Abstract: Objective  To explore the effect of applying a checklist for the quality improvement of standardized arterio-venous access operation during hemodialysis.  Methods  This was a perspective and multi-center study. A quality control checklist was constructed based on the guidelines for arterio-venous access operation and the related information in the literature. The primary checklist was revised by the procedures of “consultation from experts – revision – preliminary investigation – second revision”. Self-evaluation was then conducted after use of the checklist by the several blood purification centers. The drawbacks of the checklist found by the blood purification centers were corrected through several circles of PDCA process, i.e. plan, do, check and action, to improve the nursing quality. Self-evaluation was conducted again. Paired T test was used to compare the scores from the checklist before and after the improvement. P <0.05 was considered to be statistically significant.   Results   ①The checklist comprised of 10 dimensions and 22 items, including identity identification, doctor's order checking, condition assessment, occupational protection, hand hygiene timing, access puncture and drug injection, safety verification, garbage classification and wiping disinfection, humanistic care, and consumables use, with the full score of 20 points. ②After continuous improvement of the nursing quality of standardized operation, the scores of every dimension in the checklist increased; the total scores were 14.87±3.286 and 17.66±1.973 before and after quality control respectively (t=-3.276, P=0.010), in which the scores of identity identification (score: 0.5) (0.17±0.189 vs. 0.46±0.084; t=-4.529, P =0.001) and hand hygiene timing (score: 4.0) (2.83±0.871 vs. 3.51±0.354; t=-3.127, P=0.012) increased significantly after quality control.  Conclusion  The checklist can promote the improvement of nursing quality in standardized arterio-venous access operation, and can be used as a tool for the management of nursing quality.

Key words: Quality checklist, Arterio-venous fistula, Hemodialysis, Standardized operation, Quality improvement