The purpose of this study was to develop reliable assessment instruments to measure hemodialysis vascular access. The design of healthcare indicators involved an indepth-analysis of vascular access practices in hemodialysis and their underlying theoretical rationale, and was grounded on Donabedian's framework. Four indicators were selected: performance of temporary double-lumen catheter, maintenance of temporary double-lumen catheter, monitoring of arteriovenous fistula and complications of arteriovenous fistulas. The first three are process-oriented while the last one relate to outcomes. Data was collected in October and November 2008 using a tree-part questionnaire, thus divided: assessment of the indicators' operations manual, assessment of health attributes of the indicators and assessment of each of the components. The validation of the indicators was carried out by a panel of nine internationally renowned experts in nephrology. All indicators were validated by the panel, with at least a 75% favorable consensus. It is believed that the use of this instrument contributes for evaluation and improvement of quality in hemodialysis services.