Objective To improve the effectiveness and safety of prone position care for hypoxaemia in patients after open-heart surgery. Methods A total of 110 patients were divided into a control group and an observation group chronologically, with 55 in each group.The control group used the "envelope method" to perform prone position, while the observation group developed a prone checklist for performing prone position. Results Compared with the control group, the observation group had significantly shorter time spent preparing prone position, shorter duration of mechanical ventilation after prone position treatment, lower incidence of facial edema, longer duration of prone position, and higher oxygenation index after turning in the supine position(all P<0.05). Conclusion Checklist-based management optimizes operative process of prone position in patients after open-heart surgery, effectively improves nursing efficiency, enhances the effect of prone ventilation, reduces related complications, and contributes to patient safety and early withdrawal from the ventilator.