Objective To develop a dual-operator chain operation process for hemodialysis suitable for clinical practice in China, and to provide a reference for enhancing the safety of hemodialysis procedures. Methods Brainstorming was employed to analyze the problems and causes of the existing process, followed by a literature review and Delphi expert consultations to construct the dual-operator chain operation process for hemodialysis. Results The dual-operator chain operation process for hemodialysis included four primary indicators (assessment, preparation, machine operation steps, and return and disconnection steps), and 20 secondary indicators. The importance ratings assigned by experts during the two rounds of consultation ranged from 4.00 to 4.93 and 4.00 to 5.00, with coefficients of variation of 0.05 to 0.22 and 0 to 0.11, respectively, and coordination coefficients of 0.238 to 0.311 (all P<0.05). Conclusion The developed dual-operator chain operation process for hemodialysis can serve as a reference for standardizing clinical hemodialysis procedures and enhancing safety.