Development of critical pathway for vascular access management

Abstract

The usefulness of a critical pathway for patients undergoing vascular access surgery for maintenance hemodialysis was examined. Records on nursing charts and self-assessment of vascular access management were compared between 11 patients who had received surgery before the introduction of the critical pathway and 8 patients who received surgery after introduction of a critical pathway. Average rate of precise records on nursing charts rose from 18.8% to 93.2% after the introduction of the critical pathway (p<0.01). The usefulness of educational procedures for selfassessment of vascular access was evaluated by questionnaire when the patients were discharged from the hospital. Average rate of correct answer was 95% in the postpathway period, which was significantly higher than 43.5% in the pre-pathway period (p<0.01). A critical pathway is a good tool for coordinating high quality nursing care and self-assessment of vascular access management.