Objective To explore the nursing effect of the establishment of standard nursing procedures of hemodialysis vascular access in the nursing consortium on arteriovenous fistula in patients with maintained hemodialysis（MHD）. Methods In this study,10 primary hemodialysis centers in the nursing consortium of our hospital were used as pilots from May 2020 to May 2021,and 5 hemodialysis centers were selected as the experimental group by the random number table method,and the remaining 5 were the control group. The experimental group was implemented with the standard nursing process of hemodialysis access established in this study,and the control group received routine arteriovenous fistula nursing. The dialysis adequacy,arteriovenous fistula complications,the self-management ability and other indicators of the 2 groups were compared before the implementation and 3 months,6 months,and 12 months after the implementation. Results 143 cases in the experimental group and 155 cases in the control group completed the study. 3 months,6 months and 12 months after implementation,the kt/V value of the experimental group was significantly higher than that of the control group（P<0.05）;6 months and 12 months after implementation,the QA,URR and self-management ability of the experimental group were significantly higher than those of the control group（P<0.05）. 12 months after the implementation,the incidence of hematoma and stenosis in the experimental group was significantly lower than that in the control group（P<0.05）. Conclusion The establishment of the standard nursing process of hemodialysis access in the nursing consortium can effectively improve the dialysis adequacy of MHD patients,improve the self-management ability of patients with arteriovenous fistula,and reduce the complications of arteriovenous fistula.

Objective To summarize the clinical experience of the establishment and management of wound repair wards led by specialized nurses in our hospital,and to discuss the relevant experience of wound specialty care. Methods Wound repair wards were led by specialized nurses,and a specialized treatment and nursing team was set up to conduct multidisciplinary cooperation,and to implement professional care for patients. 329 patients admitted in wound surgical wards from January 2017 to November 2017 were selected as a control group. 340 patients admitted in wound repair wards from December 2017 to June 2018 were allocated into an experimental group. The outcome measurement of number of dressing changes for wounds,length of stay,healing time,healing rate,medical expenses and patient satisfaction between two groups were compared. Results The number of wound dressing changes in the experimental group and the control group were（25.37±14.33） and（29.06±13.88）;the length of stay were（59.78±30.28） d and （67.61±32.06） d;the wound healing time were （98.24±34.58） d and （110.53±36.53） d;the medical expenses were 15 697.0 RMB and 18 850.0 RMB,which were all statistically significant（P<0.05）. Compared with the control group,the wound healing rate increased from 87.8% to 94.1%,and the patient satisfaction increased from 91.8% to 97.1%. Conclusion The specialized wards for wound healing are operated well and the management of wound is standardized,which facilitates the overall level of nursing care in the hospital and the development of specialized care.