Objective To construct the structure-process-outcome index of hand hygiene (HH) compliance of staff in blood purification center by Donabedian quality theory, conduct continuous quality improvement, and explore whether the three-dimensional indexes guided by the quality theory can improve the quality of HH management. Methods HH compliance of all staff in blood purification center of a medical center was continuously improved, before the intervention, the routine continuous quality improvement method focusing on outcome indexes was adop-ted, intervention measures were performed under the guidance of Donabedian quality theory, structure-process-outcome three-dimensional index of HH compliance of staff in blood purification center was paid attention to, effect of the method and routine continuous quality improvement method on HH was observed. Results Compared with before intervention, HH compliance rate of all kinds of staff in blood purification center improved after intervention (doctor group: 52.38% vs 75.22%; nursing group: 69.49% vs 88.17%; attendant group: 52.72% vs 73.93%; cleaner group: 12.54% vs 56.83%), accuracy rate also improved (doctor group: 80.91% vs 94.07%; nursing group: 87.08% vs 95.49%; attendant group: 37.74% vs 56.20%; cleaner group: 57.14% vs 59.49%), diffe-rences were all statistically significant (all P < 0.05). Before and after the intervention, scores of HH knowledge check in staff in blood purification center ([78.12±8.37] points vs [88.82±6.57] points), consumption of alcohol-based hand rub ([33.33±2.07] bottles vs [53.50±1.81] bottles), qualified rate of detection result of hand bacteria (58.82% vs 91.18%), and patients' satisfaction with HH of staff (88.92% vs 96.30%) were all significantly different (all P < 0.05). The deep venous catheter infection rate was 2.1 per 1 000 catheter-days before intervention, and no deep venous catheter infection occurred after intervention. Conclusion HH quality management of staff under the guidance of Donabedian quality theory has remarkable achievement in HH compliance rate and accuracy rate, HH knowledge examination, as well as patients' satisfaction with HH of staff, which is worthy to be promoted.