Objective To analyze the practical effect of refined skin care in improving pain and coordination of hemodialysis patients with blunt needle puncture. Methods From January 2020 to January 2022,80 patients who underwent blunt needle puncture of hemodialysis in our hospital were selected as the research objects. They were divided into control group and observation group by random number table method, with 40 cases in each group. The control group received routine nursing, and the observation group received fine skin care. The pain, puncture coordination, complication rate and nursing satisfaction were compared between the two groups. Results The VAS score and complication rate of the observation group were lower than those of the control group, and the puncture coordination score and nursing satisfaction were higher than those of the control group, the differences were statistically significant (P<0.05). Conclusion The application effect of skin refined nursing in hemodialysis patients with blunt needle puncture is better, which can relieve the pain of patients, improve the cooperation degree of patients, and has fewer complications and high patient satisfaction. It is worthy of application