【Abstract】Objective To design a "Hemodialysis Safety Checklist" for clinical use, in order to standardize the hemodialysis procedure, raise the rate of standardized treatment and nursing operations, and increase the overall safety and nursing quality in hemodialysis center. Methods We first retrospectively analyzed the causes of hemodialysis incidents from 2016 to 2018 in the Hemodialysis Center, Zigong First People's Hospital, Sichuan Province. A primary checklist of“Questionnaire for the Present Performance of Hemodialysis Nursing Operations" was set up following the Hemodialysis Guidelines, using the hemodialysis safety checklists from foreign countries as the references, and taking the present status in Zigong city as the basis. A "Hemodialysis Safety Checklist" was then designed based on the practice results of the“Questionnaire for the Present Performance of Hemodialysis Nursing Operations" and two rounds of consultation from experts using the Delphi method. We inspected the operations for patients before entering the hemodialysis room, and before, during and after hemodialysis according to the checklist in "Hemodialysis Safety Checklist". Results The“Hemodialysis Safety Checklist”contained 24 items in the 4 stages. The research objects, including doctors (n=30) and nurses (n=30) working in hemodialysis centers and maintenance hemodialysis patients (n=30), were recruited from 4 higher level hospitals in Zigong city, Sichuan Province. Their implementation rate was 70.00% before use and 93.33% after use of the "Hemodialysis Safety Checklist". The difference in overall implementation rate was statistically significant (c2=5.455, P=0.020). The satisfaction rate of doctors, nurses and patients increased significantly (c2=4.043, 4.320 and 5.455 respectively; P=0.044, 0.038 and 0.020 respectively). No adverse events occurred. Conclusion The implementation of the "Hemodialysis Safety Checklist" can standardize the nursing operations, raise the application rate of guidelines, and provide reliable safety management and higher quality care for hemodialysis patients.