Abstract: Objective: To identify factors restricting operating room nursing quality in secondary hospitals and to assess nurses' training needs, thereby providing a reference for the development of quality improvement and training strategies. Methods: A descriptive qualitative study design was utilized. Using purposive sampling, 14 operating room nurses from 10 secondary hospitals in Guangdong province were selected for semi-structured interviews from June to November 2025. Traditional content analysis was conducted using NVivo 15 software to extract themes from the interview data. Results: Three major themes and eight sub-themes affecting operating room nursing quality in secondary hospital were identified, including training system development (mentor-led teaching mode, assessment and evaluation criteria, specialized surgical training); nurses' patient safety competency (safety awareness, work attitude and responsibility, clinical practical ability); human resource operation status (human resource allocation, surgical workload). Nurses' training needs were explored across three dimensions, including instructional design, teaching resources, and teaching content. Conclusion: Multiple factors affect the nursing quality of operating room in secondary hospitals. Targeted strategies should be adopted to strengthen safety culture construction and optimize human resource allocation. Meanwhile, diversified training needs of nurses should be fully addressed to empower professional teaching, standardize clinical teaching and assessment criteria, and ultimately improve the overall quality of nursing services.

Key words: secondary hospital; operating room; nursing quality; training; qualitative study