Objective To investigate the effect of graded nursing intervention based on the modified early warning score（MEWS） system in children with severe pneumonia. Methods One hundred and ten cases of children with severe pneumonia treated in a hospital in Kaifeng from October 2018 to October 2020 were selected as study subjects

numbered according to the order of admission

with the odd numbers being the control group（55 cases） and the even numbers being the study group（55 cases）. Patients in the control group were given conventional care

while patients in the study group were given graded care interventions based on the MEWS system. The duration of symptoms and hospital stay

the occurrence of complications

the occurrence of critical conditions

the blood gas indexes [partial pressure of carbon dioxide（PaCO

2

）

oxygen saturation（SaO

2

）

partial pressure of oxygen（PaO

2

）] before and after 72 h of intervention

and family members’ satisfaction with care were compared between the two groups. Results The duration of cough

shortness of breath and hyperthermia and the length of hospital stay were shorter in the study group than in the control group

and the differences were statistically significant（P

<

0.05）. The incidence of complications was 3.64%（2/55） in the study group

which was significantly lower than that of 16.36%（9/55） in the control group

and the difference was statistically significant（χ

2

=4.950

P=0.026）. The incidence of critical illness in the study group was 10.91%（6/55）

which was significantly lower than that in the control group（29.09%

16/55）（χ

2

=5.682

P=0.017）. Before care

the differences in PaO

2

SaO

2

and PaCO

2

levels of the children in the 2 groups were not statistically significant（P

>

0.05）; at 72 h of care

the PaO

2

and SaO

2

levels of the children in the study group were higher than those in the control group

and the PaCO

2

levels were lower than those in the control group

and the differences were statistically significant（P

<

0.05）. The satisfaction rate of the family members of the children in the study group was 94.55%（52/55）

which was significantly higher than that of the control group（78.18%

43/55）

and the difference was statistically significant（χ

2

=6.253

P=0.012）. Conclusion The graded care based on MEWS system applied to children with severe pneumonia can not only accelerate the recovery of children

reduce the occurrence of complications and critical conditions

but also effectively improve the blood gas status of children and increase family members’ satisfaction with care

which has good application effect and is worthy of clinical promotion.