Objective To explore the effectiveness of using Excel sheets combined with QR codes for precision naviga-tion and location management of sterile instrument rooms in the operating room.Methods The study focused on the location management of nearly 1,000 sterile instruments in three sterile instrument rooms of our hospital.Instruments from July to Septem-ber 2023 were used as the control group,employing traditional location management methods.Instruments from October to De-cember 2023 were used as the observation group,applying Excel sheets and QR codes for precise navigation and location manage-ment.Results The time taken by new nurses and interns to find and retrieve sterile instruments decreased from(4.61±0.32 min)to(1.41±0.15 min).The accuracy of retrieving sterile instruments increased from 83.33％to 98.33％.The compliance rate for location management of sterile instruments improved from 75％to 100％.Nurse satisfaction increased from 81.67％to 96.67％,with significant differences observed(P＜0.05).Conclusion The application of Excel sheets combined with QR codes for precision navigation and location management of sterile instrument rooms in the operating room effectively reduces re-trieval time for sterile instruments,decreases error rates,optimizes management processes,enhances work efficiency,avoids sur-gical delays,ensures patient safety,minimizes conflicts between medical staff and patients,and increases nurse satisfaction.This approach is worthy of clinical promotion and application.