Objective To guide clinical nurses identify and warn nursing risk, and to provide decision supports for risk prevention and control scheme. Methods A smart nursing risk management system (SNRMS) was established based on literature research, evidence screening and Delphi study, then nursing risk indicators were screened and assessment tools were selected, assessment guideline and prevention and control measures targeted for each risk factor were developed and added in the INRMS, which was then integrated with the medical record system, and its interface and function were optimized. Then the system was applied in all general wards of our hospital after medical staff training. Its application in each ward was audited by nursing department quarterly, the incidence of adverse events was calculated, and medical staff′s application satisfaction was investigated using self-designed questionnaire. Results The application rate of the SNRMS in general wards reached 100%, pressure injury decreased significantly after the application （P＜0.05）. Nurses′ total satisfaction to the system was 90.56%, and their approval rate on the system improving work efficiency, ensuring patient safety, providing scientific decision support was 85.66%, 84.30%, 89.66% respectively. Conclusion Application of the SNRMS can strength nurses′ nursing risk foreseebility and awareness of risk management, improve work efficiency, reduce incidence of nursing adverse events, and ensure patient safety.