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Aim: This is the second of two articles that report on work commissioned by the NHS Executive North West, to explore the perceived barriers to healthy eating within the nursing profession., Method: Observations were made of catering facilities within eight healthcare sites (six acute hospitals, an NHS walk-in centre and an NHS Direct site) across the North West region. Twenty four unstructured interviews were conducted with nurses and three were sampled from each healthcare site., Results: Four main themes emerged as barriers to healthy eating: availability; variety; distance from catering facilities; and breaks/staffing levels/workload issues, Conclusion: Respondents in this study do not consider their working environments to be conducive to healthy eating practices.

Aim: The aim of this study commissioned by the NHS Executive North West was to identify the main areas of the nurse's working environment that prevent healthy eating, to ascertain if nurses have enough nutritional knowledge to make informed choices, and to review sources, availability and quality of food provided for nursing staff., Method: A purposive sample size of 126 nurses from across eight healthcare sites in the North West region completed questionnaires., Results: Shift patterns and failure to take breaks were identified as the two main barriers to healthy eating by respondents. However, satisfaction with food on offer and a supportive environment were also identified as important influences., Conclusion: Several recommendations were made as a result of the study. Ideally, nurses should take regular breaks. Food should carry nutritional labelling and nutritional information should be displayed at healthcare sites in a more imaginative and innovative way. More refrigerated vending machines with a selection of healthier options should be supplied. Packed lunches or plated salads obtainable from restaurants by evening and night-shift nurses should be offered, in addition to a better selection of sandwiches and other food choices outside the hours of 9 am to 5 pm, Monday to Friday. Nurses should be encouraged to drink the recommended amount of eight glasses of water per day (Health and Fitness Tips 2000) by providing adequate water dispensers. The possibility of having separate catering facilities for staff who wish to avoid patients and visitors during breaks should be explored.

Thirty six people suffered from severe vomiting and diarrhoea 15 min to 3 h after eating vanilla slices from the same bakery. Five patients were admitted to hospital, and one developed unusual skin lesions after admission. Staphylococcus aureus was isolated in large numbers from vanilla slices of the same batch as those giving rise to symptoms, and from five faecal specimens obtained from affected persons. Bacillus cereus and Bacillus subtilis were also isolated from the slices. Unbaked custard provides an ideal environment for bacterial multiplication, especially when (as on this occasion) the ambient temperature is persistently high.