward rounds.
• Conduct bed to bed ward rounds.
• See the doctor’s instruction regarding diet and look for diagnosis
• Observe the condition of the patients in terms of his/her illness, appetite, oral tolerance vis-à-vis requirement
• If required modify diet as per requirement
• Briefly counsel the patient’s attendant regarding the diet to be provided from the hospital
• Get feedback regarding the diet acceptance or tolerance by the patient
• Diet prescription interpreted on the treatment chart by the Dieticians

 Diet Counseling for Out-door Patients

General OPD Daily in Diet Clinic of New OPD Block - Room No. 3026

 Timings:

Monday, Tuesday, Wednesday, Thursday and Friday           9 am - 4 pm Saturday                                                                        9 am - 2 pm

Out-door Patient Consultation in Advance cardiac Center

General OPD (Daily)                             11:00   - 1 pm  &     2:30 - 4:30 1012, block –B, ACC

Out Patient Consultation in Advance Pediatric Centre

General OPD (Daily)                           11:15 am – 1 pm  &  2.30  -  4.30 pm

(Room No 4405, 4^th floor block –D)

MEAL SERVICES- Meal services are provided to general as well as private ward patients. In general ward tea and breakfast services are decentralized and lunch and dinner are centralized, whereas all meal services are centralized in private wards. The therapeutic section caters to patients who are on special feeds and diets. There are approximately 600 normal diets. The cost for general diet is Rs. 35/- per day and Rs. 150/- per day for private ward patients.

EDUCATION AND TRAINING- Since the Department of Dietetics is an expertise in food services management and therapeutic nutrition, hence the department undertakes training of dietetics interns. The department provides internship training to students of Post Graduate diploma in Dietetics and M.Sc. Food and Nutrition, coming from Universities all across India.

They are selected on the basis of screening test, which is held twice a year in March and September. Duration of internship varies from 6 weeks to 3 months. Also, interns join for short term attachment program for a term of 3 months and 6 months for which they get the training certificate from the institute. Only the students who have under gone Internship training in the department are eligible. Admission is done on the basis of merit. On an average 80 students are given internship training and 25 – 30 undertake short term attachment training in the department of dietetics every year.

The interns are given exposure to the functioning of the department, ward rounds, diet counseling to patients in diet clinic, presenting seminars and case presentations besides exposure to maintaining diet records in the kitchen.

Eligibility for Screening Test

     Eligibility for Screening Test- is   PG Diploma in dietetics and Nutrition        

                        or

      M.Sc (Foods and Nutrition).

 Academic/ Research/ Training activities

• Research work is also carried out by dieticians in collaboration with other departments of PGIMER.
• Some of the Dietitians have been presenting the scientific papers in various conferences & CME’s in India as well as abroad and are participating in the annual conferences like Indian Dietetic Association (IDA), Indian Society for Parental and Enteral Nutrition (ISPEN), Nutrition Society of India (NSI) & also attending Continuity Medical Education (CME) & various workshops related to Nutrition & Dietetics.
• Poster presentations/ exhibitions & quiz etc. are organized by the Deptt of dietetics from time to time to celebrate Nutrition week and breast feeding week every year.
• For general public health and nutrition education, dieticians are also involved in giving radio talks and writing nutrition related articles in leading newspapers.
• Some of the dieticians are also Co guides of Junior and Senior Resident in their MD/MS thesis.

Any significant achievement / recognition appreciation awards received by department

• A booklet “Dietetic for you” for dietetics interns, nurses and resident doctors has been authored by the dieticians of Department of Dietetics.

• Mrs. Sunita Malhotra also authored a book “Dietetics in Practice A handbook” for Graduate and post graduate students of dietetics, nurses, resident doctors and other health care professionals. She received the “A.N. Radha award” for presenting scientific paper in the National Conference in 2007 organized by IDA held at Nagpur, India. She is also the recipient of “Young Investigator Award” in the 16^th world congress of Clinical Nutrition New Delhi, for her scientific paper presentation in the year 2011.

• Dr. Nancy Sahni authored a book chapter in "Hospital administratin-problem sovling approach. Elsevier, 2014; Nutraceuticals in "food safety from farm to fork, CBS publication, 2015; Diet and Nutrition in "Endometriosis-an Engima' CRC Press, 2019.

• Dr. Nancy Sahni has awarded young investigators at world congress of clinical nutrition (2011); Runner up tropy in annula conference of peritoneal dialysis (2015); Best paper award at Indian association of surgenons for sleep apnoea (2019).

• Mr. B. N. Behera along with Dr. Usha Dutta (Associate Prof GE dept.)Presented the paper on Nutritional deficiency in post-partum period is associated with increased risk of gall bladder dysfunction which was presented in the Australian Gastroenterology week held in Brisbane in October 2008 & won the best paper award. Also his paper along with Dr. Usha Dutta associate professor on the High Protein Diet elicits better gall bladder contractions than High Fat Diet” presented at Plenary session of the 50^th annual conference of Indian Society of GE held at Kolkata on 9^th December 2009 & has been awarded the prestigious ISC systopic award 2009.

• Mr. B. N. Behera was awarded A.N.Radha award in the year 2009 for his scientific paper presentation organized by IDA held at Lucknow, India.

Food preparation –

• Diet Schedule- A standard diet schedule is followed for normal and therapeutic diets and feeds.
• Recipe Standardization – According to the diet schedule various recipes are standardized using specific amounts of ingredients.
• Portion Control – This is according to the standard diet schedule and supervised by dieticians

Process for Food processing:- After receiving the raw ration items, these are being stored in the main dietetics store and sub store. According to the census of the patients ration is calculated as per diet schedule. The raw ration item are issued to the respective head cooks and accordingly the precooking like cutting of vegetable, Atta kneading etc., and pre-preparation is done. The normal and therapeutic meals are cooked accordingly. The cooked food is then loaded in the food trolleys under the supervision of the dietician. The food is then distributed as per the diet lists in the respective wards. All the food trolleys are then washed properly for further use.

Feed back

• In General as well as private wards the feedback forms are given to the patients on a regular basis. On the basis of the various suggestions/opinions thus obtained, we try and improve our meal services accordingly.

Safe water – Water used for cooking is supplied from the overhead tank which is maintained by engineering department, and occasional microbiological testing of water is done by the hospital infection control committee. No raw food is served by the department. Most of the bacteria like C. Botulinum, S. Typhi, Shigella are destroyed above 80ºC.In most of the Indian cooking procedure the temp are above 100º C so the chances of their survival in cooked food is very remote.

Hospital Dietary Procurement based on actual consumption of raw materials forecasting for the next

full financial year is done. The yearly procedures are approved by the PGI purchase committee and the purchases as per requirements are made from the approved sources. For practical purposes food items are categorized into perishable and non-perishable items. The perishable items are procured daily, bi and tri weekly and the non-perishable items are procured bi monthly/monthly/quarterly/half yearly or yearly. Milk and milk products are purchased from Punjab Dairy development corporation, Mohali which are Government organizations. The rest of the ration items are purchased by floating yearly tenders and entertaining the lowest quotations.

Related Committees with composition:- In order to streamline the functioning of Dietetics department following committees are constituted:

Dietary purchase committee – The following are the members of dietary purchase committee:

1.       Prof. S.K Sinha                                         Chairperson
2.       Prof Devi Dayal                                        Member
3.       Dr. Poonam Khanna                                  Member
4.       Rep. of F.A.                                              Member
5.       Officer Incharge, Dietetics                         Member
6.       Sr. Dietician                                             Member
7.       Store Officer                                            Member Convener

Fruit and Vegetable checking committee

1. Assistant Dietician                             Member
2. Storekeeper                                     Member
3. MHA                                                Member

Ration Store inspection committee

1. Store officer                               member
2. Nursing supdtt                            member
3. Chief Dietician                            member

Expenditure:- The total Expenditure During the last fiscal year 2021-2022 was Rs 4.87 Cr.

Storage-The items are procured and verified by the Dietician in charge stores before taken on stock books.  Stock books for all the items are maintained separately. All receipts and issues are entered daily.

Separate stores are being maintained for equipment that includes cooking gadgets, utensils serviettes, machinery, food trolleys and linen items. Services items like crockery, cutlery and linen are procured annually.

Quality check of Food Items:- Quality is checked by a committee of three members for dry rations, fruits, vegetables. Chicken & eggs are checked by dieticians. Milk quality is checked every day with the help of Lactometer by the dietician.

Perishable items such as fruits, vegetables and eggs are stored in a cold room whereas chicken and paneer are stored in deep freezer, thus maintaining their quality. Dry rations are stored in a spacious store room which is regularly cleaned and given the anti-rodent & anti cockroach treatment routinely.

Equipment used in the department of dietetics

The department of dietetics uses following infrastructure to prepare, store and distribute meals to patients in various wards of hospital.

Atta kneading machines                                       Potato peelers

Microwave Ovens                                                 Griller & Toasters

Mixer Grinders                                                      Bulk Cookers

Food Trolleys                                                        Walk-in Cold Storage

Sink Sterilizers                                                      Cooking Gadgets

Deep Freezers                                                       Automatic Chapati making Machine

Human Resource deployment

1.     Distribution of Kitchen workers:

There are Total 180 kitchen staff working in Dietetics Department.

Stewards, Cooks, Bearers (Regular)             - 49 Daily Wage Bearers            (Contractual)      - 131

Medical checkup:- Routine medical examinations is done for food handlers once in a year and suitable treatment are given to them.

Personal hygiene – Regular checking of hair, nail, dress are done by the dieticians for maintaining good personal hygiene of food handlers and are taught them about the cleanliness and hygienic food preparation and services on regular basis.

INSTITUTE HOSPITALITY- In addition to meal services, Dietetics Department also looks after Institute’s guest houses. The Department provides cooks for the Primary Health Centre at Naraingarh, Haryana, where residents from PGI are posted.

SUBJECT : 56^th   Annual report of the Dietetics Deptt. of the year 2022-2023