Objective To explore the application effect of fine nursing management in severe respiratory patients with infection. Methods 100 patients with severe respiratory disease admitted to respiratory intensive care unit (RICU) of our hospital from October 2020 to October 2022 were selected as the research objects. They were divided into control group (50 cases) and observation group (50 cases) according to the random number table method. The control group was given routine nursing management, and the observation group was given meticulous nursing management based on it. The infection rate; Consumption of hand sanitizer, RICU stay time, and total hospital stay; Respiratory rate and heart rate; Satisfaction were compared between the two groups. Results Compared with the control group (52.00%), the infection rate in the observation group (26.00%) was significantly lower (P<0.05); Compared with the control group, the consumption of hand hygiene disinfectant in the observation group was significantly increased, and the RICU stay time and total hospital stay were significantly shortened (P<0.05); Compared with that before management, the respiratory rate and heart rate of the two groups decreased significantly after management, while the respiratory rate and heart rate of the observation group were significantly lower than those of the control group (P<0.05); Compared with the control group (84.00%), the observation group's satisfaction with management (98.00%) was significantly higher (P<0.05). Conclusion Based on the fine nursing management, it can effectively prevent the occurrence of infection in patients with severe respiratory disease, shorten the hospital stay, improve physical signs, and improve patient satisfaction, which has a high clinical reference value.