Vascular access management journey map of hemodialysis patients

Abstract Objective This study aimed to use patient journey mapping as a visualization tool to depict the experiences of patients undergoing hemodialysis during vascular access management at different stages, and to provide evidence for optimizing vascular access management strategies and improving patients’ quality of life. Methods Using purposive sampling, 15 patients undergoing maintenance hemodialysis at the Blood Purification Center of a tertiary hospital in Nanjing were selected from July to September 2025. A qualitative phenomenological approach was used. Data were collected through semi-structured interviews, with participants’ nonverbal behaviors observed and documented during the interviews. Colaizzi’s seven-step phenomenological analysis was used to extract and analyze themes. Patients’ behavioral, cognitive, and emotional touchpoints at each stage were integrated to construct a journey map of vascular access management in patients undergoing hemodialysis. Results The journey was divided into three stages: the pre-initiation stage of vascular access, the early initiation stage of vascular access, and the maintenance stage of vascular access use. From the dimensions of tasks, emotions, and pain points, 27 themes were identified, including access decision-making dilemma, immediate self-management, access maturation monitoring, anticipatory fear of cannulation pain, and identification and emergency management of complications. A journey map of vascular access management in patients undergoing hemodialysis was then developed. Conclusion The pathway of vascular access maintenance for patients undergoing hemodialysis involves multiple challenges and opportunities. Healthcare professionals should move beyond a single and static management model, promote multidisciplinary collaboration, and establish full-cycle and individualized vascular access management programs to comprehensively improve patients’ vascular access management capacity, thereby reducing complications, enhancing dialysis adequacy, and improving quality of life.