Objective To develop a nursing quality evaluation index system for preventing vascular crisis in hand surgery department, and to evaluate its application effect.Methods The three-dimensional quality structure model was taken as the theoretical framework, a nursing quality evaluation index system for preventing vascular crisis in hand surgery department was constructed through literature analysis, semi-structured interviews and Delphi expert consultation. Then a total of 200 patients who underwent single finger amputation replantation or flap transplantation were divided into a control group and an experimental group chronologically, with 100 cases in each group, the control group received routine nursing, while the experimental group received nursing based on the constructed nursing quality evaluation index system.Results The constructed nursing quality evaluation index system consisted of 3 primary indicators (structure quality, process quality, outcome quality), 10 secondary indicators, and 47 tertiary indicators. After application of the index system, the rates of timely detection of vascular crisis, survival rates of reimplanted fingers or flaps, and patient satisfaction scores in the experimental group were significantly higher than those of the control group, while its incidence of vascular crisis was significantly lower than that of the control group (all P＜0.05).Conclusion Construction and application of a nursing quality evaluation index system for preventing vascular crisis in hand surgery department, is conducive to detecting vascular crisis timely, reducing the incidence of vascular crisis, improving the survival rates of reimplanted fingers or flaps, and enhancing patient satisfaction.