Abstract: 【Abstract】Objective To optimize the clustered nursing strategy for patients with autologous arteriovenous fistula thrombus (AVFT) so as to improve clinical compliance with medical workers, reduce the incidence of AVFT, and increase the quality of life in patients with the fistulas. Methods We invited 10 clinically experienced experts from different fields to score every criterion and to screen out high-quality evidences in the multi-criteria decision analysis (MCDA), and thus to form the recommendations to clustered nursing strategy for AVFT based on the final rank of scoring. Results The recommended opinions suitably contained in the clustered nursing strategy for AVFT and their corresponding scores were as follows: guiding patient self-management
(1482.56), personalized prevention of low blood pressure (1478.52), fine regulation of far- infrared exposure (1435.35), systematic planning puncture points (1397.86), personalized ultrasound examinations (1368.11), and intra- path arterial pressure monitoring (1325.79). Conclusion After optimization, the clustered nursing strategy for AVFT needs to be refined and upgraded and its effects should be further inspected during clinical applications, so as to reduce the incidence of AVFT and promote the quality of life in hemodialysis patients with fistulas.

Key words: Multi- criteria decision analysis, Autologous arteriovenous fistula, Thrombus, Clustered care, Strategy optimization