Objective To explore the effects of the hierarchical management model in operating room nursing. Methods Thirty-two members of the operating room nursing staff of a hospital in Luoyang were selected as the study subjects and set up as the control group and the study group according to before（January 2019-December 2019） and after（January 2020-December 2020） the implementation of the hierarchical management model. The control group worked under conventional operating room management strategies while the hierarchal management model was implemented for the study group. The nursing staff’s quality of care scores and the occurrence of adverse nursing events in the 2 groups were compared. Results The nursing staff in the study group had higher scores in basic nursing care

sterilization and isolation

nursing paperwork

equipment items

emergency drugs

ward management and nursing skills than the control group

and the differences were statistically significant（P<0.05）. The incidence of adverse nursing events among nursing staff in the study group was 0.22%（2/906）

which was lower than that of the control group

which was 1.05%（9/856）

and the difference was statistically significant（χ2=4.895

P=0.027）. Conclusion Applying the hierarchal management model to operating room nursing can give full play to the advantages of nursing staff at different levels

improve the quality of nursing care in the operating room

reduce the risk of adverse nursing events

and help the smooth running of surgeries.