Fulmer SPICES: An Overall Assessment Tool of Older Adults
WHY: Normal aging brings about inevitable and irreversible changes. These normal aging changes are partially responsible for the increased risk of developing health-related problems within the elderly population. Prevalent problems experienced by older adults include: sleep disorders, problems wiui eating or feeding, incontinence, confusion, evidence of falls and skin breakdown. Familiarity with these commonly-occurring disorders helps the nurse prevent unnecessary iatrogenesis and promote optimal function of the aging patient. Flagging conditions for further assessment will allow the nurse to implement preventative and therapeutic interventions.
BEST TOOL: The most appropriate instrument for obtaining the information necessary to prevent health alterations is SPICES developed by Terry Fulmer, PhD, RN, FAAN at New York University, Division of Nursing. SPICES is an acronym for the common syndromes of the elderly requiring nursing intervention:
S is for Sleep Disorders
P is for Problems with eating or feeding
I is for Incontinence
C is for Confusion
E is for Evidence of Falls
S is for Skin Breakdown
TARGET POPULATION: The problems assessed through SPICES occur commonly among the entire elderly population. Therefore, the instrument may be used for both healthy and frail older adults.
VALIDITY/RELIABILITY: The instrument has been used extensively to assess the elderly population. Notably, members of the Geriatric Nurse Resource Project at Yale University Medical Center use the tool to assess and prevent the most frequent health problems of older adults. It is also being used at New York University Medical Center. Psychometric testing has not been done.
STRENGTHS AND LIMITATIONS: The SPICES acronym is easily remembered and may be used to recall the common problems of the elderly population in all clinical settings. It provides a simple system for flagging areas in need of further assessment and provides a basis for standardizing quality of care around certain parameters. SPICES is an alert system and refers to only the most frequently-occurring health problems of older adults. Through this initial screen, more complete assessments are triggered. It should not be used as a replacement for a complete nursing assessment. Permission is hereby granted to reproduce this material for not-for-profit educational purposes only, provided The Hartford Institute for Geriatric Nursing, Division of Nursing, New York University is cited as the source.
Available on the internet at www.hartfordign.org. E-mail notification of usage to: hartford.ign(5)nyu.edu.
by Meredith Wallace, PhD, RN, MSN, CS and Terry Fulmer, PhD, RN, FAAN
Copyright Alabama State Nurses’ Association Sep-Nov 2003
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