Objective To investigate the application effect of nursing identification in the safety management of operating rooms for elderly patients undergoing ophthalmic day surgery. Methods Elderly patients who underwent day surgery in the operating room of Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University between January and October 2024 were selected. All subjects were randomly divided into a control group and a trial group using a random number table method. The control group only received routine operating room care, while the trial group received a combination of routine operating room care and preoperative nursing identification intervention. The differences in physiological stress indicators, nursing satisfaction, and surgical cooperation rate between two groups of patients were compared. Results This study included 50 cases in both the trial group and the control group, with an age range of 61-79 years old. There was no statistically significant difference in age and gender between the two groups (P>0.05). The systolic blood pressure [(136.72±10.82) vs. (145.70±13.11) mm Hg] (1 mm Hg=0.133 kPa), diastolic blood pressure [(83.48±8.59) vs. (88.54±8.35) mm Hg], and heart rate [(80.34±7.17) vs. (85.12±8.49) beats/min] of the trial group patients were lower than those of the control group, and the satisfaction rate was higher than that of the control group (100.00% vs. 84.00%), with statistical significance (P<0.05). There was no significant difference in surgical cooperation rate between the two groups (P>0.05). Conclusion After applying nursing identification, patients’ objective physiological stress indicators decreased while their subjective cooperation remained stable, resulting in a higher patient satisfaction rate and clinical promotion value.