The operations of knee joint injection of hyaluronic acid (KJI) require a sterile surgical disinfection environment (SSDE) due to bacterial infection into the thigh bone, a severe condition for a patient. The KJI is very common in outpatient clinics, especially in elderly people. The SSDE requests several surgical nurses to assist with this mission, even in outpatient clinics. The good KJI is usually not easy to notice, but sometimes, someone feels bruising, temporary redness, swelling, and itching, but it resolves quickly. The skill proficiency directly affects how the patient feels. In the medical beauty industry, patients are asking and looking for painless shots, not to mention suffering from subsequent bacterial infections. A good prognosis health education includes not rubbing the injection site; it is very common to talk to the patient. The previous literature seldom discusses nursing education using video teaching interactive (VTI) training games. This study focuses on nursing education on KJI procedures within SSDE using a VTI game. Javascript and html5 computer languages construct the system. The real time system operation was built, the system would reciprocal and calculate the nurse responding time for memo each of operations step until they proficiency. It would be easy for new nurses to know how to keep clean with this skill. After repeat and iterative gaming on the VTI game, it would be effective to learn KJI skills and enhance quality on SSDE due to skill proficiency.