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STOKE MANDEVILLE SPINAL NEEDS ASSESSMENT CHECKLIST - ADULT

​​The Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC is a collaborative, patient-reported needs assessment designed to:

  • Identify an inpatient’s knowledge, skills, and self-management needs following spinal cord injury.

  • Direct individualised, MDT-led goal planning.

  • Monitor rehabilitation progress and outcomes over time.

It is not a discipline-specific measure, but a rehabilitation planning tool grounded in rehabilitation psychology, social cognition, and self-efficacy theory.

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Background

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The initial development of the NAC was supported by a grant from Stoke Mandeville Hospital in 1994, with Integrated Medical Systems supporting further development in 2004.

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The Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC) is a rehabilitation outcome measure that assesses patient attainment of changes in rehabilitation outcomes through self-rating of perceived physical and/or verbal independence (also known as verbally instruction). This measure is used specifically for patients with a spinal cord injury or disorder (SCI/D). The SMS-NAC is completed with the patient by a member of the multidisciplinary team following mobilization/admission and prior to discharge. The SMS-NAC can be used to identify the patient’s current level of physical/verbal independence, as well as identifying specific targets for rehabilitation goals. 

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The SMS-NAC consists of multiple domains covering:

  • Activities of daily living

  • Skin care

  • Bladder care

  • Bowel care

  • Mobility

  • Wheelchair and equipment

  • Community participation

  • Psychological health

  • Physical healthcare

  • Discharge coordination

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Downloads​

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Patient advice sheet (English)

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SMS-NAC (English)

 

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Interpretation​

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  • The NAC should be administered in the context of a patient in receipt of a structured course of spinal rehabilitation involving different domains of rehabilitation. Review of the domains to be administered should be made to complement the domains of rehabilitation provided to the patient.

  • Scores in each domain are typically converted into percentage independence per domain. Low scores indicate priority areas for rehabilitation goals.​

  • Administration of the NAC should be (1) early in discharge, e.g. within 2 weeks of mibilisation, and (2) roughly four weeks prior to discharge. 

  • Gains over time represent skill acquisition, increased knowledge and/or improved self-efficacy, not just physical recovery.

  • Clinicians should look for domains with the lowest admission scores, domains showing limited improvement at follow-up, as well as using this to facilitate discussions with patients about their perceived rehabilitation needs and goals in a collaborative fashion.

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  • The SMS-NAC should directly inform goal planning meetings with patients and their MDT

  • Should should be derived from SMS-NAC identified needs, relate to everyday life beyond the hospital, and have clear operationalised elements

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