Objective To investigate the effect of tiered accountability management under integrated health care on the quality of nursing management in the operating room of the general surgery department. Methods A total of 128 patients undergoing general surgery admitted to the General Surgery Department of Xiayi County Central Hospital from January to December 2019 were selected as the study participants. In this study

63 patients before the implementation of tiered accountability management under integrated health care from January to June 2019 were included in the control group

and 65 patients after the implementation of tiered accountability management under integrated health care from July to December 2019 in the observation group. Patients in the control group received routine nursing management intervention

and patients in the observation group; tiered accountability management under integrated health care. The length of hospital stay

quality of life

and satisfaction were compared between the two groups. The nursing management ability and nursing quality of the nursing staff were also compared between the two groups. Results The length of hospital stay in the observation group was significantly shorter than that in the control group（P<0.05）. The scores of the WHO Quality of Life Scale（WHOQOL） in all dimensions in the two groups were significantly higher than those before the operation

with the observation group significantly higher than the control group（P<0.05）. The satisfaction rate of nursing in the observation group was 95.38%（62/65）

which was significantly higher than that（84.13%

53/65） in the control group（χ~2=4.443

P=0.035）. The scores of teamwork ability

clinical resilience ability

environmental management

and aseptic management of nursing staff in the observation group were significantly higher than those in the control group（P<0.05）. The nursing quality scores of device preparation

nursing document writing

emergency drug management

and basic nursing in the observation group were significantly higher than those in the control group（P<0.05）. Conclusion The application of tiered accountability management under integrated health care can effectively shorten the length of hospital stay

raise the quality of life of patients undergoing general surgery

and increase the nursing management ability and nursing quality of nursing staff. These benefits hold much promise for clinical application.