Abstract: Objective: To systematically synthesize evidence on Arteriovenous Fistula (AVF) puncture technique management, identify barriers to facilitate evidence translation into clinical practice. Methods: We systematically integrated evidence and established audit criteria. Baseline audits were conducted among 75 healthcare professionals, 462 AVF patients and the department in a tertiary grade A hospital. Barriers were analyzed using the i-PARIHS framework. Results: Among 22 audit criteria, compliance rates ranged from 0% to 100%. Key barriers included: lack of ultrasound equipments, insufficient nurse competency in ultrasound assessment, and absence of training protocols. Conclusion: Significant gaps exist between current AVF puncture practices and evidence-based standards. Identifying barriers to implementing evidence provides a scientific approach for optimizing AVF puncture management as well as targeted reform.

Key words: Arteriovenous Fistula; puncture technique; i-PARIHS framework; audit criteria; barrier analysis