Objective To explore the implementation effect of a hand surgery nursing alliance program. Methods We set up a nursing alliance project team, evaluated training needs of the co-construction department, and developed a needs-based individualized co-construction scheme. We introduced working rules and regulations to the co-construction departments, provided theoretical lectures, ward rounds,discussion on difficult nursing cases, and demonstration of specialty nursing techniques, and also provided continuing education course, online lectures and consultations,as well as study materials. The program was carried out in 2 primary hospitals for 3 years. Theoretical and practical competence of nursing staff working in the co-construction departments, specialty nursing quality, and professional identity of the project team members were compared before and after the program. Results All the above 4 parameters were significantly improved after implementation of the program (P<0.05 for all). Conclusion The hand surgery nursing alliance program can enhance professional competence of nursing staff, improve nursing quality in primary hospitals, and promote the development of hand surgery.