Objective To study the effect of nursing human resource management adopting Nursing Activities Score(NAS)joint hierarchy.Methods From January 2022 to December 2023,120 nursing staff in the Fourth Affiliated Hospital of Nanjing Medical University were included as research subjects.From January to December 2022,nursing staff was allocated according to traditional human resources management methods.From January to December 2023,nursing staff was allocated according to the NAS joint with hierarchy.Management effect was evaluated before and after the management from three aspects:nursing skill score,nursing service quality score,and nursing satisfaction.Results Before the implementation,nursing staff scored low in all four dimensions of the nursing skill score.But after the implementation,there was a significant improvement in nursing skill scores.The nursing service quality score was higher after the implementation(P<0.05).Before the implementation,nursing satisfaction was 77.5%,and after management,nursing satisfaction was 95.0%,and the difference was significant(x2=15.494,P<0.01).Conclusion The implementation of NAS score combined with hierarchy management in nursing human resource management can effectively improve the nursing skills and quality of nursing staff,and enhance patient satisfaction.