End-stage renal disease (ESRD) has become a public health concern worldwide as the total number of ESRD patients requiring renal replacement therapy has been growing dramatically. In Egypt, there is an increase in prevalence and incidence of ESRD exerting a great burden on the health system. Moreover, in Egypt there is insufficient information about the quality of nursing care of hemodialysis patients. The aim, develop standard of care for patients undergoing hemodialysis.Study question, what are the minimal hemodialysis nursing intervention standards for safe, effective nurses' performance? Exploratory design was used in the current study .The present study was carried out in hemodialysis units in Port- Said general hospital, El-Mabara hospital and Port-Fouad general hospital in Port- Said city. The sample of this study consisted of: All hemodialysis unit nurses, physicians, nurse educators who had at least three years of experience in the field of study, the total number  of experts was 78. The data were collected using. Tool I:  Basic nurses' Competences opinionnaire sheet for hemodialysis patients. It included four parts. Part A:  demographic data, Part B:  related to nurses competencies (process): and Part C related to structured unit standards and Part D related to outcome. The results of this study indicated that all experts (100%) agreed about all structures elements, all nursing competencies & outcome. All experts (100%) thought that nurses could assume the responsibility of evaluating the basic nursing care/ activities performed for hemodialysis patients, the most common items of structure not available in all studied hospitals. Concluded, The developed hemodialysis standards of nursing care were highly reliable according to Spearman- brown confection test. Recommended, The developed standards of nursing care for management of patient undergoing hemodialysis should be available in Arabic and English language in all hemodialysis units and should be revised and updated annually;  motivation and financial rewards should be done regularly to encourage hemodialysis nurses to do their best.