Nursing instructions is focused on the development and promoting of knowledgefor hemodialysis patients. This study aimed to assessthe patient knowledge about hemodialysis, design nursing instructions about hemodialysis,implement and evaluate the effect of nursing instructions on patient's knowledge. Research design: This study was quasi experimental (pre /post- test) research design. Sample: A Convenience samples of one hundred adult patients among regular hemodialysis, their age range between (18 - 65) from both sexes and who are willing to participate in the study. Setting: The study was conducted in Hemodialysis Unit at Assiut University Hospital. Tool: A structured interview questionnaire sheet, patient knowledge assessment sheet and Nursing instructions for hemodialysis patients protocol were used. Results: There were a statistical significant difference between total scores of knowledge ( pre / post-test) (after two month ) after implementing nursing instructions (P=0.001). Conclusion:Designed nursing instructions protocol was effective in improving knowledge for patients undergoing hemodialysis.