Abstract: Objective: To search, evaluate and summarize the evidence for puncture management during the initiation period of Autologous Arteriovenous Fistula (AVF) in patients with Maintenance Hemodialysis (MHD). Methods: Following the "6S" evidence pyramid model, a systematic search was conducted in relevant websites, professional association guideline platforms, and domestic and international databases for evidence on AVF puncture management in MHD patients from January 1, 2015, to December 31, 2024. Researchers trained in systematic evidence-based nursing evaluated the methodological quality of the included literature and collected the evidence after data extraction. Results: Fourteen documents were included, comprising 1 clinical decision-making document, 5 guidelines, 4 policy texts, 2 evidence summaries, 1 evidence-based practice article, and 1 Meta-analysis. Twenty-five pieces of evidence were summarized from nine aspects: team management, puncture timing assessment, pre-puncture preparation, puncture method, puncture fixation, needle removal management, pain management, puncture failure management, and health education. Conclusion: The evidence for puncture management during the initiation period of AVF in patients with MHD summarized in this study is scientific and practical, and can provide a basis for medical staff to improve puncture management during the initiation period of AVF in MHD patients and the quality of care.

Key words: Maintenance Hemodialysis; Autologous Arteriovenous Fistula; activation period; puncture; evidence summary