BACKGROUND: Perioperative nurses have several high-risk tasks. Musculoskeletal disorders (MSDs) are severe problems, while preventive measures are mostly insufficient. The ‘Ergonomic patient handling card®’ education scheme was introduced in Finland in 2009 aimed at improving both nurses’ and patients’ safety. Experiences of this multicomponent program from the care units and home care are good; the physical workload and sickness absences due to MSDs are decreasing. As the perioperative nurses’ work in operating rooms (OR) varies considerably from the work in care units, a special education scheme needed to be developed. OBJECTIVE: The aim was to plan the ‘Ergonomic patient handling card®’ perioperative care education scheme [later pCard] and to define competencies, skills, and knowledge levels required to perform perioperative work safely, complying with legislative requirements, OR-safety and care quality. METHODS: Using a focus group and risk assessments in the acute care hospital the most stressful tasks in ORs in Finland were defined. The planning of the pCard content was based on the risk analysis aimed at defining competencies to mitigate the physical risks and on the evaluation of two pilot courses. RESULTS: The requested, approved corrections were incorporated into the new pCard scheme. Practical training emphazises working with safe methods and the safe usage of appropriate equipment.