What does SPICES stand for?
SPICES is an acronym for a multidimensional screening tool used in identifying risk factors in older patients. Fulmer SPICES focuses on prevalent issues experienced in old age such as sleep disorders, eating and feeding problems, inconsistency, confusion, evidence of falls, and skin breakdown. Older adult inpatients are particularly vulnerable to adverse hospital events associated with factors related to frailty. Therefore, this tool helps nurses identify geriatric syndromes early, which promotes better maintenance and care for healthy and frail older adults.
How useful is it as a tool?
Hospitals and home care always strive to achieve efficiency and effectiveness in older adults’ care. Throughout the years, evidence-based assessment instruments have been suggested for each geriatric syndrome. However, the clinical evaluation of older people in primary care remains challenging because their vulnerability varies widely in conceptualization and application. Statistically, the SPICES tool has been proved to be efficient in delivering safe, quality, and efficient older patient care. Bedside nurses use this tool in screening commonly assessed elements. These elements are then recorded in an electronic health record, which is summarized electronically and used to determine trigger alerts in each patient.
How valid and reliable is it?
Different assessment tools such as Camberwell Assessment of Need for Elderly (CANE), Vulnerable Elders Survey-13 (VES-13), and Charlson Comorbidity Index (CI) have been in existence but have, however, been proved to be too lengthy for clinical routines. SPICES tool was therefore designed as a shorter and more efficient version. Although the full psychometric test has not been done to prove its reliability, various validation tests have been conducted. A predictive validity study conducted in a home care in Portugal showed SPICES’ usefulness and validity through the use of questionnaires on patients and general practitioners ( Balsinha et al, 2018). The analysis provided proved that SPICES is valid and predictive of adverse events.
Enumerate strengths and limitations of Fulmer SPICES tool
SPICES tool has been well accepted overall by physicians and patients as a screening protocol. This is because its criteria have been proved to constitute a valid assessment for screening with adverse outcomes. Additionally, most components of SPICES are already included in the admission nursing assessment, and any missing elements can be added with ease. However, even though the SPICE tool yields new valuable information about the unmet needs of older people in primary care, its implementation may not be straightforward and requires facilitating strategies.