Objective To construct and implement a quality improvement program for arteriovenous fistula (AVF) cannulation care based on the "Structure-Process-Outcome" three-dimensional quality management model, and to systematically evaluate its application effectiveness in a multi-center hemodialysis consortium.  Methods A prospective interventional study was adopted. From July 2023 to June 2025, structured intervention measures were implemented across institutions of eight members in the Peking University People's Hospital Hemodialysis Alliance, carrying out phased monitoring and continuous improvement and focusing on the core indicators of   cannulation injury rate, proportion of injuries related to difficult vascular access, and composition of cannulation methods.  Results  During the study period, a total of 420 999 cannulation manipulations were monitored, with 1,570 cannulation injuries recorded. The incidence of cannulation injury decreased significantly from 0.43% to 0.33% (P＜0.001). The utilization rate of the rope-ladder technique increased significantly (P＜0.001). The alignment between nursing competency level and vascular access grading became more rational. The adoption rate of the improvement measures ranged from 37.5% to 100.0% among participating hospitals, demonstrating better clinical practicability.  Conclusion  Based on the professional nursing quality indicators and related controls, the quality of AVF cannulation care can be continuously improved by the three-dimensional quality management model. This model reduces cannulation injury rate to enhance overall nursing quality, and is valuable to be widely promoted.