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This study seeks to extend knowledge of care pathways through describing the conception and development of them within a children's hospital. The care pathway was conceived by the nurse manager as a tool to improve care to children with minor injuries, and to their families. More specifically, it was developed as a tool to multi-skill experienced nurses in a children's emergency department to assess and treat children with minor injuries. It is argued that the conception of care pathways aligned with the purposes of the manager, and integrated rather than reflected national NHS policies. Prospective managers are not confined to developing care pathways as prescribed; the care pathway tool may be used for varying management initiatives. [ABSTRACT FROM AUTHOR]